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The Sensitivity of Auditory Brainstem Response Testing for the Diagnosis of Acoustic Neuromas
Richard J. Schmidt, MD;
Robert T. Sataloff, MD, DMA;
Jason Newman, MD;
Joseph R. Spiegel, MD;
Donald L. Myers, MD
Arch Otolaryngol Head Neck Surg. 2001;127:19-22.
Objectives To determine the sensitivity of auditory brainstem response (ABR) testing
for detecting acoustic neuromas and to determine whether the test is less
sensitive for detecting small tumors.
Design Retrospective review of the medical charts of 58 patients with acoustic
neuroma who had all of the data necessary for inclusion in the study.
Setting University-affiliated referral practice of one neurotologist.
Patients Patients with acoustic neuromas who had both ABR tracings and magnetic
resonance imaging films available for review.
Main Outcome Measures Positive ABR and negative ABR results correlated with tumor size.
Results Tumor size ranged from 0.4 to 7 cm. The overall sensitivity of ABR in
diagnosing acoustic neuromas was 90%. However, ABR was progressively less
sensitive with decreasing tumor size. Only 7 (58%) of the 12 tumors 1 cm or
smaller were detected by ABR.
Conclusion Auditory brainstem response testing cannot be relied on for detection
of small acoustic neuromas and should not be used as a criterion to determine
whether magnetic resonance imaging should be performed when an acoustic neuroma
is suspected clinically.
From the Departments of Otolaryngology–Head and Neck Surgery
(Drs Schmidt, Sataloff, Newman, and Spiegel) and Neurosurgery (Dr Myers),
Thomas Jefferson University, Philadelphia, Pa.
Corresponding author and reprints: Robert T. Sataloff, MD, DMA, 1721
Pine St, Philadelphia, PA 19103.
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