61. NIDCD Health Information: Vestibular Schwannoma (Acoustic Neuroma) And Neurofibr Vestibular Schwannoma (acoustic neuroma) and Neurofibromatosis. http://www.nidcd.nih.gov/health/hearing/neurnoma.asp

Home Health Information Hearing, Ear Infections, and Deafness Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis On this page: What is a vestibular schwannoma (acoustic neurinoma)? How is a vestibular schwannoma diagnosed? How is a vestibular schwannoma treated? What is the difference between unilateral and bilateral vestibular schwannomas? ... Where can I get additional information? What is a vestibular schwannoma (acoustic neurinoma)? Top How is a vestibular schwannoma diagnosed? Early diagnosis of a vestibular schwannoma is key to preventing its serious consequences. Unilateral/asymmetric hearing loss and/or tinnitus and loss of balance/dizziness are early signs of a vestibular schwannoma. Unfortunately, early detection of the tumor is sometimes difficult because the symptoms may be subtle and may not appear in the beginning stages of growth. Also, hearing loss, dizziness, and tinnitus are common symptoms of many middle and inner ear problems ( the important point here is that unilateral or asymmetric symptoms are the worrisome ones ). Once the symptoms appear, a thorough ear examination and hearing test (audiogram) are essential for proper diagnosis. Computerized tomography (CT) scans, enhanced with intravenous dye (contrast), and magnetic resonance imaging (MRI) are critical in the early detection of a vestibular schwannoma and are helpful in determining the location and size of a tumor and in planning its microsurgical removal.

62. FC-Atlanta - Spotlight On - Acoustic Neuroma Association April 1, 2002 Organization name acoustic neuroma Association Founded 1977 ContactPerson Lois White Address 600 Peachtree Pkwy, Suite 108, Cumming, GA 30041 http://fdncenter.org/atlanta/spotlight/at_spotlight_040102.html

April 1, 2002 Organization name: Acoustic Neuroma Association Founded: Contact Person: Lois White Address: 600 Peachtree Pkwy, Suite 108, Cumming, GA 30041-6899 Phone: Fax: E-mail: ANAusa@aol.com URL: http://www.anausa.org/ Mission: To provide information and support to those diagnosed with, treated for, or affected by acoustic neuroma or other benign tumors of the cranial nerves. Background: The Acoustic Neuroma Association was founded in Carlisle, Pennsylvania, by a recovered patient, Virginia Fickel Ehr, who found no patient information or patient support available when she had surgery for the removal of an acoustic neuroma in 1977. She resolved that future acoustic neuroma patients should have easy-to-read medical material about their condition and support and comfort from each other. With the help of her physician, she contacted eight other patients and formed the organization. The association is now incorporated and has 501 © (3) status (non-profit) from the Internal Revenue Service. The group currently serves nearly 5,000 members, is governed by an all-patient Executive Board and is operated by a small staff in Cumming, GA, a northern suburb of Atlanta. Current Programs: ANA produces eight informational booklets, maintains a website at

63. Diagnosing Acoustic Neuroma By keywords acoustic neuroma. Receive HealthLink via email! Subscribenow . Diagnosing acoustic neuroma. Q I have never http://healthlink.mcw.edu/article/880000011.html

Search Articles: search tips Please Take the HealthLink Survey Email this article Print this article Find related articles: By topic: Brain/Nervous System Cancer Ears/Hearing By keywords: Receive Health Link via email! Subscribe now >> Diagnosing Acoustic Neuroma Q: I have never written a medical letter before, but after reading the response you gave a patient with an Acoustic Neuroma, I feel compelled to do so. I was diagnosed with an Acoustic Neuroma and had surgery performed in 1991. In my research about this condition, I have come across many articles that rebut your statements. Although an acoustic neuroma tumor is non-cancerous, and yes, no one will die of cancer from this type of tumor; it does grow, albeit slowly, and will invade the cranial cavity. It will encompass several nerves, finally pressing upon the brain stem to create severe nerve problems and cause eventual death to the patient. No one should take an acoustic neuroma lightly. Could you please correct your misleading information regarding Acoustic Neuroma and its treatment in a future column? Please urge any patient to see an Otolaryngologist (ENT specialist) immediately.

