[Intracochlear schwannoma : Tumor removal via subtotal cochleostomy and partial cochlear reconstruction with preservation of semicircular canal function. German version].

We report about a patient who in 2005, aged 37 years, experienced sudden mild to moderate, mid-frequency sensorineural hearing loss in the right ear along with tinnitus and mild dizziness. MRI of the temporal bone revealed a very small (1 mm) contrast-enhancing lesion in the second turn of the right cochlea. Hearing gradually deteriorated with complete hearing loss in 2015. At this time, an MRI scan showed a lesion completely filling the cochlea.The tumor was removed via transmeatal subtotal cochleostomy. The cochlea was partially reconstructed with cartilage and fascia. A cochlea implant dummy electrode was inserted as a placeholder in order to prevent complete fibrosis of the "neocochlea" during follow-up MRI examinations.Vestibular function tests 2 months postoperatively showed preserved caloric excitability and a normal vestibulo-ocular reflex (vHIT) in all three planes. The patient is free of vertigo.Intralabyrinthine schwannomas (ILS) are a rare differential diagnosis of sudden hearing loss, which should be specifically checked for in MRI. Surgical removal of an intracochlear ILS through partial or subtotal cochleostomycochleoectomy with preservation of vestibular function is possible in principle. PMID: 28477092 [PubMed - as supplied by publisher]
Source: HNO - Category: ENT & OMF Tags: HNO Source Type: research