BILATERAL ACOUSTIC NEUROMAS

This article reviews 12 patients with bilateral acoustic neuromas. The sex incidence was equal and the mean age at diagnosis was 26.2 years. The family history was positive in nine of the patients. Five patient s have had incomplete surgical removal of acoustic neuromas on both si des. Two of them are completely deaf and the other three have severe s ensorineural hearing loss in one ear and no hearing in the other ear. In five patients the tumour on one side has been operated on and the o ther side is being observed with at least short-term preservation of g ood hearing. The remaining two patients died of intra-cranial complica tions, one of them post-operatively. Four patients developed facial pa lsy immediately following surgery and one developed facial weakness 6 months after surgery. Guidelines are discussed for the care of these p atients including the timing of surgery and alternative treatment opti ons (observation, radio-surgery and chemotherapy). This is essentially a group of young individuals who have had multiple operations for bil ateral acoustic tumours and associated manifestations and for whom the disease and the sequelae of treatment can be tragic.