In a patient with acoustic neuroma, all are seen except –
**Core Concept**
Acoustic neuroma, also known as vestibular schwannoma, is a benign tumor that arises from the Schwann cells of the vestibular nerve in the internal auditory canal. This tumor can cause a variety of symptoms due to compression of adjacent structures, including the facial nerve, trigeminal nerve, and cerebellum.
**Why the Correct Answer is Right**
The correct answer is associated with the typical presentation of acoustic neuroma, which often involves symptoms related to the vestibular nerve, such as unilateral hearing loss, tinnitus, and imbalance. The tumor can also cause facial weakness due to compression of the facial nerve, which is located in close proximity to the vestibular nerve. Additionally, patients may experience trigeminal neuralgia due to compression of the trigeminal nerve.
**Why Each Wrong Option is Incorrect**
**Option A:** Trigeminal neuralgia is actually a common symptom of acoustic neuroma, so this option is incorrect.
**Option B:** Hearing loss is a common symptom of acoustic neuroma, so this option is incorrect.
**Option C:** Facial weakness is also a common symptom of acoustic neuroma, so this option is incorrect.
**Clinical Pearl / High-Yield Fact**
A patient with acoustic neuroma may also experience cerebellar symptoms such as ataxia and dysarthria due to compression of the cerebellum. This is because the acoustic neuroma can grow to occupy space in the internal auditory canal and compress adjacent structures.
**Correct Answer:** D.