Based on a review of 123 consecutive examinations a classification of ten types of meatocisternograms is proposed. Surgical correlation in 53 of these cases has shown that other causes of intrameatal filling defects may mimic acoustic neurinoma presence. Furthermore, grouping of these 123 patients into three clinical groups on the basis of symptoms and findings has not resulted in a clear type correlation when using a mixture of the ethyl esters of 9- and 10- monoiodostearates (Duroliopaque). Based on an experience using this classification in well over 500 meatocisternograms, several proposals are made for the clinical management of cases of clear-cut or suspect acoustic neurinomas.