In unilateral sensorineural hearing loss suspected to be due to an acoustic neuroma, which diagnostic step is indicated and may lead to surgery?

In unilateral sensorineural hearing loss suspected to be due to an acoustic neuroma, which diagnostic step is indicated and may lead to surgery?

• A. Audiogram alone
• B. Antiviral therapy
• C. Observation only
• D. MRI or CT scan and they may need surgery

Answer: (D)

When unilateral sensorineural hearing loss raises suspicion for an acoustic neuroma, imaging to look for a tumor is essential. An audiogram can quantify the hearing loss but cannot identify the underlying cause. The test of choice to visualize a vestibular schwannoma is MRI with contrast, which shows the tumor in the cerebellopontine angle and through the internal auditory canal with high sensitivity. CT scanning can be useful if MRI isn’t available or is contraindicated, and it can detect bone changes around the internal auditory canal, but it’s not as good as MRI for soft-tissue tumors. If imaging reveals an acoustic neuroma, surgical removal may be indicated depending on the tumor’s size, location, growth, and patient factors. In short, ordering MRI (or CT if MRI cannot be used) is the diagnostic step that can lead to a decision about surgery.

When unilateral sensorineural hearing loss raises suspicion for an acoustic neuroma, imaging to look for a tumor is essential. An audiogram can quantify the hearing loss but cannot identify the underlying cause. The test of choice to visualize a vestibular schwannoma is MRI with contrast, which shows the tumor in the cerebellopontine angle and through the internal auditory canal with high sensitivity. CT scanning can be useful if MRI isn’t available or is contraindicated, and it can detect bone changes around the internal auditory canal, but it’s not as good as MRI for soft-tissue tumors. If imaging reveals an acoustic neuroma, surgical removal may be indicated depending on the tumor’s size, location, growth, and patient factors. In short, ordering MRI (or CT if MRI cannot be used) is the diagnostic step that can lead to a decision about surgery.