Acoustic neurome

ACOUSTIC
NEUROMA
A M EDICAL D ICTIONARY , B IBLIOGRAPHY ,
AND A NNOTATED R ESEARCH G UIDE TO
I NTERNET R E FERENCES

J AMES N. P ARKER , M.D.
AND P HILIP M. P ARKER , P H .D., E DITORS


ii

ICON Health Publications
ICON Group International, Inc.
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Copyright 2004 by ICON Group International, Inc.
Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it
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Printed in the United States of America.
Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D.
Editor(s): James Parker, M.D., Philip Parker, Ph.D.
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Cataloging-in-Publication Data
Parker, James N., 1961Parker, Philip M., 1960Acoustic Neuroma: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References /
James N. Parker and Philip M. Parker, editors
p.
cm.
Includes bibliographical references, glossary, and index.
ISBN: 0-497-00014-8
1. Acoustic Neuroma-Popular works. I. Title.


iii

Disclaimer
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iv

Acknowledgements
The collective knowledge generated from academic and applied research summarized in
various references has been critical in the creation of this book which is best viewed as a
comprehensive compilation and collection of information prepared by various official
agencies which produce publications on acoustic neuroma. Books in this series draw from
various agencies and institutions associated with the United States Department of Health
and Human Services, and in particular, the Office of the Secretary of Health and Human
Services (OS), the Administration for Children and Families (ACF), the Administration on
Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for
Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and
Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing
Administration (HCFA), the Health Resources and Services Administration (HRSA), the
Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the
Program Support Center (PSC), and the Substance Abuse and Mental Health Services
Administration (SAMHSA). In addition to these sources, information gathered from the
National Library of Medicine, the United States Patent Office, the European Union, and their

related organizations has been invaluable in the creation of this book. Some of the work
represented was financially supported by the Research and Development Committee at
INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to
Tiffany Freeman for her excellent editorial support.


v

About the Editors
James N. Parker, M.D.
Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the
University of California, Riverside and his M.D. from the University of California, San
Diego. In addition to authoring numerous research publications, he has lectured at various
academic institutions. Dr. Parker is the medical editor for health books by ICON Health
Publications.
Philip M. Parker, Ph.D.
Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at
INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the
University of California, San Diego and has taught courses at Harvard University, the Hong
Kong University of Science and Technology, the Massachusetts Institute of Technology,
Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health
Publications.


vi

About ICON Health Publications
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ICON Group International, Inc.
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San Diego, CA 92122 USA
Fax: 858-546-4341
Web site: www.icongrouponline.com/health


vii

Table of Contents
FORWARD .......................................................................................................................................... 1
CHAPTER 1. STUDIES ON ACOUSTIC NEUROMA ............................................................................... 3
Overview........................................................................................................................................ 3
The Combined Health Information Database................................................................................. 3
Federally Funded Research on Acoustic Neuroma ........................................................................ 9
E-Journals: PubMed Central ....................................................................................................... 11
The National Library of Medicine: PubMed ................................................................................ 12
CHAPTER 2. NUTRITION AND ACOUSTIC NEUROMA ..................................................................... 55
Overview...................................................................................................................................... 55
Finding Nutrition Studies on Acoustic Neuroma ....................................................................... 55
Federal Resources on Nutrition ................................................................................................... 56
Additional Web Resources ........................................................................................................... 57
CHAPTER 3. ALTERNATIVE MEDICINE AND ACOUSTIC NEUROMA............................................... 59
Overview...................................................................................................................................... 59
National Center for Complementary and Alternative Medicine.................................................. 59
Additional Web Resources ........................................................................................................... 64
General References ....................................................................................................................... 65
CHAPTER 4. DISSERTATIONS ON ACOUSTIC NEUROMA................................................................. 67
Overview...................................................................................................................................... 67
Dissertations on Acoustic Neuroma ............................................................................................ 67

Keeping Current .......................................................................................................................... 67
CHAPTER 5. PATENTS ON ACOUSTIC NEUROMA ........................................................................... 69
Overview...................................................................................................................................... 69
Patent Applications on Acoustic Neuroma.................................................................................. 69
Keeping Current .......................................................................................................................... 71
CHAPTER 6. BOOKS ON ACOUSTIC NEUROMA ............................................................................... 73
Overview...................................................................................................................................... 73
Book Summaries: Federal Agencies.............................................................................................. 73
Chapters on Acoustic Neuroma ................................................................................................... 74
Directories.................................................................................................................................... 79
CHAPTER 7. PERIODICALS AND NEWS ON ACOUSTIC NEUROMA ................................................. 83
Overview...................................................................................................................................... 83
News Services and Press Releases................................................................................................ 83
Newsletter Articles ...................................................................................................................... 85
Academic Periodicals covering Acoustic Neuroma...................................................................... 90
APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 93
Overview...................................................................................................................................... 93
NIH Guidelines............................................................................................................................ 93
NIH Databases............................................................................................................................. 95
Other Commercial Databases....................................................................................................... 97
APPENDIX B. PATIENT RESOURCES ................................................................................................. 99
Overview...................................................................................................................................... 99
Patient Guideline Sources............................................................................................................ 99
Associations and Acoustic Neuroma ......................................................................................... 106
Finding Associations.................................................................................................................. 107
APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 109
Overview.................................................................................................................................... 109
Preparation................................................................................................................................. 109
Finding a Local Medical Library................................................................................................ 109
Medical Libraries in the U.S. and Canada ................................................................................. 109

viii Contents

ONLINE GLOSSARIES................................................................................................................ 115
Online Dictionary Directories ................................................................................................... 118
ACOUSTIC NEUROMA DICTIONARY .................................................................................. 119
INDEX .............................................................................................................................................. 151


