Diagnosis and Cost Analysis in Acoustic Neuromas

• Published in: Otology Japan Vol. 8; no. 1; pp. 1 - 5
• Main Authors: Hara, Akira, Ito, Zenya, Wada, Tetsuro, Takahashi, Kazuhiko, Akizuki, Hiromitsu, Kusakari, Jun
• Format: Journal Article
• Language: English
• Published: Japan Otological Society 1998
• Subjects: acoustic neuroma; auditory brainstem response; cost-effectiveness; diagnosis
• ISSN: 0917-2025; 1884-1457
• DOI: 10.11289/otoljpn1991.8.1

The clinical records of 68 patients of acoustic neuroma diagnosed at the Department of Otolaryngologyor Neurosurgery of University of Tsukuba Hospital from March 1988 to December 1996 werereviewed. The majority of patients presented with asymmetric hearing loss and/or tinnitus. Fifty-onecases were diagnosed by otolaryngologists and the tumor sizes were large in 19 cases, medium in 7cases, small in 17 cases and ear tumor in 11 cases (including 3 cases with neurofibromatosis II). Theother 16 cases (2 cases were neurofibromatosis II), including 9 large, 3 medium, 6 small size tumorsand no ear tumor, were diagnosed by neurosurgeons or others. Twenty-four cases were identified by CT and/or MRI after assessments of otological examinations including pure tone audiograms, equilibriumtests and auditory brainstem responses (ABRs), whereas 25 and 16 cases were directly diagnosedby CT and/or MRI with or without an assessment with pure tone audiogram, repectively. Althoughfurther studies, especially prospective survey on the frequency of abnormal ABRs and the rate oftumor identification in suspected patients (patients with asymmetric hearing loss or unexpectedotologic complaints) are necessary, the results obtained suggested that ABR is the most efficient andeconomical screening technique to select the cases for CT and/or MRI examinations.