A patient with acute facial palsy was found to have acoustic neurinoma, which responded well to steroid therapy.
The patient was a 72-year-old male who had had intermittent dizziness and slight hearing impairment on the right side for two years. One morning severe hearing loss, dizziness and otalgia occurred. On the next day, he had sudden total facial palsy on the right side.
Examination revealed complete right deafness and total canal paresis, but X-rays were abnormal. Steroid therapy relieved facial palsy and dizziness, but hearing and caloric response did not improve.
Four years later, his gait became gradually disturbed, and he felt an abnormal sensation on the right side of his face.
CT scan showed a right cerebellopontine angle tumor (27×21mm) with cyst formation.At operation a schwannoma of the superior vestibular nerve was removed.
This case demonstrates that acoustic tumor must be ruled out even when facial palsy develops suddenly.
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