[Auditory evaluation in the management of acoustic neurinoma].

OBJECTIVE

The hearing level is a major point to take into account for managing a patient with an acoustic neuroma. The Gardner-Robertson classification is the most frequently reported as well as the AAO-HNS classification. It combines the use of pure tone audiometry and speech audiometry. The goal of this study is to determine the effect of the level of presentation for the speech material and the effect of the type of list selected for the determination of the speech discrimination score.

METHODS

The speech determination score has been determined for 94 patients with different type of lists of 20 items: sentences, bi and monosyllabic words at two levels of presentation: at speech recognition threshold level plus 35dB and at the most comfortable level. The impact of the choice of the frequencies selected to determine the pure tone average, especially 3000Hz or 4000Hz has been also evaluated.

RESULTS

There is a statistical difference when the frequency 4000Hz is selected rather than 3000Hz in the determination of the pure tone average. The speech discrimation score obtained with the use of monosyllabic word lists is statistically different than those obtained with bisyllabic words.

CONCLUSION

To classify a patient's hearing whatever the classification, the speech discrimination score should be determined using monosyllabic word lists. Any other type of lists (sentences, spondees) leads to a significantly different score.