The earliest symptom of acoustic nerve tumour is
**Core Concept**
Acoustic nerve tumors, also known as vestibular schwannomas, are benign growths that arise from the Schwann cells of the vestibulocochlear nerve (cranial nerve VIII). These tumors can cause a variety of symptoms due to their slow growth and compression of surrounding structures.
**Why the Correct Answer is Right**
The earliest symptom of acoustic nerve tumor is typically **tinnitus**, which is a subjective sensation of noise or ringing in the ear. This is due to the compression of the cochlear nerve fibers by the tumor, leading to abnormal electrical discharges in the auditory pathway. Tinnitus is often described as a hissing, roaring, or ringing sound and can be unilateral or bilateral. In the early stages, patients may not experience any significant hearing loss or other symptoms.
**Why Each Wrong Option is Incorrect**
* **Option A:** Hearing loss is a common symptom of acoustic nerve tumors, but it is not typically the earliest symptom.
* **Option B:** Vertigo is another symptom of acoustic nerve tumors, but it is usually a later manifestation of the disease.
* **Option D:** Facial weakness is not a typical symptom of acoustic nerve tumors, as the facial nerve is not directly affected by the tumor.
**Clinical Pearl / High-Yield Fact**
The earliest symptom of acoustic nerve tumor is often a subtle one, and patients may initially attribute it to normal fluctuations in hearing or earwax buildup. It's essential to take a thorough history and perform a detailed physical examination to diagnose this condition early.
**Correct Answer:** C. Tinnitus.