The prevalence of "incidental" acoustic neuroma

Objective: To estimate the prevalence of "incidental" acoustic neuromas (ANs) in the population at large. Design: An intracranial magnetic resonance imaging (MRI) database of 46414 patients presenting to the University of California, San Francisco (UCSF), without known audiovestibular complaints was searched retrospectively from July 1995 to February 2003. Seventy percent of these MRIs included gadolinium, and none was specifically targeted through the internal auditory canal. A medical chart review of 688 patients with acoustic neuromas presenting to UCSF between 1980 and 1999 was searched for sex distribution. Setting: Tertiary care university medical center Results: Eight patients with incidental AN were discovered. This figure suggests that undiagnosed ANs may be present in at least 0.02% of the population. Three patients were found to have audiovestibular symptoms on inquiry after diagnosis. Audiometry revealed asymmetry at 4 kHz in only 3 of 7 patients, with an otherwise symmetric audiogram in the remaining patients. Tumor size in this population ranged from 3 to 28 mm. Incidental ANs were more common in men, but ANs were more common in women overall. Conclusions: The prevalence of incidental AN appears to be roughly 2 in 10000 people. This figure indicates that AN may be less prevalent than suggested in previously reported temporal bone studies and more prevalent than suggested by epidemiologic studies.