64. Acoustic Neuroma An acoustic neuroma is a slowgrowing brain tumor that grows around the acoustic(hearing) nerve. acoustic neuroma. Q I have an acoustic neuroma. http://healthlink.mcw.edu/article/880000007.html

Search Articles: search tips Please Take the HealthLink Survey Email this article Print this article Find related articles: By topic: Cancer Ears/Hearing By keywords: Receive Health Link via email! Subscribe now >> Acoustic Neuroma Q: I have an acoustic neuroma. I would like to know if there is a possible way to get rid of this growth. How may I cope as time goes on? A: An acoustic neuroma is a slow-growing brain tumor that grows around the acoustic (hearing) nerve. These tumors are not malignant and do not spread, so will not kill directly. Unfortunately, though, the tumors could eventually press on vital nerves and lead to hearing loss, ear ringing, facial paralysis or even - in rare cases - death. You are fortunate that the tumor was caught early before damage was done. Please consult a neurosurgeon about having it surgically removed. Article Created: 1997-02-03 Article Updated: 1999-02-02 Dr. Rebekah Wang-Cheng is a former Professor of Medicine at the Medical College of Wisconsin. Her medical advice column, which answers health-related questions from readers, also appeared in the Milwaukee Journal-Sentinel Home About HealthLink Medical College of Wisconsin Clinical Trials ... Privacy

65. Acoustic Neuroma: BC Cancer Agency Brain Central Nervous System acoustic neuroma Print Wizard Printthis Page. General Information / Anatomy / Function / Statistics http://www.bccancer.bc.ca/PPI/TypesofCancer/BrainnCentralNervousSystem/AcousticN

Agency Links: Home Contact Us Legal Privacy ... Types of Cancer Acoustic Neuroma Acoustic Neuroma Diagnosis Etiology Prevention Symptoms ... Print this Page General Information / Anatomy / Function / Statistics Seen most often in middle aged women Revised March1999 Print Wizard Print this Page The BC Cancer Agency is a part of the Provincial Health Services Authority If you notice a problem with this page, please report it via the Bug Report Form . Thank you. Unofficial document if printed . Please refer to the following web address for up-to-date information:

66. RNID - Information - Factsheets - Acoustic Neuroma acoustic neuroma. About this factsheet. This factsheet is part of RNID's medicalrange. What is acoustic neuroma? acoustic neuromas are brain tumours. http://www.rnid.org.uk/html/factsheets/med_acoustic_neuroma.htm

news information services support ... interactive information: about rnid factsheets technology directory ... site map are you Individual Company Professional Social service Journalist Please select your interest Hearing aids BSL DDA Benefits Tinnitus Noise Please select Acoustic neuroma About this factsheet This factsheet is part of RNID's medical range. It is written for people who would like to know more about acoustic neuromas. This factsheet tells you: What acoustic neuroma is. The different kinds of treatment available. At the end of this factsheet we give you details of organisations you can contact for further information. What is acoustic neuroma? Acoustic neuromas are brain tumours. They are not life-threatening unless they become very big and press on other parts of the brain. They are benign tumours, which means they do not spread around the body, or tend to regrow if they are completely removed. Acoustic neuromas usually grow slowly. The correct name for acoustic neuromas is vestibular schwannoma. The cells that create them are called Schwann cells. These cells make up the lining of the eighth cranial nerve (hearing nerve) as it passes through a tiny canal in the skull that connects the inner ear to the brain. When these cells overproduce, a tumour develops. The cells fill the canal, and as the tumour grows, it extends into the brain, becoming pear-shaped and putting pressure on the nerves and brain.

67. Acoustic Neuroma acoustic neuroma. acoustic neuromas are benign tumors arising fromthe vestibular nerve in the base of the skull. These tumors grow http://www.sd-neurosurgeon.com/diseases/ac_neuroma.html

Hydrocephalus Parkinson's Disease Pituitary Tumors Acoustic Neuroma ... Trigeminal Neuralgi a HyperhIdrosis Carpel-Tunnel AV Malformations Aneurysms ... Related Links Acoustic Neuroma Acoustic neuromas are benign tumors arising from the vestibular nerve in the base of the skull. These tumors grow slowly, expanding into the cranial cavity, compressing the brainstem and causing cranial nerve dysfunction. Affected individuals develop progressive hearing loss in one ear, ringing in the ear, a sense of imbalance, loss of sensation in the face and weakness of facial muscles. Very large tumors cause headaches, double vision and hydrocephalus. Interestingly, the surgical treatment of acoustic neuromas parallels the history of the development of neurosurgery. Acoustic neuromas are rare. The incidence is 10 per million population per year or about 2,800 new cases in the US each year. These tumors are only rarely associated with genetic errors which are passed to succeeding generations.