1

FORWARD
In March 2001, the National Institutes of Health issued the following warning: "The number
of Web sites offering health-related resources grows every day. Many sites provide valuable
information, while others may have information that is unreliable or misleading."1
Furthermore, because of the rapid increase in Internet-based information, many hours can
be wasted searching, selecting, and printing. Since only the smallest fraction of information
dealing with acoustic neuroma is indexed in search engines, such as www.google.com or
others, a non-systematic approach to Internet research can be not only time consuming, but
also incomplete. This book was created for medical professionals, students, and members of
the general public who want to know as much as possible about acoustic neuroma, using the
most advanced research tools available and spending the least amount of time doing so.
In addition to offering a structured and comprehensive bibliography, the pages that follow
will tell you where and how to find reliable information covering virtually all topics related
to acoustic neuroma, from the essentials to the most advanced areas of research. Public,
academic, government, and peer-reviewed research studies are emphasized. Various
abstracts are reproduced to give you some of the latest official information available to date
on acoustic neuroma. Abundant guidance is given on how to obtain free-of-charge primary
research results via the Internet. While this book focuses on the field of medicine, when

some sources provide access to non-medical information relating to acoustic neuroma,
these are noted in the text.
E-book and electronic versions of this book are fully interactive with each of the Internet
sites mentioned (clicking on a hyperlink automatically opens your browser to the site
indicated). If you are using the hard copy version of this book, you can access a cited Web
site by typing the provided Web address directly into your Internet browser. You may find
it useful to refer to synonyms or related terms when accessing these Internet databases.
NOTE: At the time of publication, the Web addresses were functional. However, some links
may fail due to URL address changes, which is a common occurrence on the Internet.
For readers unfamiliar with the Internet, detailed instructions are offered on how to access
electronic resources. For readers unfamiliar with medical terminology, a comprehensive
glossary is provided. For readers without access to Internet resources, a directory of medical
libraries, that have or can locate references cited here, is given. We hope these resources will
prove useful to the widest possible audience seeking information on acoustic neuroma.
The Editors

1

From the NIH, National Cancer Institute (NCI): />


3

CHAPTER 1. STUDIES ON ACOUSTIC NEUROMA
Overview
In this chapter, we will show you how to locate peer-reviewed references and studies on
acoustic neuroma.

The Combined Health Information Database
The Combined Health Information Database summarizes studies across numerous federal

agencies. To limit your investigation to research studies and acoustic neuroma, you will
need to use the advanced search options. First, go to From
there, select the “Detailed Search” option (or go directly to that page with the following
hyperlink: The trick in extracting studies is found in
the drop boxes at the bottom of the search page where “You may refine your search by.”
Select the dates and language you prefer, and the format option “Journal Article.” At the top
of the search form, select the number of records you would like to see (we recommend 100)
and check the box to display “whole records.” We recommend that you type “acoustic
neuroma” (or synonyms) into the “For these words:” box. Consider using the option
“anywhere in record” to make your search as broad as possible. If you want to limit the
search to only a particular field, such as the title of the journal, then select this option in the
“Search in these fields” drop box. The following is what you can expect from this type of
search:
•

Tinnitus and Acoustic Neuroma
Source: ANA Notes. 2003;68.
Contact: Available from Acoustic Neuroma Association. 600 Peachtree Parkway, Suite
108, Cumming, GA 30041. 770-205-8211; Fax:770-205-0239. Web site:
. E-mail:
Summary: Dr. John W. House discusses tinnitus, including diagnosis, treatment and
prognosis, and its relationship to acoustic neuroma. Dr House describes tinnitus as a
common symptom of hearing loss and a possible early sign of an acoustic neuroma.


4

•

Acoustic Neuroma

Cochlear Implantation in a Patient After Removal of an Acoustic Neuroma: The
Implications of Magnetic Resonance Imaging With Gadolinium on Patient
Management
Source: Archives of Otolaryngology-Head and Neck Surgery. 121(4): 465-468. April
1995.
Summary: In this article, the authors report a case in which an acoustic tumor was
removed from an only-hearing ear in a patient with neurofibromatosis after hearing loss
had progressed in the ear but before the development of total deafness. Postoperatively,
the patient successfully underwent cochlear implantation. The authors also discuss
decisions that were made during the surgical procedure, as well as the feasibility of
cochlear implantation in patients with profound deafness after the excision of acoustic
neuromas. 2 figures. 29 references. (AA-M).

•

Acoustic Neuroma Standard of Care
Source: Otolaryngologic Clinics of North America. 29(2): 277-289. April 1996.
Summary: Patients who have undergone acoustic neuroma surgery require expert,
comprehensive nursing care. This article includes information on the standard of care
and tables on neurological assessment. It also discusses potential complications,
including cranial nerve involvement, meningitis; the Acoustic Neuroma Association;
home safety; and discharge instructions. The authors conclude that a holistic,
multidisciplinary approach can promote the recovery of acoustic neuroma patients and
ultimately improve their outcomes. They emphasize that nurses play a key role in
assisting patients to adjust to potential limitations and achieve their post-operative
goals. 7 tables. 8 references.

•

Comprehensive Management of Bilateral Acoustic Neuromas: Current Perspectives
Source: Archives of Otolaryngology: Head and Neck Surgery. 120(12): 1307-1314.
December 1994.
Summary: This article describes a management strategy for patients with bilateral
acoustic neuromas and presents case reports to show their diversity. The authors note
that patients with neurofibromatosis 2 present complex and challenging management
problems, because either growth or surgical removal of the acoustic neuroma may
result in total hearing loss. Early diagnosis with gadolinium-enhanced magnetic
resonance imaging and refinements in hearing preservation surgery have improved the
ability to prevent total hearing loss. For patients with larger tumors or no useful
hearing, the auditory brain-stem implant allows restoration of some auditory function
when the tumor is removed. The authors also discuss the newly identified
neurofibromatosis 2 tumor suppressor gene. 6 figures. 46 references. (AA-M).

