Can an MRI miss an acoustic neuroma?

[ScoobyDoo]

Well, thanks everyone, for your kind words.  I guess at this point I'll put it down as a 0 cm AN, subject to revision. 

My audiologist, without actually saying so much, seems pretty assured that this is what the problem is.  He said any one of my current symptoms alone would necessitate a visit to the ENT for an MRI, all of them together, well, it's imperative.  I think what caught him most was the dramatic change in my audiogram since October 2005.  There's a substantial drop all across the spectrum, with the largest in the high frequency range.  And all this with the left ear humming away perfectly.  No, uh, sorry, it's the right ear that hums.  The left ear is pretty well behaved, just sitting there listening.  The really strange thing was the bone conduction test.  Every time she put a tone into my right ear, I heard it on my left side.  And I must admit, I felt kinda funny sitting there when the test was going to start in the right ear, and I'm thinking "Ok, well, let's get it started."  Apparently she had started it, I just didn't realize it. 

I must admit it's somewhat concerning me right now.  I felt suspicious that I had one back in 2005 but was relieved when I didn't.  I don't want to say that I know it's there, because I don't want to come across with doom and gloom.  It's just that there's something pretty wrong going on in my right ear, and it's getting considerably worse with time.  I'm wondering what else it could be?  I guess the most important thing is that I really would like an answer to "what's going on"?  Maybe it's that M&M that I put in my ear to see if it would melt.  Or it could be that microwave that I repaired myself.  I thought all of these safety gadgets were stupid.  Guess it would be ok if I hadn't kept watching the food cook?  Or maybe I shouldn't have boosted my cell phone to 300 Watts.

Well, time will tell.  The hardest part is the waiting.  I'd rather just hear one way or another, good or bad, so I know and then can deal with it.

[Tumbleweed]

Scoobydoo:

It sounds like your new audiologist is on top of things. As for your question about what else might be causing these symptoms, theoretically there are two other possibilities that come to mind (with the caveat that I'm no doctor!):
1. canicular dehissence (a split in the IAC along structural lines)
2. vascular compression (blood flow being restricted to the affected ear for some reason)

I have no reason to believe either one of these things is happening to you. But since you asked what else it could be besides an AN...

Hopefully it'll just turn out to be one of those unexplained things that don't require treatment, under the broad banner of sensorineural hearing loss. Please let us know what you find out.

Best wishes,
Tumbleweed

[ppearl214]

Hi Scooby and tickled things are under control.   Please keep us updated as to the MRI (make sure with contrast, ok? ) and keeping fingers crossed that it's not an AN and something that is very easily manageable for you.

Hang in there... will look for the updates.
Phyl

[Crickett]

As the others have said, get another MRI, to be sure.  But, I lost my hearing due to no reason at all and my audiograms look similar to yours.  I want to blame it on something, and since the doctors have no idea, I guess it was a virus that hit me and settled on destroying my auditory nerve (better than my heart!).  This may also have happened to you.  But rule out anything you can.  The cost of an MRI is nothing compared to peace of mind.

[ScoobyDoo]

I have an appointment with my family dr. on March 9th (earliest I could get in).  From there I get the referral to the ENT for the MRI.  Looks like I have to be patient, it may take a while.

[ScoobyDoo]

Hi, everyone.

Thought I'd just post an update.  Not a lot going on with me, but certainly many having surgery and my best goes out to everyone!

I had my appointment with the family doctor.  He seemed a bit put out that the audiologist had recommended that I be tested for possible "retrocochlear involvement".  He said that since I had an MRI in 2005 there is no need for another one.  He thinks that it's either due to the acoustic trauma or a meniere's-type loss.  However, it's a high-frequency loss without vertigo and the hearing loss does not fluctuate.  He did refer me to an ENT and I called the ENT office today to see if they had an appointment date for me.  They say that the earliest I can see the ENT is September, so it looks like I'll just have to wait over the summer.

When the MRI (without contrast) was done in 2005 and it came back negative, it was put down to acoustic trauma (air horn blast) that I received around 1994.  Since then I came across a note about a hearing test I had done in 1999.  I had forgotten all about it up until this point.  Although I don't have a copy of it (and I called their office but they don't keep reports that long), I had written down that I had good bilateral hearing and there was no need for a hearing aid.  In 2005 I had significant unilateral hearing loss and in 2009 I have a profound hearing loss in that same ear.

Does anyone know how a loud blast affects your ears long term?  At 6' in front of the air horn, the sound measures 116.6 dB.  I was about that distance.  Would I have normal hearing 5 years later, and then 5 years after that have severe hearing loss, and then 5 years later a profound hearing loss?

I find this all very confusing.  Unfortunately, nobody (as in doctors) has been able to give me a real cause for the loss, and I would like to know if there is anything that can be done before my hearing is completely gone in my right ear.

[nancyann]

hey Scooby:  The only thing that sounds similar to me is my older brother having hearing problems in both ears due to his attending so many concerts in the '60's & 70's.
The loudness was incredible back then, especially if you were close to the speakers (he's 56 y.o.).  No AN, just hearing loss, more so than my oldest brother.

Always good thoughts,  Nancy

[Tumbleweed]

ScoobyDoo:

Hearing loss from exposure to very loud noise happens quickly. The delicate hair cells that transduce sound get damaged. I'm not aware of any delayed reaction. Hearing may recover slightly and stabilize, but progressive hearing loss cannot, to my knowledge, be explained by a single exposure to loud noise.

Best,
TW

[QRM]

When I lost my hearing 10 years ago I had a MRI  (without contrast) and that came up negative. The folks at HEI reckons, based to my size of tumour, that hearing loss a decade ago was when the tumour started and the MRI and Docs missed it.

Like everyone said hearing loss can be caused by a hundred and one things, but in answer to this post question, it looks like you can miss an AN with a MRI.

[DLM4me]

I know I'm jumping in really late, and I'll admit straight off that I have not read the whole thread, but I just wanted to throw my experience into the mix.

Six years ago I started having episodes of losing my balance.  My hearing was perfectly normal at that time.  The balance issue was a problem, though, so my primary doctor ordered a brain MRI with contrast.  NOTHING showed up.  Between then and now I've fallen three times--and I broke bones each time I fell.   Only now, six years later, did we finally get a diagnosis following another MRI w/contrast: It's an acoustic neuroma.  Based on its current size, we can backdate it to exactly around the time I started losing my balance.  What I've learned recently is that ANs may not show up on MRI when they're very small.  Because I had already had an MRI w/contrast, which showed nothing, no one thought it was justified to do another one in the interim.  So, to answer your question, yes, it's definitely possible for an MRI, even with contrast, to miss an early AN.