Acoustic neuroma physical examination
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Common physical examination findings of acoustic neuroma include lateralization to the normal ear in Weber test, decreased or absent ipsilateral corneal reflex, and facial twitching or hypesthesia.
Diagnosis of acoustic neuromas begins with a history and physical examination, followed by otologic testing, and finally radiologic scanning.
- Sensorineural hearing loss in the affected ear
- Rinne test is positive
- Rinne test is positive: air conduction > bone conduction (both air and bone conduction are decreased equally, but the difference between them is unchanged).
- Weber test lateralizes to normal ear.
- Nystagmus may be present
Often, the physical exam is normal at the time the tumor is diagnosed. Occasionally, the following cranial nerves may be affected:
- Cranial nerve V- A decreased or absent ipsilateral corneal reflex.
- Cranial nerve VII- Facial twitching or hypesthesia may occur. Drooling may occur. Drooping on one side of the face may occur. Loss of taste may occur.
- Cranial nerve VIII- In sensorineural hearing loss Rinne test is positive and Weber test is abnormal.
- Cranial nerve IX- the back half of the tongue can lose its sense of taste.
- Cerebellum: The following tests may be positive:
- Ataxia may be present.
- Romberg, Hall-Pike, and other balance tests are typically normal.
- Acoustic neuroma. Medline Plus(2015) https://www.nlm.nih.gov/medlineplus/ency/article/000778.htm Accessed on October 2 2015
- Vestibular Schwannoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Vestibular_schwannoma Accessed on October 2 2015