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Acoustic tumour detection with early auditory evoked potentials and neuroradiological methods

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Summary

A total of 43 patients with surgically identified acoustic neuromas were tested. Results of early auditory evoked potentials (EAEP) and of neuroradiological methods were analysed. Abnormal EAEPs were observed in all patients. In 73% of the cases the EAEP indicated the retrocochlear site of the lesion; in 27%, however, the results did not localize the exact site of the lesion owing to a lack of waves I, II and III due to a pronounced hearing loss.

Neuroradiological procedures provided an indication of the site and extent of the tumour. The number of true positives was 21 of 29 cases with polytomography of the petrous bone, 23 of 28 with computed tomography and in all cases when pontine angle cisternography and computed tomography combined with gas cisternography were performed.

The EAEPs provide a screening-test for acoustic tumour detection at an early stage. Wave abnormalities indicative of a lesion at the acoustic nerve should lead to a neuroradiological investigation and are particularly valuable in cases with small intracanalicular tumours.

Zusammenfassung

43 Patienten mit einem operativ gesicherten Akustikusneurinom (AN) wurden untersucht, wobei die Aussagekraft der frühen akustisch evozierten Potentiale (FAEP) und verschiedener neuroradiologischer Methoden überprüft wurde. Veränderte FAEPs wurden bei allen Patienten gefunden (100% richtig-positive Befunde). In 73% der Fälle erlaubten die FAEP eine Aussage über den retrocochleären Sitz der Schädigung; in 27% jedoch war eine topische Zuordnung nicht mehr möglich, da die topographisch wichtigen Wellen I-III wegen der Hörstörung nicht zur Darstellung gelangten.

Die neuroradiologischen Methoden zeigten Sitz und Ausdehnung des Tumors an. Richtig-positive Befunde zeigten sich in 21 von 29 der Fälle bei der Felsenbeintomographie, in 23 von 28 bei der Computertomographie, in allen 19 Fällen bei der Cisternographie und bei allen 6 Patienten, bei denen eine CT in Verbindung mit einer Luftfüllung durchgeführt wurde.

Die FAEP eignen sich als Sreening-Test, wobei sich der Tumor in einem frühen Stadium erfassen läßt. Treten Wellenveränderungen auf, die auf eine Schädigung am N. VIII hinweisen, ist eine weiterführende neuroradiologische Untersuchung indiziert. Die FAEP-Methode hat sich besonders bei kleinen noch intrakanalikulär gelegenen Tumoren bewährt.

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Authors and Affiliations

  1. Department of Psychiatry, University Hospital Mainz, Langenbeckstr. 1, D-6500, Mainz, Federal Republic of Germany

    K. Maurer

  2. Department of Neuroradiology, University Hospital Mainz, Langenbeckstr. 1, D-6500, Mainz, Federal Republic of Germany

    D. Strümpel & S. Wende

Authors
  1. K. Maurer
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  2. D. Strümpel
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  3. S. Wende
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Maurer, K., Strümpel, D. & Wende, S. Acoustic tumour detection with early auditory evoked potentials and neuroradiological methods. J Neurol 227, 177–185 (1982). https://doi.org/10.1007/BF00313573

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  • DOI: https://doi.org/10.1007/BF00313573

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