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Clinical correlates of acoustic neuroma morphology

Published online by Cambridge University Press:  29 June 2007

David A. Moffat ,
Jonathan Golledge ,
David M. Baguley  and
David G. Hardy
David A. Moffat
Affiliation:
Department of Otoneurosurgery, Addenbrooke's Hospital, Cambridge.
Jonathan Golledge*
Affiliation:
Department of Otoneurosurgery, Addenbrooke's Hospital, Cambridge.
David M. Baguley
Affiliation:
Department of Otoneurosurgery, Addenbrooke's Hospital, Cambridge.
David G. Hardy
Affiliation:
Department of Otoneurosurgery, Addenbrooke's Hospital, Cambridge.
*
Mr D. A. Moffat, F.R.C.S., Department of Otoneurosurgery, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ
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Abstract

Thirty–eight patients with vestibular schwannomas were reviewed. A correlation was found between tumour morphology and clinical presentation. Based on our knowledge of the variability in the neurilemmalneuroglial junction and therefore the site of origin of these tumours in relation to the internal auditory canal, a classification into three different appearances on magnetic resonance imaging was possible. Dumbbell shaped tumours (21 per cent) represented laterally arising schwannomas, lollipop shaped tumours (18 per cent) were medially arising and cone shaped tumours (61 per cent) were the more common intermediate form. Patients with laterally arising dumb–bell shaped tumours were more likely to present early with hearing loss and had smaller tumours than patients with medially arising lollipop shaped ones. The relatively well preserved hearing in patients with medially arising tumours made them more likely to present at a later stage with signs of trigeminal compression, cerebellar dysfunction and raised intracranial pressure.

Keywords

Cranial nerve neoplasmsvestibular schwannomaClassification
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 4 , April 1993 , pp. 290 - 294
Copyright
Copyright © JLO (1984) Limited 1993

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Footnotes

Presented at the Audiology in Europe Symposium, September 1992, Cambridge

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