<prompt> Acoustic neuroma causes ?Cochlear deafnessRetrocochlear deafnessConductive deafnessNone of the above  <response>: The clinical features depend on the extent of tumor and involved structure :? 1 When tumor is still confined to the internal auditory canal Cochleovestibular symptoms are the earliest symptoms of acoustic neuroma when tumour is still confined to internal auditory canal. The commonest presenting symptoms are unilateral deafness or tinnitus, or a combination of both. Hearing loss is retrocochlear sensorineural type. There is marked difficulty in understanding speech, out of propoion to the pure tone hearing loss, a characteristic feature of acoustic neuroma. Vestibular symptoms are imbalance or unsteadiness. True veigo is very rare. 2 When tumor extends beyond IAC and involves other structures Vthcranial nerve :- It is the earliest nerve to be involved. There is reduced corneal sensitivity and loss of corneal reflex which is the earliest sign of acoustic neuroma. Numbness or paresthesia of face may occur. Involvement of Vth nerve indicates that tumor is roughly 2.5 cm in diameter and occupies the CP angle. VIP nerve :- Sensory fibres of facial nerve are involved. There is hypoesthesia of posterior meatal wall Hitzelbergs sign, loss of taste, and loss of lacrimation on Schirmers test. Motor fibres are more resistant. IXth and Xth nerves :- Dysphagia and hoarseness due to palatal, pharyngeal and laryngeal paralysis. Brainstem :- Ataxia, weakness, numbness of arms legs, exaggerated tendon reflexes. Cerebellum :- Ataxia, Dysdiadochokinesia, Nystagmus. Due to raised ICT :- Headache, neusea, vomiting, diplopia due to VI nerve involvement, and papilloedema. 