Decision Analysis in Diagnosis of Small Acoustic Tumors
작은 청신경종양의 진단접근과정에 대한 연구
박, 기현; 전, 영명; 박, 홍준; 이, 동훈
Taehan Ibi Inhukwa Hakhoe chi, 42(1):22-28, 1999
Taehan Ibi Inhukwa Hakhoe chi; Journal of the Korean Otolaryngological Society; 대한이비인후과학회지
Background and Objectives: With great development that took place in the last 10 years in the imaging techniques such as MRI with gadolinium, small acoustic tumors can be detected before significant symptoms have developed. However,
acoustic neuroma is not easy at its earlier stage due to the lack of its characteristic symptoms. The detection rate of acoustic neuroma using traditional audiologic methods such as ABR and pure tone audiogram with speech discrimination score is
relatively low contrary to expectation. Therefore, there is a need to develop other methods of diagnosis at an earlier stage. the aim of this study was to review symptomatology, diagnostic approach and the management of acoustic neuroma and to
decision analysis tree of the diagnostic work-up. Materials and Methods: From June 1994 through May 1998, eight patients with a small acoustic neuroma were treated at Ajou University Hospital. We analysed these 8 patients by age, sex,
complaint, size of tumor, preoperative and postoperative audiologic studies, caloric test, treatment modalities and preoperative and postoperative imaging study. Results: Acoustic neuroma had variable symptoms, with the most common initial
symptom of our cases being sudden hearing loss. The sensitivity of ABR was relatively lower than we thought. Two out of three in the observation group showed an abrupt deterioration of hearing. Conclusion: When acoustic neuroma is
patients with unilateral hearing loss, tinnitus and dizziness are very important symptoms to consider. We developed a decision analysis tree for diagnosis of small acoustic neuroma, which should be treated with earlier intervention of MRI.
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