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Case report
Acoustic neuroma with orofacial paresthesia: description of an atypical presentation
  1. Chee Chean Lim1,
  2. Khairunnisak Misron2,
  3. Yew Toong Liew1 and
  4. Eugene Hung Chih Wong3
  1. 1Department of Otorhinolaryngology-Head and Neck Surgery, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
  2. 2Otorhinolaryngology-Head and Neck Surgery, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia
  3. 3Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
  1. Correspondence to Dr Eugene Hung Chih Wong; eugene.wong.hc{at}


Acoustic neuroma (AN) usually manifests with asymmetric hearing loss, tinnitus, dizziness and sense of disequilibrium. About 10% of patients complain of atypical symptoms, which include facial numbness or pain and sudden onset of hearing loss. Patients with atypical symptoms also tend to have larger tumours due to the delay in investigation. We report a particularly interesting case of a patient presented to us with numbness over her right hemifacial region after a dental procedure without significant acoustic and vestibular symptoms. Physical examination and pure tone audiometry revealed no significant findings but further imaging revealed a cerebellopontine angle mass. The changing trends with easier access to further imaging indicate that the presentation of patients with AN are also changing. Atypical symptoms which are persistent should raise clinical suspicion of this pathology among clinicians.

  • Ear, nose and throat
  • Ear, nose and throat/otolaryngology
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  • Contributors CCL: data collection, literature review and writing up. YTL: literature review, writing up and editing. KM: literature review and data collection. EHCW: literature review and final editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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