Audiological examinations are vital in the diagnosis of acoustic neuroma. In interpreting their results, however, it is necessary to consider the patient's hearing level. The most sensitive audiological examination is auditory brain stem response (ABR) audiometry. Its most useful parameter is the IT5. A U-shaped audiometric configuration suggests AN, since it is seen in 10% of patients with small tumors. Psychological audiometric tests can be excluded from the battery of screening tests since they have low rates of positive diagnosis. The stapedius reflex (SR) test also has a low positive diagnostic rate in cases of small tumors. Even with the parameters of absence of reflex, elevated threshold, and decay combined, the overall SR test has a lower positive diagnostic rate than ABR audiometry. Nevertheless, the SR test can be employed as a screening device in cases in which the hearing level at 2 kHz and lower is 70 dB or lower, even if it is 71 dB or higher at 4 kHz and 8 kHz. At present, ABR audiometry is applicable in only about half of AN cases. Therefore, the need for early diagnosis must be further emphasized.
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