• S Berrettini, F Ravecca, F Russo, P Bruschini, and S Sellari-Franceschini.
• Istituto di Clinica Otorinolaringoiatrica dell'Universitá di Pisa, Italy.
• J Otolaryngol. 1997 Apr 1; 26 (2): 97-103.

ObjectiveThe most common initial symptoms of the acoustic neuroma are unilateral hearing loss that evolves gradually, tinnitus, and unsteadiness. However, atypical presentations may sometimes occur, more often with a small intracanalicular neuroma or with a large medial neuroma placed in the cerebellopontine angle.ResultsIn our group of 51 patients suffering from acoustic neuroma, atypical presentations were observed in 9 cases (17.6%). Two patients had normal hearing function but reported tinnitus; two patients reported sudden hearing loss, with partial recovery; two patients had a history of fluctuating hearing loss; two patients reported neurologic symptoms (one reported trigeminal paresthesia and the other had a history of trigeminal paresthesia and recurrent headache); and one patient reported profound hearing loss for many years and the recent onset of unsteadiness.ConclusionPatients with these atypical presentations have to undergo a diagnostic evaluation for acoustic neuroma and must be evaluated with BAEPs and then with gadolinium-enhanced MRI.

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