•

Acoustic Neuroma: Triumph and Disaster
Source: British Journal of Medicine. 49(2): 85,87. 1993.
Summary: This article describes the diagnosis and treatment of acoustic neuromas.
Topics covered include a description of acoustic neuromas; the growth rate of these
tumors; acoustic neuromas in young patients; the role of genetics; symptoms of acoustic
neuroma; diagnostic tests; management considerations; surgical treatment; monitoring
of the facial nerve during surgery; managing patients with bilateral acoustic tumors; and
the importance of a multidisciplinary team of professionals to treat patients with
acoustic neuromas.


Studies

•

5

Treating the Oral Sequelae of an Acoustic Neuroma
Source: JADA. Journal of American Dental Association. 127(2): 231-233. February 1996.
Summary: This article describes the treatment of oral complications that arose after
surgery for the removal of an acoustic brain tumor. The authors contend that a thorough
oral examination can pinpoint the cranial nerves that have been affected by the tumor or
the surgery, and that dental appliances can offer special protection after surgery. The
authors present the dental case of a 49-year-old woman after undergoing acoustic
neuroma removal. Postoperative care included the construction of a special periodontal
appliance to allow healing of a chronic ulcer on the patient's lip, attributed to paralysis
of the face after surgery and resulting inadvertent chewing. 5 figures. 10 references.

•

LINAC Radiosurgery for Acoustic Schwannomas
Source: Acoustic Neuroma Association NOTES. Number 47: 1, 3. September 1993.
Contact: Available from Acoustic Neuroma Association (ANA). 600 Peachtree Parkway,
Suite 108, Cumming, GA 30041-8211. (770) 205-8211. Fax (770 www.ANAUSA.org.
Summary: This article describes the use of linear accelerators (LINACs) to perform
radiosurgery for acoustic schwannomas. After a brief history of the development and
use of LINAC radiosurgery, the author discusses the details of this technique. The
author also reports on his experience in treating 34 patients with acoustic schwannomas.
The author concludes that radiosurgery represents an attractive alternative for patients
who are older than 65, have persistent or recurrent tumor after surgery, or conditions
such as cardiac or pulmonary disease.

•

When to Suspect an Acoustic Neuroma
Source: American Family Physician. 52(6): 1768-1774. November 1, 1995.
Summary: This article discusses acoustic neuroma, a tumor that compresses the
cochlear (acoustic) branch of the eighth cranial nerve, causing hearing loss, tinnitus, and
disequilibrium. The author presents and discusses two illustrative cases of acoustic
neuroma. The author discusses diagnosis, including the use of gadolinium-enhanced
magnetic resonance imaging; surgical removal using a translabyrinthine approach; and
the use of radiation therapy and expectant management in patients at high surgical risk.
5 figures. 2 tables. 16 references. (AA-M).

•

Management of Bilateral Acoustic Neuroma
Source: Otolaryngologic Clinics of North America. 25(2): 449-469. April 1992.
Summary: This article discusses the management of bilateral acoustic neuroma. The
authors review the literature, present their methods of diagnosis and treatment,
summarize their results and complications encountered, and discuss their management
philosophy in the care of patients with neurofibromatosis 2. Specific topics covered
include the differences between neurofibromatosis 1 and 2, nomenclature, genetics,
epidemiology, diagnostic criteria, pathogenesis, clinical presentation, diagnostic testing,
family screening and counseling, surgical techniques, stereotactic radiotherapy (gamma
knife), and chemotherapy. The authors then report on their 20 years' experience
managing 86 acoustic tumors in 49 patients with neurofibromatosis. 3 figures. 5 tables.
67 references. (AA-M).


6

•

Acoustic Neuroma

Is There Still a Role for Auditory Brainstem Response Audiometry in the Diagnosis
of Acoustic Neuroma?
Source: Archives of Otolaryngology-Head and Neck Surgery. 125(2): 232-234. February
1999.
Contact: Available from American Medical Association. Subscriber Services Center, P.O.
Box 10946, Chicago, IL 60610-0946. (800) 262-2350. Fax (312) 464-5831. E-mail:
Summary: This article discusses the use of auditory brainstem response (ABR)
audiometry in the diagnosis of acoustic neuroma. The author describes the pros and
cons of the use of ABR in the diagnostic workup. In the final section of the article, the
author provides recommendations for the role of ABR audiometry. The author argues
for a reduced role (compared to 10 years ago) for ABR audiometry in the diagnosis of
acoustic neuroma. If MRI (magnetic resonance imaging) can be provided at reduced
cost, it provides definitive diagnosis and there is little need for ABR audiometry in the
workup of acoustic neuroma. However, ABR audiometry still has a role in several
scenarios: patients in whom MRI is contraindicated (excessive obesity or the presence of
metal or pacemaker implants); elderly or terminally ill patients who are poor surgical
risks, with minimal symptoms attributable to acoustic neuroma and in whom large
tumors must be ruled out; and preoperative ABR audiometry to predict the likelihood of
hearing preservation. For those patients who undergo ABR audiometry instead of MRI
as the initial study, they must be informed that if the results of ABR audiometry are
normal, a small acoustic tumor may be missed 10 to 30 percent of the time. These
patients must then undergo a follow up evaluation and audiogram 6 months to 1 year
later to look for progression of symptoms and unilateral hearing loss. 22 references.

