Non-auditory presentations of cerebellopontine angle lesions

Most patients with cerebellopontine angle (CPA) neoplasms present with asymmetric hearing loss and/or tinnitus. For this reason it is well accepted that patients with these symptoms deserve a detailed neurotologic evaluation. Non-auditory presentations of CPA neoplasms, on the other hand, are frequently handled in a more complacent manner which may delay diagnosis and, therefore, result in increased morbidity. Six patients seen in the last 18 months serve to exemplify this point, as all 6 presented with non-auditory symptoms of CPA lesions and, in all cases, the diagnosis was delayed for at least 6 months. Any cranial neuropathy, unless otherwise explained, should suggest the presence of an intracranial or skull base lesion. The practicing physician must learn to give these non-auditory symptoms respect equal to that of asymmetric hearing loss and tinnitus and, therefore, equal evaluation.