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Three numb tongues, two MRIs and a gold weight in an eyelid: a case series of acoustic neuromas and their relevance to dental practice Robert JR Reilly Elizabeth Todd Kirstyn Donaldson Alex Crighton Dental Update 2024 50:1, 707-709.
Authors
Robert JRReilly
Clinical Lecturer and Honorary Registrar in Oral Medicine, University of Glasgow, MVLS, School of Medicine, Dentistry and Nursing. Department of Oral Medicine, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde
Acoustic neuromas are brain tumours originating from the Schwann cells of the vestibulocochlear nerve. As acoustic neuromas grow, the vestibulocochlear, facial and trigeminal nerves are often compressed, resulting in the common presenting complaints of hearing loss, balance disturbance, facial nerve weakness and altered sensation of the orofacial region. Thus, patients with an acoustic neuroma may present to the dentist with a range of problems. Herein we present three cases of acoustic neuroma that were diagnosed following presentation to the Glasgow Dental Hospital Oral Medicine Department and discuss the common clinical features, radiological findings and management options for acoustic neuromas.
CPD/Clinical Relevance: Dentists should be aware of the common presenting features of acoustic neuromas and when onward referral is indicated.
Article
Acoustic neuromas (AN), also known as vestibular schwannomas or cerebellopontine angle (CPA) tumours are benign tumours originating from the Schwann cells of the vestibulocochlear nerve (CN VIII) (Figure 1).1,2 Although usually benign, it must be noted that there are reports documenting de novo malignancy and malignant transformation.3 A 2010 study of 1621 patients showed an AN incidence rate of 1.1:100,000 with the average age of presentation 53 years, and no reported differences in laterality or affected sex.1 AN account for 8% of all intracranial tumours,4 with the majority of cases being unilateral, less than 5% present bilaterally.1 Bilateral AN is characteristic of neurofibromatosis type 2 (NF2), a genetic condition predisposing the patient to neural, cutaneous and ocular lesions,5 with 7% of AN cases presenting on a background of NF2.4 Other risk factors for AN development are poorly understood, but potentially include high-dose ionizing radiation, atopic disease, mobile phone use, and dental radiographs, although interestingly, tobacco has demonstrated an inverse relationship.6,7,8,9
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