The earliest and most common presenting symptom of a vestibular schwannoma (acoustic neuroma) is:
- A Facial numbness (CN V involvement with large tumour)
- B Episodic vertigo indistinguishable from Meniere's disease
- C Unilateral slowly progressive sensorineural hearing loss, often with unilateral tinnitus ✓
- D Facial weakness indicating early CN VII compression
Explanation
Despite originating from the vestibular division of CN VIII, vestibular schwannoma most commonly presents with unilateral, progressive, high-frequency sensorineural hearing loss (~96%) and ipsilateral tinnitus — the cochlear nerve is compressed early. The slowly progressive nature and unilateral character distinguish it from other SNHL. ABR characteristically shows prolonged I-V interpeak latency. Vertigo is less common because slow tumour growth allows central vestibular compensation. Facial weakness is a late sign as CN VII remarkably tolerates progressive compression. All unilateral SNHL should prompt evaluation to exclude retrocochlear pathology.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.