Acoustic Neuroma Diagnosis: External Auditory Canal Hypesthesia as an Early Sign

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Abstract
PATIENTS presenting with a unilateral sensorineural hearing impairment and a vestibular disturbance are common in otologic practice. It is essential to determine whether the lesion causing this disturbance is centered in the end organ or in the eighth nerve. The facial nerve passes through the internal auditory canal with the vestibular and cochlear nerves. If a deficit in the function of the facial nerve can be established, the anatomic site of the lesion is localized to the internal auditory canal. Quantitation of vestibular and cochlear nerve function has become rather sophisticated, whereas the evaluation of the facial nerve still remains relatively rudimentary.1,2 The purpose of this paper is to demonstrate hypesthesia in the cutaneous area of the facial nerve as an early sign of acoustic neuroma. Sensory Distribution of the Seventh Nerve In 1907, Ramsey Hunt pointed out the cutaneous sensory components of the seventh cranial nerve apart from

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