What is a typical feature of Acoustic Neuroma?

• A. High-frequency hearing loss with poor speech discrimination
• B. Conductive hearing loss
• C. No vertigo
• D. Rapid full hearing recovery

Answer: (A)

Acoustic neuroma involves the vestibulocochlear nerve, and its typical presentation is unilateral sensorineural hearing loss that progresses over time. The key pattern clinicians look for is high-frequency hearing loss with disproportionately poor speech discrimination. This happens because neural damage from the tumor affects the auditory nerve fibers, especially the high-frequency ones at the base of the cochlea, so pure-tone thresholds may not tell the full story—speech understanding becomes worse than expected for the measured thresholds.

Other features can include tinnitus and imbalance, since the vestibular part of the nerve is also involved, though vertigo isn’t required. Conductive hearing loss points to middle-ear problems rather than a nerve tumor. Rapid full hearing recovery would be unusual, as the tumor does not spontaneously reverse and hearing loss tends to be progressive or stable rather than suddenly resolved.