Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-10T13:53:57.614Z Has data issue: false hasContentIssue false

The incidence of symptoms consistent with cerebellopontine angle lesions in a general ENT out-patient clinic

Published online by Cambridge University Press:  29 June 2007

J. P. Harcourt*
Affiliation:
Department of Otolaryngology, Northwick Park Hospital, Harrow, Middlesex, UK.
S. Vijaya-Sekaran
Affiliation:
Department of Otolaryngology, Northwick Park Hospital, Harrow, Middlesex, UK.
E. Loney
Affiliation:
Department of Otolaryngology, Northwick Park Hospital, Harrow, Middlesex, UK.
P. Lennox
Affiliation:
Department of Otolaryngology, Northwick Park Hospital, Harrow, Middlesex, UK.
*
Address for correspondence: Mr J. P. Harcourt, M.A., F.R.C.S., 33 Cloncurry Street, London SW6 6DR.

Abstract

To quantify the potential burden for screening for cerebellopontine angle lesions, all adult new patients attending the ENT outpatient department of a district general hospital were documented to see if their presenting symptom(s) could be consistent with the presence of a cerebellopontine angle lesion. Of the patients, 19.7 per cent were found to be potential candidates for screening. A 15 decibel asymmetry at one frequency was found in 11.8 per cent of patients. The burden of screening with a variety of audiological and symptomatic protocols was quantified. Effective age limits to reduce the burden for screening were found to be either 65 or 75 years of age. With such a large potential pool of patients for further investigation, the results of this study could be used to suggest protocols which are likely to produce a load of cases, which matches local resources for screening.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bell, R. A. (1996) Economics of MRI technology. Journal of Magnetic Resonance Imaging 6: 1025.CrossRefGoogle ScholarPubMed
Black, W. C., Beam, C. A., Camaratta, J., Hanley, J., Malenka, D., Sugarman, M., Thornbury, J. R., Wagner, R. F. (1996) Report from efficacy subgroup MR methodology workshop. Journal of Magnetic Resonance Imaging 6: 13.CrossRefGoogle ScholarPubMed
Casselman, J. W., Kuhweide, R., Dehaene, I., Ampe, W., Deviles, F. (1994) Magnetic resonance examination of the inner ear and cerebellopontine angle in patients with vertigo and/or abnormal findings at vestibular testing. Acta Otolaryngologica (Stockh) (Suppl 513): 1527.CrossRefGoogle ScholarPubMed
Charabi, S., Thomsen, J., Mantoni, M., Charabi, B., Jorgensen, B., Borgesen, S. E., Gyldensted, C., Tos, M. (1995) Acoustic neuroma (vestibular schwannoma): Growth and surgical and nonsurgical consequences of the wait-and-see policy. Otolaryngology - Head and Neck Surgery 113: 514.Google ScholarPubMed
Don, M., Masuda, A., Nelson, R., Brackmann, D. (1997) Successful detection of small acoustic tumours using the stacked derived-band auditory brain stem response amplitude. American Journal of Otology 18: 608621.Google ScholarPubMed
Evans, D. G., Huson, S. M., Donnai, D., Neary, W., Blair, V., Tears, D., Newton, V., Strachan, T., Ramsden, R., Harris, R. (1992) A genetic study of type 2 neurofibromatosis in the United Kingdom. I. Prevalence, mutation rate, fitness and confirmation of maternal transmission effect on severity. Journal of Medical Genetics 29: 841846.CrossRefGoogle ScholarPubMed
Fisher, E. W., Parikh, A. A., Harcourt, J. P., Wright, A. (1994) The burden of screening for acoustic neuroma: asymmetric otological symptoms in the ENT clinic. Clinical Otolaryngology 19: 1921.CrossRefGoogle ScholarPubMed
Hogstrom, B., Sverre, J.-M. (1996) Health economics in diagnostic imaging. Journal of Magnetic Resonance Imaging 6: 2632.CrossRefGoogle ScholarPubMed
Levy, R. A., Arts, H. A. (1996) Predicting neuroradiologic outcome in patients referred for audiovestibular dysfunction. American Journal of Neuroradiology 17: 17171724.Google ScholarPubMed
Mangham, C. (1991) Hearing threshold difference between ears and risk of acoustic tumour. Otolaryngology – Head and Neck Surgery 105: 814817.CrossRefGoogle Scholar
Moffat, D. A., Baguley, D. M., Beynon, G. J., Da Cruz, M. (1998) Clinical acumen and vestibular schwannoma. American Journal of Otology 19: 8287.Google ScholarPubMed
Moffat, D. A., Hardy, D. G., Baguley, D. M. (1989) Strategy and benefits of acoustic neuroma searching. Journal of Laryngology and Otology 103:5159.CrossRefGoogle ScholarPubMed
Morrison, G. A. J., Sterkers, J. M. (1996) Unusual presentations of acoustic tumours. Clinical Otolaryngology 21: 8083.CrossRefGoogle ScholarPubMed
Ravi, K. V., Wells, S. C. (1996) A cost effective screening protocol for vestibular schwannoma in the late 90s. Journal of Laryngology and Otology 110: 11291132.CrossRefGoogle ScholarPubMed
Schlauch, R. S., Levine, S., Li, Y., Haines, S. (1995) Evaluating hearing theshold differences between ears as a screen for acoustic neuroma. Journal of Speech and Hearing Research 38: 11681175.CrossRefGoogle Scholar
Sheppard, I. J., Milford, C. A. M., Anslow, P. (1996) MRI in the detection of acoustic neuromas – a suggested protocol for screening. Clinical Otolaryngology 21: 301304.CrossRefGoogle ScholarPubMed
Sidman, J., Carrasco, V., Whaley, R., Pillsbury, H. (1989) Gadolinium – the new gold standard for diagnosing cerebellopontine angle tumours. Archives of Otolaryngology – Head and Neck Surgery 115: 12441247.CrossRefGoogle Scholar
Thomsen, J., Tos, M., Borgesen, S. E., Moller, H. (1992) Surgical results after translabyrinthine removal of 504 acoustic neuromas. In Proceedings of the First International Conference on Acoustic Neuromas. Kugler Publications, Amsterdam/New York, pp 331335.Google Scholar
Tos, M., Charabi, S., Thomsen, J. (1997) Increase of diagnosed vestibular schwannoma in Denmark. Acta Otolaryngologica (Suppl 529): 5355.CrossRefGoogle ScholarPubMed
van Leeuwen, J. P. P. M., Harhangi, B. S., Thewissen, N. P. M. W., Thijssen, H. O. M., Cremers, C. W. R. J. (1996) Delay in the diagnosis of acoustic neuromas. American Journal of Otology 17: 321325.Google ScholarPubMed
Welling, D. B., Glasscock, M. E., Woods, C. I., Jackson, C. G. (1990) Acoustic neuroma: a cost-effective approach. Otolaryngology – Head and Neck Surgery 103: 364370.CrossRefGoogle ScholarPubMed