68. Acoustic Neuromas All Diagnoses. PRIMARY TUMORS. acoustic neuroma. Chondroma. Diagnosis. The best wayto diagnose an acoustic neuroma is with a magnetic resonance imaging scan (MRI). http://www.cinn.org/ibsc/braintumor/diagnoses/acousticneuromas.html

All Diagnoses PRIMARY TUMORS Acoustic Neuroma Chondroma Chondrosarcoma Chordoma ... Hemantioblastoma Hemangiopericytoma Lipoma Lymphoma Medulloblastoma Meningioma Neuroblastoma Neurocytoma ... METASTATIC TUMORS CYSTS Arachnoid Colloid Dermoid Epidermoid Medical History Neurological Examination MRI CT PET MR Spectroscopy Biopsy Surgery RADIATION THERAPY STEREOTACTIC RADIOSURGERY Multi-Disciplinary Approach ... Patient Second Opinion Acoustic Neuromas This tumor is also called schwannoma, neurolemmoma or neurinoma. It is typically a benign tumor that comes from a balance nerve, which is part of the hearing nerve. This tumor is located in the back part of the skull in an area called the cerebello-pontine angle or CP angle. This tumor tends to grow very slowly, especially in the elderly. This is a relatively common tumor; more than 2000 cases are discovered in the U.S. each year. Acoustic Neuromas are most commonly discovered in middle aged patients. Symptoms The most common symptoms of an acoustic neuroma include, hearing loss on the side of the tumor, ringing in the ear (known as tinnutis), balance problems and headache. This tumor can also cause weakness of the face.

69. Acoustic Neuroma Page MULTIDISCIPLINARY GROUP OF STUDY ON DIAGNOSIS AND SURGERY OF acoustic neuroma. http://open.cineca.it/entunibo/anpage.htm

MULTIDISCIPLINARY GROUP OF STUDY ON DIAGNOSIS AND SURGERY OF ACOUSTIC NEUROMA UNIVERSITY OF BOLOGNA - ENT DEPARTMENT - S.ORSOLA HOSPITAL NEUROSURGERY DEPARTMENT - BELLARIA HOSPITAL STAFF RESEARCH PUBLICATIONS CASE REPORT ... Home Page

70. ACOUSTIC NEUROMA KANSAS CITY Welcome to the acoustic neuroma Association Support Group of Kansas Citymetropolitan area, serving western Missouri and Eastern Kansas. http://www.anakc.org/

Acoustic Neuroma Association Support Group Meetings Report on Survey Findings Links Acoustic Neuroma Archive Acoustic Neuroma Association Acoustic Neuroma Patient Webring Acoustic Neuroma Resources ... University of California, San Francisco Welcome to the Acoustic Neuroma Association Support Group of Kansas City metropolitan area, serving western Missouri and Eastern Kansas. Newly diagnosed acoustic neuroma patients who have not yet had the tumor removed, those who have had the tumor removed by whatever procedure, however long ago and family members are welcome to attend. For additional information: Please contact Kim Jackson Group Coordinator kimjackson428@aol.com

71. Acousticneuroma acoustic neuroma acoustic neuromas Early in tumor growth the acousticneuroma is limited to the internal auditory canal. Patients with http://www.nycornell.org/ent/acoustic.neuroma.html

