突発難聴の形で発症した聴神経腫瘍

抄録

A 41-year-old woman suddenly noticed hearing loss and tinnitus of the left ear. She did not experience any vertigo. Sudden deafness was suspected, and she was treated with steroid hormone intravenously 4 days after the onset of hearing loss. Audiometric testing revealed a sensorineural deafness with an average of 63 dB. The response to caloric stimulation was normal in both ears. Stenvers view showed no abnormalities. Two weeks after treatment the hearing in her left ear recovered to 26 dB. in pure tone average.
Twenty seven months later she consulted an ophthalmologist with a complaint of headache and myodysopsia. Papilledema was noted. CT disclosed masses in the right frontal lobe and left cerebelloportine angle. Stenvers view showed normal internal auditory canal in both ears. Pure tone audiogramas revealed sensorineural hearing loss with an average of 72 dB. in the left ear. Caloric response was absent in both ears. A meningioma in the right frontal lobe and an acoustic neurinoma in the left cerebellopontine angle were removed by neurosurgeons.
The authors stress that patients with sudden deafness should be followed after treatment for as long as possible, even if hearing is improved by medical treatment, and that ABR is desirable in the diagnostic evaluation of acoustic neurinoma.