CPA tumors with normal routine audiometry and positive reflex and BSER tests

Area of Science:

• Neurology
• Audiology
• Neurosurgery

Background:

• Large cerebellopontine angle tumors can present asymptomatically.
• Early diagnosis of acoustic neuromas is crucial for effective treatment and hearing preservation.

Observation:

• Three patients with normal hearing and speech discrimination were found to have large cerebellopontine angle tumors.
• Stapedius reflexes were absent in the affected ears of these patients.
• Brain stem evoked responses (BSER) were abnormal in all three cases.

Findings:

• Stapedius reflex testing and BSER are highly sensitive in detecting acoustic neuromas.
• These tests can identify tumors even when hearing is not yet grossly affected.
• Postoperative BSER showed minimal changes in the nonoperated ear.

Implications:

• Stapedius reflex testing and BSER are valuable diagnostic tools for early acoustic neuroma detection.
• These electrophysiological tests can aid in timely surgical intervention, potentially preserving hearing.
• The findings support the integration of these tests in routine audiological and neurological evaluations for at-risk individuals.