•

Complications in Acoustic Neuroma Surgery
Source: Otolaryngologic Clinics of North America. 25(2): 389-412. April 1992.

Summary: This article outlines complications that can arise during and after acoustic
neuroma surgery. The authors begin with a brief summary of the work of Dr. Harvey
Cushing and Dr. William House. The remainder of the article discusses intracranial
vascular complications, posterior fossa hemorrhage, supratentorial hemorrhage,
cerebellar problems, complications of positioning in surgery, incomplete tumor removal,
facial paralysis, pneumocephalus, injury of cranial nerves, meningitis, aseptic
meningitis, cerebrospinal fluid (CSF) leaks and their management, medical
complications, miscellaneous perioperative complications, vertigo and imbalance, and
contralateral hearing loss. The authors conclude that the occurrence of complications can
be greatly reduced through a team approach using the combined talents of a
neurotologist, neurosurgeon, and frequently, an internist. 4 figures. 65 references.

•

Case Report: Acoustic Neuroma Appearing as Trigeminal Neuralgia
Source: JADA. Journal of the American Dental Association. 125(8): 1122-1125. August
1994.
Summary: This article presents a case report and discussion of the differentiation
between acoustic neuroma and trigeminal neuralgia. The authors stress that a complete
history and examination, often including radiological imaging, is needed to differentiate
the diagnosis of trigeminal neuralgia from more life-threatening disorders. The case
report documents a 43-year-old man with a six-month history of lightning-like flashes of
pain in his left lip and cheek. The authors discuss facial pain and its etiology;


Studies

7

neurological abnormalities caused by certain intracranial tumors; pharmaceutical and

surgical options for trigeminal neuralgia; and choosing diagnostic tests. 2 figures. 30
references. (AA-M).
•

Preservation of Facial, Cochlear, and Other Nerve Functions in Acoustic Neuroma
Treatment
Source: Otolaryngology-Head and Neck Surgery. 110(2): 146-155. February 1994.
Summary: This article presents data from the past 7 years of the treatment of acoustic
neuromas by surgical excision at one facility in Paris, France. The translabyrinthine
approach has been used in more than 85 percent of cases. The authors note that results
improved during 1991 after the introduction of continuous facial nerve monitoring and
the use of the Beaver mini-blade for dissection of tumor from nerve. The authors report
on their results in hearing preservation and note that, despite earlier diagnosis, the
number of patients suitable for hearing preservation surgery remains very limited and
careful selection is required. They conclude that their experiences emphasize the
advantages of the translabyrinthine approach, which offers greater security to the facial
nerve and lower morbidity. 3 figures. 4 tables. 30 references. (AA-M).

•

Conservative Management of Acoustic Neuroma: An Outcome Study
Source: Otolaryngology Journal Club Journal. 4(5): 275-277. October 1997.
Summary: This article provides a condensation of a research study undertaken to
analyze selection criteria, clinical outcome, and tumor growth rates in patients with
acoustic neuroma in whom the initial management strategy was observation. The
authors conducted a retrospective review of patients with conservatively managed
unilateral acoustic neuroma. Sixty-eight patients (31 men and 37 women, mean age 67.1
years) were observed for an average of 3.4 years after diagnosis. Minimum follow up
was 6 months. Patients with neurofibromatosis type II were excluded. Initial symptoms
included hearing loss in 58 patients (85 percent), vertigo in 26 patients (38 percent),

tinnitus in 23 patients (34 percent), trigeminal neuropathy in 3 patients (4 percent), and
facial neuropathy in 2 patients (3 percent). Reasons for the initial selection of
conservative treatment included advanced age, patient preference, minimal symptoms,
poor general medical condition, asymptomatic tumor, and tumor in only the hearing
ear. Results in this population showed that 58 patients (85 percent) were successfully
managed with observation alone; 10 patients (15 percent) ultimately required treatment.
Of those 10 people, 9 underwent neurosurgery and 1 underwent radiosurgery, at the
mean time interval of 4 years after diagnosis. In this time frame, 48 tumors (71 percent)
showed no growth and 20 tumors (29 percent) enlarged. The authors conclude that
observation is a reasonable management strategy in carefully selected patients with
acoustic neuromas. Diligent follow up with serial magnetic resonance imaging is
recommended, because some tumors will enlarge to a point at which active treatment is
required. 3 tables. 4 references. (AA-M).

•

Acoustic Neuroma Update
Source: Otolaryngologic Clinics of North America. 29(3): 377-392. June 1996.
Summary: This article provides an update on the diagnosis and management of acoustic
neuromas. The authors discuss managed care versus the 'gold standard' of care.
Treatment options described, include observation, surgery, facial nerve preservation,
hearing preservation, and stereotactic radiation therapy. The article also addresses the
management of patients with neurofibromatosis type 2, including hearing preservation,


8

Acoustic Neuroma

middle fossa decompression of the internal auditory canal, and auditory brainstem

implant. The authors stress that the outcome for patients with both unilateral and
bilateral tumors continues to improve. 9 figures. 19 references.
•

Hearing Preservation in Vestibular Schwannoma Surgery: Fact or Fantasy?
Source: Journal of Laryngology and Otology. 109(5): 374-380. May 1995.
Summary: This article reports on a study in which the authors reviewed 57 papers
dealing with the issue of hearing preservation in vestibular schwannoma surgery,
published in otolaryngologic and neurosurgical literature between the years 1977 and
1994. The authors have made an attempt to verify whether the claims of hearing
preservation are real, whether there is a price to be paid in terms of morbidity, and
whether there are univocal criteria for reporting results. Their review shows that there is
a wide disarray in reporting hearing results and the claims of hearing preservation are
often unreal and misleading. On retabulating the results of a few series according to the
minimal prerequisites for normal hearing and according to other various commonly
reported criteria, it became evident that rates of hearing preservation differed greatly,
depending upon criteria. While any measurable hearing could be preserved in many
cases, only a few had normal hearing preserved. 1 table. 57 references. (AA-M).