Acoustic Neuroma Figure 1 is a view of the head from above. The posterior fossa with the intracranial contents of the cerebellum, brain stem and cranial nerves, as well as the temporal bone can be seen. The temporal bone is a part of the skull base. In the temporal bone is the internal auditory canal that allows the cochleovestibular (hearing and balance) nerve and the facial nerve to pass from their intracranial site of origin to either the cochlea (snail like hearing organ), vestibular apparatus (balance organ with the 3 semicircular canals), or the muscles that move the face. Acoustic neuromas most commonly arise in this canal. In Figure 1, a small intracanlicular tumor (colored brown in this illustration) can be seen. In Figure 2 , a larger acoustic neuroma is present. This tumor has grown out of the internal auditory canal into the region known as the cerebellopontine angle, or CPA. The tumor has a characteristic shape, with a root like extension in the internal auditory canal and a globular portion in the intracranial cavity, just touching the brainstem, cerebellum and some of the cranial nerves. Patients may have the same symptoms as when the tumor is in the internal auditory canal or patients may have additional symptoms such as headache. The brainstem compressive stage can be seen in Figure 3 . In this figure the brainstem, cerebellum and cranial nerves are being compressed by the tumor. Acoustic neuromas are almost universally benign (not cancer), so they do not erode into, or replace brain tissue. Rather acoustic neuromas cause damage by taking up space in the intracranial cavity where no extra space exists. Compression and attentuation of vital structures in this stage can lead to increased headaches and numbness of the face.

72. Acoustic Neuroma Find a Doctor Index of Patient Information Clinic Maps and Directions AcousticNeuroma (Vestibular Schwannoma) Jeffrey P. Harris, MD, Ph.D. Introduction http://www-surgery.ucsd.edu/ent/PatientInfo/info_acoustic.html

Find a Doctor Index of Patient Information Clinic Maps and Directions Acoustic Neuroma (Vestibular Schwannoma) Jeffrey P. Harris, M.D., Ph.D. Introduction Diagnosis Acoustic Neuromas are most frequently diagnosed by MRI scan in a patient with unilateral hearing loss. Important information to be determined from the MRI scan are distance the tumor extends laterally in the auditory canal, the extent to which the tumor expands in the cerebello-pontine angle, and whether or not the brain stem is contacted or distorted. Other important diagnostic tests are the audiogram and the recordable brain stem audio evoked responses (BAERs) because these will provide indicators of the possibility of saving hearing. Classification Based on the MRI scan, Acoustic Neuromas fall into three classifications: Entirely intracanalicular , which means the entire tumor is no bigger than a bean and is completely within the bony canal. Intracranial extension without brain stem distortion , which means the intracranial portion of the tumor is small, i.e. 1-2 cm. Intracranial extension with brain stem distortion , which means the intracranial portion of the tumor is bigger than 2 cm and pressing on the bone of the brain.

73. Acoustic Neuroma Home Page Department of Otolaryngology/Head and Neck Surgery acoustic neuroma Home PageThe OHSU acoustic neuroma Treatment Team acoustic neuroma Background. http://www.ohsu.edu/som-Otolaryn/somweb/acoustic.htm

Department of Otolaryngology/Head and Neck Surgery Acoustic Neuroma Home Page The OHSU Acoustic Neuroma Treatment Team At OHSU, patients with acoustic neuromas are cared for by a team of physicians in order to provide the maximum expertise in the treatment of these tumors. Acoustic neuromas are located at the cranial base, on the border between the brain and the ear canal. A joint approach, undertaken by both a specialty-trained otologist who specializes in treatment of problems in the inner ear and its nerves and a neurosurgeon who specializes in brain tumors, allows us to be maximally familiar with all areas of treatment of this problem. When appropriate, a radiation therapist who specializes in the treatment of tumors in the brain and the head and neck may also be involved. Sean O. McMenomey, M.D., Associate Professor of Otolaryngology and Neurosurgery Johnny B. Delashaw, Jr., M.D., Professor of Neurosurgery and Otolaryngology General Principles of Acoustic Neuroma Treatment Acoustic Neuroma Background What To Expect During Treatment Acoustic Neuroma Glossary ... Quality of Life Following Acoustic Neuroma Surgery An article by Dr. McMenomey et al in Neurosurgical Focus, 1998. View an Acoustic Neuroma Surgery (Download RealPlayer free) Back to Otology and Neurotology Home Page Back to Otology/Neurotology/Skull Base Surgery Homepage

74. Acoustic Neuroma Links acoustic neuroma Links. Acoustic acoustic neuroma Stories Experiencesof individual patients with acoustic neuroma surgery. Acoustic http://www.ohsu.edu/som-Otolaryn/somweb/links.htm

