False positive stapedial reflexes and brain stem evoked response findings in patients with suspected retrocochlear...

Patients with suspected retrocochlear disease are usually evaluated with stapedial reflex studies and BSER. Positive responses on these tests usually indicate the need for CT scans with air contrast myelogram. We have been impressed with the lack of sensitivity of these audiometric tests in separating tumor from non-tumorous causes. Although we have never found an acoustic neuroma or cerebellopontine angle tumor without stapedial reflex and BSER abnormalities, we have encountered 20 patients who have strong evidence to support a retrocochlear tumor on audiometric testing but with negative CT with air contrast scans. This report will deal with our experience with these cases and indicate the necessity for obtaining air contrast CT scans before alarming the patient about a retrocochlear disorder or possible surgery. There appear to be many non-tumorous disorders associated with stapedial reflex decay and positive BSER.