•

Sensitivity of Auditory Brainstem Response Testing for the Diagnosis of Acoustic
Neuromas
Source: Archives of Otolaryngology-Head and Neck Surgery. 127(1): 19-22. January
2001.
Contact: Available from American Medical Association. Subscriber Services, P.O. 10946,
Chicago, IL 60610-0946. (800) 262-3250 or (312) 670-7827. Fax (312) 464-5831. E-mail:
Website: www.ama-assn.org/oto.
Summary: This article reports on a study undertaken to determine the sensitivity of
auditory brainstem response (ABR) testing for detecting acoustic neuromas and to

determine whether the test is less sensitive for detecting small tumors. The authors
completed a retrospective review of the medical charts of 58 patients with acoustic
neuroma. Tumor size ranged from 0.4 to 7 centimeters. The overall sensitivity of ABR in
diagnosing acoustic tumors was 90 percent. However, ABR was progressively less
sensitive with decreasing tumor size. Only 7 (58 percent) of the 12 tumors 1 centimeter
or smaller were detected by ABR. The authors conclude that ABR cannot be relied on for
detection of small acoustic neuromas and should not be used as a criterion to determine
whether magnetic resonance imaging should be performed when an acoustic neuroma
is suspected clinically (based on the symptoms). The ability to detect small tumors is
important because outcome with regard to facial nerve function and hearing
preservation following surgery, as well as costs, is improved following treatment for
small tumors. 1 figure. 1 table. 19 references.

•

Some Aspects of Life Quality After Surgery for Acoustic Neuroma
Source: Archives of Otolaryngology-Head and Neck Surgery. 118(10): 1061-1064.
October 1992.
Summary: This article reports on an investigation performed to describe some aspects of
the quality of life in subjects after translabyrinthine removal of an acoustic neuroma,
resulting in unilateral total deafness. Ninety-three percent of a surveyed population of
subjects who were operated on during 1976 through 1990 responded: 118 men and 155


Studies

9

women with a median age of 58 years (range, 18 to 81 years). Among the subjects, 22
percent had received postoperative hearing rehabilitation with various types of hearing

aids in the ear not operated on. In 62 percent, tinnitus was experienced in the ear with
tumor before surgery, and at the time of the questionnaire, 49 percent experienced
tinnitus in the ear operated on. Half a year after surgery, 56 percent still experienced
dizziness. Sixty-four percent reported damage to the facial nerve in relationship to the
operation. In conclusion, the study demonstrates that deafness, dysequilibrium, and
reduced facial nerve function causes the most severe problems. The authors propose
that improved information to patients before surgery may reduce the frequency of
negative experiences. 3 figures. 5 tables. 12 references. (AA-M).
•

Trigeminal Neuralgia Due to an Acoustic Neuroma in the Cerebellopontine Angle
Source: Journal of Orofacial Pain. 14(2): 147-151. Spring 2000.
Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol
Stream, IL 60188-1881. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. Website:
www.quintpub.com.
Summary: This case report first reviews the intracranial tumors associated with
symptoms of trigeminal neuralgia (TN). Among patients with TN like symptoms, 6 to 16
percent are variously reported to have intracranial tumors. The most common
cerebellopontine angle (CPA) tumor to cause TN like symptoms is a benign tumor called
an acoustic neuroma. The reported clinical symptoms of the acoustic neuroma are
hearing deficits (60 to 97 percent), tinnitus (50 to 66 percent), vestibular disturbances (46
to 59 percent), numbness or tingling in the face (33 percent), headache (19 to 29 percent),
dizziness (23 percent), facial paresis (17 percent), and trigeminal nerve disturbances (12
to 45 percent). Magnetic resonance imaging (MRI) or computed tomography (CT) are
used to detect intracranial tumors. The authors then report a rare case of a young female
patient who was mistakenly diagnosed and treated for a temporomandibular disorder
(TMD) but who was subsequently found to have an acoustic neuroma located in the
CPA. 2 figures. 23 references.

•

Evaluation and Management of Acoustic Neuroma
Source: Current Opinion in Otolaryngology and Head and Neck Surgery. 1(1): 53-63.
1993.
Summary: This review article summarizes advances in basic science and the
controversies regarding the clinical management of acoustic neuroma. Topics covered
include the application of genetic mapping and molecular oncology to the study of
acoustic tumors, tumor growth rate, timing of surgery, subtotal removals, the
importance of residual tumor, radiosurgical versus surgical approaches,
neurofibromatosis 2, and the complications and quality-of-life issues relevant to acoustic
tumors. 93 references. (AA-M).

Federally Funded Research on Acoustic Neuroma
The U.S. Government supports a variety of research studies relating to acoustic neuroma.
These studies are tracked by the Office of Extramural Research at the National Institutes of


10

Acoustic Neuroma

Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable
database of federally funded biomedical research projects conducted at universities,
hospitals, and other institutions.
Search the CRISP Web site at />You will have the option to perform targeted searches by various criteria, including
geography, date, and topics related to acoustic neuroma.
For most of the studies, the agencies reporting into CRISP provide summaries or abstracts.
As opposed to clinical trial research using patients, many federally funded studies use
animals or simulated models to explore acoustic neuroma. The following is typical of the
type of information found when searching the CRISP database for acoustic neuroma:

•

Project Title: DOPPLER ULTRASOUND COCHLEAR BLOODFLOW MONITOR
Principal Investigator & Institution: Voie, Arne H.; Spencer Technologies 701 16Th Ave
Seattle, Wa 98122
Timing: Fiscal Year 2000; Project Start 01-JAN-1998; Project End 31-AUG-2004
Summary: Cochlear blood flow monitoring is essential during neuro-surgical
procedures, which may disrupt inner ear blood flow, and also promises to provide
important information to determine therapy for Sudden Deafness Syndrome. LaserDoppler flowmetry has been used in the cochlear, but is surgically difficult to
implement, is vulnerable to motion artifact, and observes regional rather than total
cochlear blood flow. This proposal is to build a novel high-frequency pulse Doppler
ultrasound instrument to detect blood flow in the common modiolar vein (CMV), which
comprises venous return for nearly all inner ear blood flow. The device will detect blood
flow via the round window niche, which is easily accessible and outside the acoustic
neuroma operating field. This instrument will provide immediate benefits in intraoperative monitoring of cochlear blood flow during acoustic neuroma surgery, and as a
diagnostic aid for sudden deafness. In Phase I a prototype was successfully constructed
and then tested on guinea pig model of the human CMV. Phase II will include
integration of the ultrasound transducer into a catheter which can be secured in the
human round window niche, and clinical trial testing. Phase II results will be used to
design a Phase III device for the commercial market. PROPOSED COMMERCIAL
APPLICATION This proposal is to build a cochlear blood flow monitor to be utilized in
neurosurgical suites for presurgical assessment and diagnosis, and the otolaryngology
office, where patients are now routinely seen for presurgical assessments including
electrocochleograms and for diagnosis regarding sudden deafness. This device will help
determine appropriate therapy for patients in both venues.
Website: />
•

Project Title: MEASUREMENT OF VESTIBULAR FUNCTION IN MENIERE'S
DISEASE

Principal Investigator & Institution: Rauch, Steven D.; Associate
Massachusetts Eye and Ear Infirmary 243 Charles St Boston, Ma 02114

Professor;

Timing: Fiscal Year 2002; Project Start 01-APR-2000; Project End 31-MAR-2005
2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health
Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration
(FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ),
and Office of Assistant Secretary of Health (OASH).


Studies

11

Summary: (Adapted from the Investigator's Abstract) The overall objective of the
investigators is to apply both classic and new measures of vestibular function to the
study of Meniere's disease (MD). These measures would enable earlier diagnosis which,
in turn, could lead to better treatment response. These methods have the potential to
provide a superior means of monitoring the course of the disease and its response to
therapy. Finally, these vestibular function measures may provide new insights into the
pathophysiology of MD symptoms since they are based upon the physiology of specific
parts of the vestibular end-organs. To accomplish these goals, this project will apply
vestibular function tests to three groups of subjects: normal controls, subjects with total
unilateral vestibular hypofunction (UVH) after acoustic neuroma removal, and MD
subjects who, by the nature of their disease, have partial UVH. The three specific aims of
this grant are: 1) Characterize the temporal relationship between acute vertigo attacks

and long-term loss of vestibular function in MD subjects by correlating results of serial
vestibular test batteries with clinical vestibular symptom status; 2) Test the hypothesis
that otolith organ dysfunction is an early and consistent finding in MD by applying two
new tests of otolith function, positional optokinetic afternystagmus (pOKAN) and
vestibular evoked myogenic potentials (VEMP); and 3) Lay the groundwork for detailed
clinicopathological studies of the correlation between vestibular function tests and
temporal bone vestibular otopathology by soliciting enrollment of study subjects as
future temporal bone donors to the NIDCD National Temporal Bone, Hearing and
Balance Pathology Resource Registry.
Website: />
E-Journals: PubMed Central3
PubMed Central (PMC) is a digital archive of life sciences journal literature developed and
managed by the National Center for Biotechnology Information (NCBI) at the U.S. National
Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and
unrestricted.5 To search, go to />and type “acoustic neuroma” (or synonyms) into the search box. This search gives you
access to full-text articles. The following is a sample of items found for acoustic neuroma in
the PubMed Central database:
•

3
4

Vestibular schwannoma with contralateral facial pain -- case report. by Eftekhar B,
Gheini M, Ghodsi M, Ketabchi E.; 2003;
/>
Adapted from the National Library of Medicine: />
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic
literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a
world-class library of the digital age.
5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse

sources stored in a common format in a single repository. Many journals already have online publishing operations,
and there is a growing tendency to publish material online only, to the exclusion of print.


12

Acoustic Neuroma

The National Library of Medicine: PubMed
One of the quickest and most comprehensive ways to find academic studies in both English
and other languages is to use PubMed, maintained by the National Library of Medicine.6
The advantage of PubMed over previously mentioned sources is that it covers a greater
number of domestic and foreign references. It is also free to use. If the publisher has a Web
site that offers full text of its journals, PubMed will provide links to that site, as well as to
sites offering other related data. User registration, a subscription fee, or some other type of
fee may be required to access the full text of articles in some journals.
To generate your own bibliography of studies dealing with acoustic neuroma, simply go to
the PubMed Web site at Type “acoustic neuroma”
(or synonyms) into the search box, and click “Go.” The following is the type of output you
can expect from PubMed for acoustic neuroma (hyperlinks lead to article summaries):
•

Acoustic neuroma in patients with completely resolved sudden hearing loss.
Author(s): Nageris BI, Popovtzer A.
Source: The Annals of Otology, Rhinology, and Laryngology. 2003 May; 112(5): 395-7.
/>bstract&list_uids=12784975

•

Acoustic neuroma in pregnancy: emergency cesarean section and definitive

neurosurgery.
Author(s): Sharma JB, Pundir P, Sharma A.
Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the
International Federation of Gynaecology and Obstetrics. 2003 March; 80(3): 321-3.
/>bstract&list_uids=12628539

•

Acoustic neuroma management: an evidence-based medicine approach.
Author(s): Nikolopoulos TP, O'Donoghue GM.
Source: Otology & Neurotology : Official Publication of the American Otological
Society, American Neurotology Society [and] European Academy of Otology and
Neurotology. 2002 July; 23(4): 534-41.
/>bstract&list_uids=12170158

•

Acoustic neuroma presenting as exercise-induced vertigo.
Author(s): Chee NW, Tong HM.
Source: The Journal of Laryngology and Otology. 2002 August; 116(8): 630-2.
/>bstract&list_uids=12389693

6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of
Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction
with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text
journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with
their citations electronically prior to or at the time of publication.


