Diagnosis of Acoustic Neuroma through Telemedicine

A 65-year-old male individual presented to an electronic urban primary health center with complaints of impaired hearing in the left ear, loss of sensations on the left side of the face, loss of sensation of taste of the left side of the tongue, and tingling and numbness of the left side of the face for 2 months. He had a history of diabetes for 8 years and hypertension for 5 years and on regular medication. The patient was completely evaluated by the medical officer and referred to a general medicine doctor for teleconsultation. The general medicine specialist had clinical evaluation, and after detailed discussion with the medical officer, he was referred to a neurosurgeon for further evaluation and management to Guntur Medical College. He had evaluated the client and recommended magnetic resonance imaging scans, and imaging revealed an extra-axial cerebellopontine angle solid mass lesion of size 3 cm × 2 cm with cystic component, arising from the left internal auditory canal causing mass effect on the middle cerebellar peduncle, suggestive of left acoustic neuroma without mass effect. He had specialized radiation therapy of 30 fractions of 25 gray in 5 cycles from July 20 to August 5, 2019, currently on regular medication for diabetes and hypertension and Vitamin B12 supplements, and follow-up scheduled in July 2020.