Which statement best describes the common presenting features of acoustic neurinoma?

• A. Bilateral conductive hearing loss with normal sensorineural function
• B. Progressive unilateral sensorineural hearing loss, tinnitus, dizziness; facial numbness may occur later
• C. Sudden complete vision loss
• D. Chronic headaches with scalp tenderness

Answer: (B)

Acoustic neurinoma (vestibular schwannoma) involves the vestibulocochlear nerve (CN VIII), so the first clues are related to hearing and balance on the affected side. The common presentation is a gradual, progressive unilateral sensorineural hearing loss accompanied by tinnitus. Dizziness or disequilibrium from vestibular involvement is also typical. As the tumor enlarges, it may extend to nearby structures such as the facial nerve, leading to facial numbness or weakness later in the course. Vision loss and scalp-tender headaches aren’t characteristic features of this tumor, which helps distinguish it from other conditions.