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Acoustic Neuroma B057

Last amended 
14 October 2019
Current RMA Instruments
Reasonable Hypothesis96 of 2019
Balance of Probabilities97 of 2019
Changes from previous Instruments

SOP bulletin 211

ICD Coding
  • ICD-9-CM Codes: 225.1
  • CD-10-AM Codes: D33.3
Brief description

An acoustic neuroma is a benign tumour affecting the vestibular or cochlear nerve to the ear.

Confirming the diagnosis

The diagnosis is suggested by an otherwise unexplained asymmetric hearing loss and may be further pointed to by brainstem-evoked response audiometry.  Confirmation of diagnosis typically requires a CT or MRI scan of the brain.  Histology is generally only obtained at the time of surgical removal and is not required for diagnosis.

The relevant medical specialist is an ENT surgeon.

Additional diagnoses covered by SOP
  • Vestibular schwannoma
Conditions not covered by SOP
  • Acoustic neuroma associated with neurofibromatosis#
  • Schwannomatosis#

# non-SOP condition

Clinical onset

The condition may present with asymmetrical (sensorineural) hearing loss or tinnitus, balance/vertigo symptoms, or occasionally with facial numbness or paralysis.  It may be found incidentally on imaging of the brain (CT or MRI) performed for another reason.

Clinical worsening

The only worsening factor is for inability to obtain appropriate clinical management.  The condition is slowly progressive without treatment. Treatment can consist of surgery, radiation therapy, or observation.  Long term control can be acheived with appropriate therapy.  Surgery may result in morbidity (hearing loss, vestibular symptoms, facial weakness).