Rotterdam, Netherlands

When a patient is suspected of having retrocochlear pathology, several diagnostic procedures are available to detect acoustic neuromas. In a retrospective study we investigated the sensitivity of Brainstem Evoked Response Audiometry (BERA) in the detection of acoustic neuromas in 1132 patients being suspected of having CPA pathology. In 15 % the BERA was pathologic. In all these patients MR imaging was done. In 12 % of the patients with a normal BERA also MR imaging was performed. We found a sensitivity of 96 % and a specificity of 90 %.

In the early detection of acoustic neuromas a test with a high sensitivity ( i.e. few false-negative tests) is important. Both BERA and MRI have a high sensitivity. It is nowadays desirable to use the least expensive test. In our country MRI is more expensive than BERA. Therefore, in our hospital with approximately 500 new patients a year suspected of having CPA pathology, the sensitive and relatively cheap BERA is the first diagnostic test. When the BERA is pathologic a MRI is made