The Department of Otolaryngology/Head and Neck Surgery Otology/Neurotology/Skull Base Surgery Acoustic Neuroma Links Acoustic Neuroma Association - Includes links for local support groups, email discussion groups, FAQs, detection/treatment info, and links to other resources. Acoustic Neuroma Stories - Experiences of individual patients with acoustic neuroma surgery. Acoustic Neuroma Resources -Web site with links to a variety of web sites to answer common questions about acoustic neuromas. Radiosurgery Service, Johns Hopkins Hospital - General information on acoustic neuromas, example of intake information form for acoustic neuroma patient. Management of Acoustic Neuromas - written by Dr. Robert Ojemann at Massachusetts General Hospital Cranial Base Center to provide background information for physicians. Acoustic Neuroma - Comprehensive information. Back to Acoustic Neuroma Home Page Back to Otology/Neurotology/Skull Base Surgery Home Page

75. Cholesteatoma acoustic neuroma Schwannoma. Book, Home Page. fossa tumors; Otolaryngologistssued most on missed acoustic neuroma. Signs Unilateral http://www.fpnotebook.com/ENT54.htm

Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement Otolaryngology Hematology and Oncology Ear Disease ... Chemodectoma Cholesteatoma Acoustic Neuroma Laryngeal Disease Laryngeal Neoplasm Lip ... Tongue Carcinoma Assorted Pages Neck Masses in Adults Neck Masses in Children Branchial Cleft Cyst Cystic Hygroma ... Submandibular Exam Cholesteatoma Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Otolaryngology Index Allergy Dermatology Ear Disease Examination Hearing Hematology and Oncology Infectious Disease Laboratory Laryngeal Disease General Lip Throat Disease Neurology Nasal Disease Obstetrics Pharmacology Procedure Radiology Salivary Sinus Disease Sports Medicine Symptom Evaluation Tongue Vertigo Page Hematology and Oncology Index Ear Tumor Ear Tumor Chemodectoma Ear Tumor Cholesteatoma Ear Tumor Neuroma Larynx Tumor Lip Tumor Mouth Tumor Mouth Tumor SCC Neck Mass Adult Neck Mass Children Neck Mass Branchial Cleft Neck Mass Hygroma Neck Mass Thyroglossal Cyst Nose Tumor Salivary Tumor Tongue Carcinoma Pathophysiology Benign squamous metaplasia of middle ear epithelium TM epithelium retracts into mastoid air cells

76. Acoustic Neuroma acoustic neuroma, NF II information, links to national and internationalsupport groups, clinics with genetic counselors and geneticists. http://www.kumc.edu/gec/support/acoustic.html

Acoustic Neuroma / Neurofibromatosis II Acoustic Neuroma Association 600 Peachtree Pkwy, #108, Cumming, GA 30041-6899 Phone: 770.205.8211, Fax 770.205.0239 Web site: anausa.org E-mail: anausa@aol.com Frequently asked questions Glossary of terms Local support Groups ... Acoustic Neuroma Association of Canada PO Box 369, Edmonton, AB T5J 2J6, Canada Phone: (403) 428-3384 About acoustic neuroma British Acoustic Neuroma Association - (BANA) Also See: National organizations information on genetic conditions or birth defects Information for Siblings and Family Members Acoustic Neuroma Patient Archive Neurofibromatosis, Type 2 (Central Neurofibromatosis or Bilateral Acoustic Neurofibromatosis) Acoustic Neuroma Resources S Wiggins Acoustic Neuromas Brain Surgery Information Center, overview, types of tumors, surgical options, surgical risks Acoustic Neuroma , Med Help International Acoustic Neuroma : The Basic Facts, University of Minnesota Acoustic Neuroma , HealthCyclopedia Acoustic Neuroma Index , Wake Forest University School of Medicine Acoustic Neuroma Surgery: A Patient's Perspective , G Hunt Acoustic Neuromas Can Be Detected, Treated Early

77. MEI: Acoustic Neuroma Surgical Photos MEI, Buttons. acoustic neuroma Surgical Photos. Pictures of various acoustic neuromas(AN). Image Small AN. Image Medium AN. Image Large AN. Image Large meningioma. http://www.michiganear.com/doctors/anphotos.html

Acoustic Neuroma Surgical Photos Pictures of various acoustic neuromas (AN). Small AN Medium AN Large AN Large meningioma [ top ] [Home] [About MEI] [Library] ... [Contact Us]

