Last reviewed: 30 Oct 2021
Last updated: 07 Jan 2020

Summary

Definition

History and exam

Key diagnostic factors

  • asymmetrical hearing loss
  • facial numbness
  • progressive episodes of dizziness

Other diagnostic factors

  • tinnitus
  • difficulty localising sounds
  • headache
  • facial weakness
  • increased or decreased tears
  • metallic or reduced taste
  • diplopia on lateral gaze
  • nystagmus
  • loss of balance and coordination difficulties
  • slower blink
  • swallowing difficulties
  • gait disturbances
  • hydrocephalus
  • papilloedema
  • increased intracranial pressure

Risk factors

  • neurofibromatosis type 2

Diagnostic investigations

1st investigations to order

  • audiogram
  • gadolinium-enhanced MRI head
  • CT head
  • auditory brainstem reflexes

Treatment algorithm

Contributors

Authors

Ryojo Akagami, BSc, MHsc, MD, FRCS(C), FAANS

Clinical Professor

University of British Columbia

Vancouver Health Sciences Centre

Division of Neurosurgery

Vancouver

British Columbia

Canada

Disclosures

RA has been reimbursed for instructing at a dissection course by Stryker and gives yearly lectures at a Canadian resident review course. RA was an expert panelist at a session on vestibular schwannomas at the 2019 NASB meeting.

Peer reviewers

David Rowed, MD

Division of Neurosurgery

University of Toronto

Toronto

Ontario

Canada

Disclosures

DR declares that he has no competing interests.

Laligam N. Sekhar, MD, FACS

Vice Chairman

Professor

Director

Cerebrovascular Surgery

Co-Director

Skull Base Surgery

Department of Neurological Surgery

University of Washington

Harborview Medical Center

Seattle

WA

Disclosures

LNS declares that he has no competing interests.

Renn Holness, MD

Professor

Division of Neurosurgery

Dalhousie University

Halifax

Nova Scotia

Canada

Disclosures

RH declares that she has no competing interests.

Iain Swan, MD, FRCS

Senior Lecturer in Otolaryngology

Honorary Consultant Otolaryngologist

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

IS declares that he has no competing interests.

Patrice Tran Ba Huy, MD

Department of Otorhinolaryngology-Head and Neck Surgery

AP-HP

Hopital Lariboisiere

Service ORL

Universite Paris 7

Paris and Laboratoire des Réseaux Sensorimoteurs

Paris

France

Disclosures

PTBH declares that he has no competing interests.

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