Preoperative speech and pure-tone audiometry in four types of patients with acoustic neuroma

Purpose: The goal of this study was to compare pure-tone and speech audiometry in 4 groups of patients with confirmed unilateral acoustic neuroma in which auditory brainstem responses and transient-evoked otoacoustic emissions were either both normal, abnormal, or one of the tests was abnormal. Material and Methods: This study was realized during a preoperative assessment of 65 patients (29 men, 36 women) from 25 to 78 years of age suffering from unilateral acoustic neuroma. The assessment, preceded by tympanometry, included recordings of auditory brainstem responses, transient-evoked otoacoustic emissions, pure-tone audiometry, speech recognition thresholds, and speech discrimination. Results: Some discrepancies between objective and behavioral test results were noticed. Subjects with no otoacoustic emissions but present auditory brainstem responses did not show any significant difference in their speech scores as compared with subjects with both auditory brainstem responses and otoacoustic emissions. Conclusions: In summary, this study showed that comparable audiometric findings in acoustic neuroma patients can be found regardless of the presence of transient otoacoustic emissions (TEOAEs). TEOAEs are a good screening tool and have been used, like auditory brainstem-evoked responses, as a predictive measure before hearing preservation procedures but cannot predict the audiogram or give information about speech perception. The findings confirm that even if auditory brainstem responses are an extremely useful diagnostic tool for identifying acoustic neuroma, this test provides only giving pieces of information regarding auditory abilities. Also, the pure-tone audiogram gives useful information but has to be used in conjunction with speech audiometry to get an accurate picture of the patient's true auditory abilities. (C) 2003 Elsevier Inc. All rights reserved.