A 58-year-old man complains of tinnitus that is loudest in his right ear and a decreased sense of taste in the anterior portion of his tongue. His symptoms have become progressively worse during the past 6 months. His physical examination is within normal limits. Which of the following is the most likely diagnosis?
A) Acoustic neuroma
B) Lacunar stroke in the internal capsule
C) Lesion in the caudal medulla
D) Lesion in the mesencephalic tegmentum
E) Lesion in the tectum

Question

Quizplus · Accepted Answer

Acoustic neuroma, also known as vestibular schwannoma, is a benign tumor that arises from the Schwann cells covering the vestibulocochlear nerve (cranial nerve VIII). It can cause symptoms such as tinnitus and hearing loss, primarily affecting one ear. The decreased sense of taste in the anterior portion of the tongue could be related to involvement of the nearby facial nerve (cranial nerve VII), which is responsible for taste sensation in the anterior two-thirds of the tongue. The progressive nature of the symptoms and the specific combination of tinnitus and taste disturbance make acoustic neuroma the most likely diagnosis.

A 58-Year-Old Man Complains of Tinnitus That Is Loudest in His