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Outcome of using magnetic resonance imaging as an initial screen to exclude vestibular schwannoma in patients presenting with unilateral tinnitus

Published online by Cambridge University Press:  29 June 2007

P. J. D. Dawes  and
H. E. Basiouny
P. J. D. Dawes*
Affiliation:
Department of Otolaryngology, Sunderland Royal Infirmary, Tyne and Wear, UK.
H. E. Basiouny
Affiliation:
Department of Otolaryngology, Sunderland Royal Infirmary, Tyne and Wear, UK.
*
Address for correspondence: Mr P. J. D. Dawes, ENT Department, Dunedin Hospital, 201 Great King Street, Dunedin, New Zealand. Fax: 0064 3 4747956
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Abstract

The improved cost-effectiveness of gadolinium-enhanced magnetic resonance imaging (MRIg) as a diagnostic tool for vestibular schwannoma has resulted in smaller tumours being diagnosed. There has been a change in the clinical presentation of these tumours and up to four per cent may present with unilateral tinnitus. The limitation of auditory brain stem response (ABR) as a screening tool that detects small tumours is recognized and there is a strong argument for using MRIg as the initial investigation.

Various screening guidelines have been proposed, some include submitting patients with unilateral tinnitus for MRIg. This report describes the findings in a group of 174 patients presenting with unilateral tinnitus who underwent MRIg as part of a guideline-directed screen to exclude vestibular schwannoma. Five patients had a cause for their tinnitus diagnosed, one a vestibular schwannoma. Two had intracranial aneurysms and another three had pathology revealed that merited onward referral. A further nine patients had incidental findings that neither accounted for their symptoms nor needed further investigation or referral.

The rationale for screening these patients with MRIg is discussed.

Keywords

Neurinoma, acousticPopulation surveillanceTinnitus
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 9 , September 1999 , pp. 818 - 822
Copyright
Copyright © JLO (1984) Limited 1999

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