Diagnosis of acoustic neuroma.

The acquisition and application of new techniques in diagnostic screening have changed the approach to patients with suspected acoustic neuroma. In this paper, we review the extensive recent literature on acoustic tumors and present a critical analysis of the various diagnostic investigations. The older tests for cerebrospinal fluid protein, vestibular testing, and arteriography have been supplanted by modern audiometry with acoustic reflex testing, brain stem evoked responses, and computed tomography (CT). The various types of plain radiography are confirmed as an extremely useful screening modality. CT is insufficiently sensitive to serve as a primary screening procedure, but is a valuable confirmatory test. We propose a logical method of screening patients suspected of having an acoustic neuroma that can be applied by any practitioner in any clinical situation.