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Various tests and procedures
for Acoustic Neuroma patients

(bulleted text by AN patients)

Tests and Studies

The tests below are useful for monitoring your AN and its effects before treatment, and/or the treatment-related complications.  We also have a separate page about MRIs; they are the most important tests for AN patients to know about.

• On my 6 month follow-up [after Cyberknife] at California Ear Institute, I received pure tone, speech discrimination, typmpanometry and otoacoustic bone emissions test. 

The pure tone test is also known as the audiogram.  The following site explains how to read your audiogram: http://www.earinfo.com/howread1.html .

• The test that measured the degree of facial weakness is an ELECTRONEURONOGRAPHY.  This is a test of your facial nerves where the tester puts electrodes at several points of your face and then stimulates the facial nerve with electricity. The test measures the relative strength of the two facial nerves, left and right. This one is NOT fun, an uncomfortable procedure. The results of my test indicated a 68% weakness on the side of the tumor.  It is noted that 17% or greater is considered significant.

• I had a vestibular function test. In this warm and then cold air is blown into the bad then good ear. Afterwards I had to look at a spot on the ceiling while counting backwards from 200 in 7's.!! At the same time my eye movements were being monitored. I kept being asked "Are you feeling dizzy yet?" To which the answer was always no.  The test took almost an hour and afterwards I was completely exhausted. From the results they were confident that the tumour was growing on the balance portion of the nerve, and not the acoustic.

[There is another version of this test where they put a little balloon in your ear and fill it up alternately with cool and warm water and test how your eyes react. Both can make you queasy or tired, but are basically painless.]

• ABR or BSER (Auditory Brain Stem Evoked Response test). It's a brainstem-related hearing test where they put electrodes on your head and you listen to clicking noise for about 40 minutes, totally painless. They get a reading on how your brain is receiving these signals. Apparently, if there is a mass, such as an AN, it would show a particular pattern and you get a positive reading. Negative would mean that it is clear of any growth or other mass. There is debate as to the efficacy of this test in picking up AN's; MRI's are still the best way to go. Here's a hyperlink which describes ABR's: http://www.glanclwyd.demon.co.uk/audiology/pabrt.htm

• After my AN surgery, I endured many tests, some of which were neuropsychological tests, where I was diagnosed with a cognitive processing disorder.  The bottom line result was that I had lost a significant % of IQ and at least 10% of of my short term memory. That helped me to understand why I couldn't remember so many thing such as prior to discovery of the AN...

• Some of us have discovered post-surgery we have ulner nerve entrapment in our arm and that a nerve conduction study done by a neurologist can confirm that. It is from having our arm over our head during surgery. Our fingers are sometimes numb and tingly, but don't know about the leg symptoms.

• There is a vestibular symptom that is not uncommon with AN patients,  referred to as a Romberg Sign or Romberg test. It most commonly happens with feet together, standing erect, and eyes closed. You can start to fall backwards without even having the sensation of falling backwards.

• Facial symmetry has returned, but not full function...  Monthly biofeedback monitoring was especially beneficial to "see" progress on computer that I couldn't see visually in my face.

Procedures after surgery.

• I had a mastoidectomy to completely seal off the CSF leak.  I have been all but guaranteed that this will work. 

• MY FACE WAS LEFT PARALYZED ON THE ONE SIDE, AND EYE LEFT OPEN, I HAD TO TAPE IT SHUT... I WAS TOLD TO WAIT 2 YEARS TO SEE IF MY FACE NERVES REGENERATED -- NO SUCH LUCK! SO I FOUND A WONDERFUL PLASTIC SURGEON DR. IN MANHATTAN, N.Y. AND I FLEW UP THERE AND SPENT IN HOSPITAL ONE WEEK having reconstructive surgery on my face. HE SPLIT A NERVE IN MY TONGUE ON THAT SIDE, TUNNELED INTO MY CHEEK, FASTENTED TO MY FACIAL NERVE TO CLOSE MY EYE. THEN HE SPLIT THE MUSCLE IN MY JAW, TUNNELED IT INTO MY CHEEK, AND FASTENED TO FACE MUSCLES UP BY THE SIDE OF MY MOUTH -- LOOKS LIKE A DIMPLE.  

At first I had to touch my tongue against my teeth in front, or roof of mouth, to make my face move. My brain just does it normally now, it learned over the years.  I AM SO MUCH BETTER! NOT MANY PEOPLE CAN TELL IT. But I still have very dry eye, with no tears; I go to the Eye Doctor every 6 months for check ups on it.

• I am in the process of getting insurance approval for neurological facial therapy for reanimation.  I have already been evaluated by a facial therapist.  It helped a lot and I have been working on several muscles and they are starting to work.

• After my AN surgery I have some facial palsy and dry eye. In March my eye doctor performed a tarsormorphy. This involved stitching about one third of my top lid to the bottom lid. After a couple of months they took the stitch out and hey presto that part of the lid is sealed! When the nerves come back to functioning this can be undone so your eyes are symmetrical again. It has given me such comfort! I used to have to keep my eye closed with my hand because it dried out so fast but now I just help my eye blink every so often. I still use drops every 2 hours and tape the eye shut when I go out and when I go to bed but it really has helped considerably.

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Last Edited: Monday, November 17, 2003