Studies

13

•

Acoustic neuroma surgery and tinnitus.
Author(s): Fahy C, Nikolopoulos TP, O'Donoghue GM.
Source: Eur Arch Otorhinolaryngol. 2002 July;259(6):299-301. Epub 2002 May 01.
/>bstract&list_uids=12115076

•

Acoustic neuroma surgery outcomes.
Author(s): Kaylie DM, Gilbert E, Horgan MA, Delashaw JB, McMenomey SO.
Source: Otology & Neurotology : Official Publication of the American Otological
Society, American Neurotology Society [and] European Academy of Otology and
Neurotology. 2001 September; 22(5): 686-9.
/>bstract&list_uids=11568680

•

Acoustic neuroma surgery: the results of long-term hearing preservation.
Author(s): Chee GH, Nedzelski JM, Rowed D.
Source: Otology & Neurotology : Official Publication of the American Otological
Society, American Neurotology Society [and] European Academy of Otology and
Neurotology. 2003 July; 24(4): 672-6.
/>bstract&list_uids=12851563

•

Acoustic neuroma with malignant transformation. Case report.
Author(s): Hanabusa K, Morikawa A, Murata T, Taki W.
Source: Journal of Neurosurgery. 2001 September; 95(3): 518-21.
/>bstract&list_uids=11565878

•

Acoustic neuroma.
Author(s): Ritchie MM, McEwen DR.
Source: Semin Perioper Nurs. 2000 October; 9(4): 168-72.
/>bstract&list_uids=12029771

•

Acoustic neuroma. Assessment and management.
Author(s): Ho SY, Kveton JF.
Source: Otolaryngologic Clinics of North America. 2002 April; 35(2): 393-404, Viii.
Review.
/>bstract&list_uids=12391625

•

Acoustic neuroma: deterioration of speech discrimination related to thresholds in
pure-tone audiometry.
Author(s): Van Dijk JE, Duijndam J, Graamans K.
Source: Acta Oto-Laryngologica. 2000 August; 120(5): 627-32.
/>bstract&list_uids=11039874


14

Acoustic Neuroma

•

Acoustic neuroma: outcome study.
Author(s): Nader R, Al-Abdulhadi K, Leblanc R, Zeitouni A.
Source: The Journal of Otolaryngology. 2002 August; 31(4): 207-10.
/>bstract&list_uids=12240754

•

Acoustic neuroma: postoperative quality of life.
Author(s): Magliulo G, Zardo F, Damico R, Varacalli S, Forino M.
Source: The Journal of Otolaryngology. 2000 December; 29(6): 344-7.
/>bstract&list_uids=11770141

•

Acoustic neuroma: predominance of Antoni type B cells in tumors of patients with
vestibular paresis.
Author(s): Stipkovits EM, Graamans K, Jansen GH, Velthof MA.
Source: Otology & Neurotology : Official Publication of the American Otological
Society, American Neurotology Society [and] European Academy of Otology and
Neurotology. 2001 March; 22(2): 215-7.
/>bstract&list_uids=11300272

•

Acoustic neuroma--surgery or radiosurgery?

Author(s): Brophy BP.
Source: Stereotactic and Functional Neurosurgery. 2000; 74(3-4): 121-8. Review.
/>bstract&list_uids=11279355

•

Acoustic tumors: operation versus radiation--making sense of opposing viewpoints.
Part I. Acoustic neuroma: decision making with all the tools.
Author(s): Chakrabarti I, Apuzzo ML, Giannota SL.
Source: Clin Neurosurg. 2003; 50: 293-312. Review. No Abstract Available.
/>bstract&list_uids=14677448

•

Acute pulmonary edema in relation with single coronary ostium following acoustic
neuroma surgery.
Author(s): Jativa M, Hantson P, Gurne O, Van Boven M, Gersdorff M.
Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 October;
50(8): 859-60.
/>bstract&list_uids=14525839

•

Association of proliferative activity and size in acoustic neuroma: implications for
timing of surgery.
Author(s): Bedavanija A, Brieger J, Lehr HA, Maurer J, Mann WJ.
Source: Journal of Neurosurgery. 2003 April; 98(4): 807-11.
/>bstract&list_uids=12691406

Studies

15

•

Audiovestibular findings prior to and after acoustic neuroma surgery.
Author(s): Hahn A, Fundova P, Schneider D.
Source: Int Tinnitus J. 2000; 6(1): 67-9.
/>bstract&list_uids=14689622

•

Audit of headache following resection of acoustic neuroma using three different
techniques of suboccipital approach.
Author(s): Santarius T, D'Sousa AR, Zeitoun HM, Cruickshank G, Morgan DW.
Source: Rev Laryngol Otol Rhinol (Bord). 2000; 121(2): 75-8.
/>bstract&list_uids=10997062

•

Benign but fatal. Acoustic neuroma.
Author(s): Bray CA.
Source: Todays or Nurse. 1984 January; 6(1): 8-15. No Abstract Available.
/>bstract&list_uids=6558990

•

Bilateral acoustic neuroma (central neurofibromatosis): clinical and genetic studies.
Author(s): Young DF, Eldridge R, Gardner WJ, Brody JA.

