Unusual presentations of acoustic tumours
Unusual presentations of acoustic tumours
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DOI：
10.1111/j.1365-2273.1996.tb01030.x
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发表时间：
1996-02-01
影响因子：
2.1
通讯作者：
Sterkers, JM
中科院分区：
文献类型：
--
作者：
Morrison, GAJ;Sterkers, JM
238例连续的听神经瘤患者，在巴黎手术已研究确定不寻常的表现和不同的症状。最常见的病史是进行性单侧听力损失（68.1%），伴有耳鸣（49.1%）或失衡（49.1%）或两者兼而有之。突发性听力损失（14.7%）或波动性听力损失（6.3%）以及单次或反复急性眩晕发作（8.8%）较少见。10.5%的患者伴有头痛，2.8%的患者唯一症状为耳鸣，其他不常见症状包括耳痛、面神经麻痹、面部或眼部疼痛、面部或眼部感觉改变、舌头刺痛。11.3%的患者纯音听觉阈值正常，言语辨别评分100%，其中53%的患者声反射阈值正常，仅76.2%的患者脑干听觉诱发反应提示耳蜗后异常。在不太常见的表现中，最初的症状类似于Meniere病、良性位置性眩晕、椎基底动脉偏头痛、椎基底动脉功能不全、贝尔麻痹和三叉神经痛。总体而言，20.6%的患者有不寻常的初始症状，36.5%的症状是不寻常的，这些症状在11.8%的患者中被孤立发现。对听性肿瘤更细微的症状谱的认识可能会在早期阶段导致正确的诊断。
A series of 238 consecutive patients with acoustic neuromas, operated on in Paris has been studied to identify unusual presentations and varied symptomatology. The most common history was that of a progressive unilateral hearing loss (in 68.1%), with tinnitus (in 49.1%) or disequilibrium (in 49.1%) or both. Sudden hearing loss (in 14.7%) or fluctuating hearing loss (in 6.3%), and a single or repeated episodes of acute vertigo (in 8.8%) were seen less commonly. Headaches occurred as an associated symptom in 10.5%, tinnitus was the sole symptom in 2.8% and other uncommon symptoms included otalgia, facial nerve palsy, facial or ocular pain, altered sensation in the face or eye, or tingling of the tongue. Some 11.3% of patients presented with normal pure tone auditory thresholds and a 100% speech discrimination score and of these patients acoustic reflex thresholds were normal in 53% and brainstem auditory evoked responses were suggestive of the retro-cochlear abnormality in only 76.2%. Amongst the less common presentations, the initial symptoms mimicked such diagnoses as Meniere's disease, benign positional vertigo, vertebro-basilar migraine, vertebro-basilar insufficiency, Bell's palsy and Trigeminal neuralgia. Overall, 20.6% of patients had unusual initial presenting symptoms, 36.5% of the symptoms were unusual and these were found in isolation in 11.8% of patients. An awareness of the spectrum of more subtle symptoms of acoustic tumours may lead to the correct diagnosis at an earlier stage.