Unilateral Ear Symptoms
Unilateral hearing loss or tinnitus may be the only symptom in an acoustic neuroma. Unless there are particular features in the history to account for these symptoms (noise exposure eg. Gun fire, previous surgery) then all patients ( < 70 years) with unilateral symptoms need to be screened for an acoustic neuroma. The gold standard method for detecting acoustic neuromas is a gadolinium enhanced MRI scan. The age factor is controversial.
What should be done if an acoustic neuroma is found in a 75 year old?
Few surgeons would recommend excision at that age. If surgery is not an option, then is it reasonable to tell a patient that they have a brain tumour but that nothing will be done? There are difficult issues and sound clinical judgement should be used in individual cases.