Source: Neurology. 1970 April; 20(4): 400-1.
/>bstract&list_uids=4998071

•

Bilateral acoustic neuroma in a large kindred.
Author(s): Young DF, Eldridge R, Gardner WJ.
Source: Jama : the Journal of the American Medical Association. 1970 October 12; 214(2):
347-53.
/>bstract&list_uids=4990044

•

Bilateral acoustic neuroma. A human temporal bone report.
Author(s): Benitez JT, Lopez-Rios G, Novoa V.
Source: Arch Otolaryngol. 1967 July; 86(1): 25-31. No Abstract Available.
/>bstract&list_uids=4961149

•

Bilateral hearing loss after unilateral removal of an acoustic neuroma by the
suboccipital approach: case report.
Author(s): Chovanes GI, Buchheit WA.
Source: Neurosurgery. 1986 September; 19(3): 452-3.
/>bstract&list_uids=3762896


16

Acoustic Neuroma

•

Biochemical studies of inner ear fluid in man. Changes in otosclerosis, Meniere's
disease, and acoustic neuroma.
Author(s): Silverstein H, Schuknecht HF.
Source: Arch Otolaryngol. 1966 October; 84(4): 395-402. No Abstract Available.
/>bstract&list_uids=5921712

•

Brain scan as an aid in the diagnosis of acoustic neuroma recurrence.
Author(s): Shephard RH, Hoather WH, McKenzie T.
Source: Acta Radiol Diagn (Stockh). 1977 January; 18(1): 65-72.
/>bstract&list_uids=878893

•

Brain stem implantable electrodes in management of total deafness after removal of
acoustic neuroma--a review of operative approaches.
Author(s): Skarzynska B, Skarzynski H, Niemczyk K.
Source: Folia Morphol (Warsz). 1996; 55(4): 442-3. No Abstract Available.
/>bstract&list_uids=9243941

•

Brainstem auditory-evoked potentials and electrocochleography: comparison of
different criteria for the detection of acoustic neuroma and other cerebello-pontine
angle tumours.
Author(s): Prasher DK, Gibson WP.

Source: British Journal of Audiology. 1983 August; 17(3): 163-74. Review.
/>bstract&list_uids=6357325

•

Brainstem potentials in the diagnosis of an acoustic neuroma. An unusual case of
normal ipsilateral and abnormal contralateral responses.
Author(s): Coelho A, Prasher D.
Source: Scandinavian Audiology. 1990; 19(4): 257-62.
/>bstract&list_uids=2075419

•

Calculation of cranial nerve complication probability for acoustic neuroma
radiosurgery.
Author(s): Meeks SL, Buatti JM, Foote KD, Friedman WA, Bova FJ.
Source: International Journal of Radiation Oncology, Biology, Physics. 2000 June 1; 47(3):
597-602.
/>bstract&list_uids=10837941

•

Cellular telephone use and risk of acoustic neuroma.
Author(s): Christensen HC, Schuz J, Kosteljanetz M, Poulsen HS, Thomsen J, Johansen
C.
Source: American Journal of Epidemiology. 2004 February 1; 159(3): 277-83.
/>bstract&list_uids=14742288


Studies

17

•

Cerebral salt wasting syndrome as a postoperative complication after surgical
resection of acoustic neuroma.
Author(s): Roca-Ribas F, Ninno JE, Gasperin A, Lucas M, Llubia C.
Source: Otology & Neurotology : Official Publication of the American Otological
Society, American Neurotology Society [and] European Academy of Otology and
Neurotology. 2002 November; 23(6): 992-5.
/>bstract&list_uids=12438868

•

Cerebro-spinal fluid leak after acoustic neuroma surgery.
Author(s): Sanna M, Falcioni M, Rohit.
Source: Otology & Neurotology : Official Publication of the American Otological
Society, American Neurotology Society [and] European Academy of Otology and
Neurotology. 2003 May; 24(3): 524.
/>bstract&list_uids=12806313

•

Cerebrospinal fluid leak after acoustic neuroma surgery: a comparison of the
translabyrinthine, middle fossa, and retrosigmoid approaches.
Author(s): Becker SS, Jackler RK, Pitts LH.
Source: Otology & Neurotology : Official Publication of the American Otological
Society, American Neurotology Society [and] European Academy of Otology and
Neurotology. 2003 January; 24(1): 107-12.

/>bstract&list_uids=12544038

•

Cerebrospinal fluid leak after acoustic neuroma surgery: influence of tumor size and
surgical approach on incidence and response to treatment.
Author(s): Brennan JW, Rowed DW, Nedzelski JM, Chen JM.
Source: Journal of Neurosurgery. 2001 February; 94(2): 217-23.
/>bstract&list_uids=11213957

•

Cerebrospinal fluid loss and threshold changes. 1. Hearing loss in the contralateral
ear after operation for acoustic neuroma: an analysis of the incidence, time course,
frequency range, size and pathophysiological considerations.
Author(s): Walsted A, Salomon G, Thomsen J, Tos M.
Source: Audiology & Neuro-Otology. 1996 September-October; 1(5): 247-55.
/>bstract&list_uids=9390806

•

Chronic otitis media masking coexistent acoustic neuroma.
Author(s): d'Ecclesia A, Contucci A, Di Girolamo S, Meglio M, Paludetti G.
Source: The Journal of Otolaryngology. 2002 February; 31(1): 49-52.
/>bstract&list_uids=11881773