What are the key clinical features that suggest a diagnosis of acoustic neuroma in a patient presenting with hearing loss?

When a patient presents with hearing loss, several key clinical features may suggest a diagnosis of acoustic neuroma, also known as vestibular schwannoma ¹. A common indicator is unilateral hearing loss, which can be progressive, sudden, or fluctuating ¹. This type of hearing loss is often associated with vestibular schwannoma due to the involvement of Schwann cells in the auditory nerve ¹ (Mohamed et al., 2023).

Beyond hearing loss, other symptoms that should raise suspicion include unilateral tinnitus, which is a ringing or buzzing sound in one ear ¹. Patients may also experience vestibular symptoms such as unsteadiness or balance problems, which are common given the tumor's origin on the vestibular nerve ¹. Less commonly, but still indicative, are other cranial nerve symptoms like facial numbness or weakness, or headaches ¹. Intralabyrinthine schwannomas, a specific type, can also present with hearing loss and other auditory symptoms (Curatoli et al., 2023).