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

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.

• Authors: P J Dawes, H E Basiouny
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 113 Issue 9 Pg. 818-22 (Sep 1999) ISSN: 0022-2151 [Print] England
• PMID: 10664684 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Costs and Cost Analysis
• Databases, Factual
• Female
• Humans
• Magnetic Resonance Imaging (economics)
• Male
• Middle Aged
• Neuroma, Acoustic (complications, diagnosis)
• Patient Selection
• Predictive Value of Tests
• Tinnitus (etiology)