The classic triad, in order of frequency: 1. Progressive unilateral sensorineural hearing loss — the presenting symptom in most cases. Gradual over months to years, though about one in ten present suddenly. Characteristically speech discrimination is worse than the pure-tone thresholds predict: patients say the phone is useless on that side even though they can hear tones. This retrocochlear pattern is a meaningful clue. 2. Unilateral tinnitus — often the symptom that finally brings the patient in. 3. Imbalance or unsteadiness — vague, continuous, worse in the dark or on uneven ground. Not discrete attacks of rotational vertigo. As the tumour enlarges: - Facial numbness, tingling or a reduced corneal reflex (CN V) — the corneal reflex is often the earliest objective sign of a larger tumour and is easily missed unless deliberately tested. - Facial weakness (CN VII) — a late feature; the facial nerve tolerates slow compression well. Early or rapid facial weakness suggests an alternative diagnosis, such as a facial nerve schwannoma or malignancy, and warrants prompt review. - Facial twitching or spasm. - Ataxia, dysmetria, wide-based...