Good Morning…

A Small presentation by.. S.Vigneshwaran 3rd year Medico

Investigations

&

Management

Investigations• Attempts should be made to

diagnose tumour in its Otological Phase

Intracanalicular

Unilateral sensorineural Hearing loss

TinnitusImbalance

Audiological tests Pure tone Audiometry

Sensorineural hearing loss – High Frequencies

Speech audiometry

Roll over phenomenonReduction of Discrimination score when loudness increased beyond Particular limit

Recruitment phenomenonSmall increase in noise level seems to be much louder and cause discomfort..

SISI

Score 0-20% in 70-90% cases

Threshold tone decay test

• Shows retrocochlear type of lesions

• Cochlear Fatigue

Stapedial reflex decay test

Involuntary muscle contractions

Vestibular tests

Neurological tests

Examination of..

•Cranial nerves

•Cerebellar functions

•Brainstem signs

Fundus Examination

Radiological tests

• Plain X-Rays

Stenver view

Transorbital view

Computed Tomography

Tumour in Posterior fossa

Magnetic Resonance Imaging..

Vertebral AngiographyTo differentiate between Acoustic neuroma & Cerebellopontine angle tumours

Evoked Response Audiometry

• Retrocochlear lesions• 8th Nerve tumour

0.2 msDelay

CSF

Raised Protein Level

Important tests for workup..

• Pure tone audiometry• Speech discrimination score• Roll over curve• Stapedial reflex decay• Evoked response audiometry• MRI with contrast

Treatment

Surgery

Radiotheraphy