Auditory brainstem response testing in acoustic neuroma diagnosis

In the past year, there was a lack of published papers on using auditory brainstem responses for acoustic tumor diagnosis. This lack is probably caused by the large number of published studies demonstrating that standard auditory brainstem response measures frequently fail to detect small (≤ 1 cm) acoustic tumors. This article reviews (1) the current opinion that auditory brainstem responses cannot be used to diagnose or screen for small tumors, (2) the use of MRI for screening despite some drawbacks, (3) a hypothesis for the inadequacy of standard auditory brainstem response measures, and (4) a new measure, the stacked auditory brainstem response, that may provide the needed sensitivity for small tumor screening. It is conclusive that standard auditory brainstem response measures are inadequate for small tumor detection, but it is premature to conclude that other new auditory brainstem response measures, such as the stacked auditory brainstem response, cannot be used to screen effectively and play an important role in acoustic tumor diagnosis.