78. Support - Acoustic Neuroma Assoc - Everybody.co.nz acoustic neuroma ASSOCIATION OF NEW ZEALAND INC. WHAT IS THE acoustic neuromaASSOCIATION OF NEW ZEALAND (Inc)? WHAT IS AN acoustic neuroma? http://www.everybody.co.nz/support/ana.html

Advertisers do not influence the content of this page home ll search ll conditions ll bulletin board ll healthy living ll ll NZ health scene ll health research ll tools quizzes ll NZ health support groups ll find an LMC ll hospitals ll nutrition research ll OTC medicines guide ll contact ll about us Allergy Arthritis Asthma, Respiratory ... Women's Health Find an LMC Click here to find a Lead Maternity Carer in your area. Maps NZ hospitals street map directory. Click here. Sex Files For sexual health info in association with the Auckland Sexual Health Service click here.

79. Acoustic Neuroma Diary Of Medical Importance My Experience with an acoustic neuroma Brain Surgery InMay 1997 I had surgery for an acoustic neuroma. My acoustic neuroma Journal. http://freepages.misc.rootsweb.com/~kathryn/personal/acoustic-neuroma-diary.htm

Genealogy Is My Bag Welcome - Have Fun Exploring! Kathryn (Rhinehart) Bassett Non genealogical things have been moved to bassett.net Genealogy Family Roots Surnames A-C D-G H-L M-Q ... Rootsweb homepage Email: kathryn@bassett.net Of Medical Importance My Experience with an Acoustic Neuroma Brain Surgery In May 1997 I had surgery for an Acoustic Neuroma. I kept this diary of my experience, but you can also see these links to information on acoustic neuromas. Acoustic Neuroma Association at http://ANAusa.org/ and the University of Washington's page with an excellent explanation of Acoustic Neuroma's. http://www.neurosurgery.washington.edu/clinical/acouneur/acouneur.html#Trans My Acoustic Neuroma Journal When I was diagnosed with an Acoustic Neuroma (hereafter called AN) I searched the Internet on that topic. Among other things, I found a web page by a guy who made a diary from diagnosis to the time he went back to work. That made me decide to keep a journal as well. With that in mind, I will go backwards in time and reconstruct the beginning. With the earlier dates, I have put in impressions at the time as well as what I now know in retrospect. By the way, a note that has nothing to do with AN; I am O+ blood type. I've found out before but never had it written down anyplace.

80. THE MERCK MANUAL, Sec. 7, Ch. 85, Inner Ear Temporal Bone Fractures. acoustic neuroma. click here for navigation help. AcousticNeuroma (Acoustic Schwannomas, Acoustic Neurinomas, 8th Nerve Tumors). http://www.merck.com/pubs/mmanual/section7/chapter85/85l.htm

This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 7. Ear, Nose, And Throat Disorders Chapter 85. Inner Ear Topics [General] Meniere's Disease Vestibular Neuronitis Benign Paroxysmal Positional Vertigo ... Acoustic Neuroma Acoustic Neuroma (Acoustic Schwannomas, Acoustic Neurinomas, 8th Nerve Tumors) Acoustic neuromas are derived from Schwann cells (see also Neurofibromatosis in Ch. 183). They arise twice as often from the vestibular division of the 8th nerve as from the auditory division and account for about 7% of all intracranial tumors. As the tumor grows larger, it projects from the internal auditory meatus into the cerebellopontine angle and begins to compress the cerebellum and brain stem. The 5th cranial nerve and later the 7th are affected. Symptoms, Signs, and Diagnosis Hearing loss and tinnitus are early symptoms. Although the patient complains of dizziness and unsteadiness, true vertigo is not usually present. The sensorineural hearing loss (see Differentiation of Sensory and Neural Hearing Losses in Ch. 82) is characterized by greater impairment of speech discrimination than would be expected with a cochlear lesion. Recruitment is absent, and tone decay is marked. Acoustic reflex decay, the absence of waveforms, and increased latency of the 5th waveform in auditory brain stem response testing are further evidence of a neural lesion. As a rule, caloric testing demonstrates marked vestibular hypoactivity (canal paresis). Early diagnosis is based on the audiologic assessment, particularly auditory brain stem response and MRI with gadolinium enhancement.

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