PDF herunterladen
CC BY 4.0 · J Neurol Surg Rep 2025; 86(01): e24-e30
DOI: 10.1055/a-2516-7311
Case Report

Complete Hearing Recovery after Retrosigmoid Resection of Jugular Foramen Schwannoma with Concurrent Ipsilateral Vestibular Schwannoma

Achilles A. Kanaris 
1   Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
Nicholas E.F. Hac
2   Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
Stephen T. Magill
3   Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
Kevin Y. Zhan
4   Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Introduction Cerebellopontine angle (CPA) tumors frequently present with hearing loss, which influences whether a hearing-preservation versus hearing ablative surgical approach is chosen. We discuss a case of complete hearing recovery after resection of a jugular foramen schwannoma (JFS) in a patient who also had a small intracanalicular vestibular schwannoma (VS).

Case A 46-year-old woman presented with left ear fullness, tinnitus, and imbalance for 9 months. She had no lower cranial nerve dysfunction. Audiometry demonstrated Class D hearing with 4% word recognition on the left. Vestibular testing showed absent caloric response on the left and subtle central findings. Magnetic resonance imaging demonstrated a left 3.3-cm JFS and separate left 1-cm intracanalicular VS. A retrosigmoid approach was performed for a radical subtotal resection of the JFS, relieving the mass effect on the vestibulocochlear nerve. The small intracanalicular VS was not manipulated. Pathology confirmed schwannoma with neurofibromatosis type 2 (NF2) mutation in the tumor but normal NF2 germline. Postoperative audiometry at 6 weeks showed normal audiometric thresholds with 100% discrimination. Subtle left caloric response was noted on postoperative vestibular testing and central oculomotor findings improved.

Discussion The presented case describes the management of concurrent ipsilateral VS and JFS in the absence of NF2 and demonstrates a unique complete and rapid recovery of hearing following JFS resection without manipulation of concurrent VS. This case supports the use of a hearing-preservation approach in similar cases and corroborates previous reports of hearing recovery following resection of non-VS CPA tumors with hearing-preservation approaches.

Keywords

hearing recovery - hearing return - retrosigmoid - jugular foramen schwannoma


Publikationsverlauf

Eingereicht: 23. Oktober 2024

Angenommen: 27. Dezember 2024

Accepted Manuscript online:
15. Januar 2025

Artikel online veröffentlicht:
06. Februar 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Samii M, Gerganov VM. Tumors of the cerebellopontine angle. Handb Clin Neurol 2012; 105: 633-639
    CrossrefPubMedSuche in Google Scholar
  • 2 Zamani AA. Cerebellopontine angle tumors: role of magnetic resonance imaging. Top Magn Reson Imaging 2000; 11 (02) 98-107
    CrossrefPubMedSuche in Google Scholar
  • 3 Moffat DA, Ballagh RH. Rare tumours of the cerebellopontine angle. Clin Oncol (R Coll Radiol) 1995; 7 (01) 28-41
    CrossrefPubMedSuche in Google Scholar
  • 4 Samii M, Babu RP, Tatagiba M, Sepehrnia A. Surgical treatment of jugular foramen schwannomas. J Neurosurg 1995; 82 (06) 924-932
    CrossrefPubMedSuche in Google Scholar
  • 5 Dale AJD. The cerebellopontine angle syndrome. Med Clin North Am 1968; 52 (04) 789-795
    CrossrefPubMedSuche in Google Scholar
  • 6 Brooks KA, Vivas EX. Natural history of hearing loss in sporadic vestibular schwannoma. Otolaryngol Clin North Am 2023; 56 (03) 435-444
    CrossrefPubMedSuche in Google Scholar
  • 7 Bakar B. The jugular foramen schwannomas: review of the large surgical series. J Korean Neurosurg Soc 2008; 44 (05) 285-294
    CrossrefPubMedSuche in Google Scholar
  • 8 Aftahy AK, Groll M, Barz M. et al. Surgical management of jugular foramen schwannomas. Cancers (Basel) 2021; 13 (16) 4218
    CrossrefPubMedSuche in Google Scholar
  • 9 Wilson MA, Hillman TA, Wiggins RH, Shelton C. Jugular foramen schwannomas: diagnosis, management, and outcomes. Laryngoscope 2005; 115 (08) 1486-1492
    CrossrefPubMedSuche in Google Scholar
  • 10 Samii M, Alimohamadi M, Gerganov V. Surgical treatment of jugular foramen schwannoma: surgical treatment based on a new classification. Neurosurgery 2015; 77 (03) 424-432 , discussion 432
    CrossrefPubMedSuche in Google Scholar
  • 11 Carlson ML, Link MJ, Wanna GB, Driscoll CLW. Management of sporadic vestibular schwannoma. Otolaryngol Clin North Am 2015; 48 (03) 407-422
    CrossrefPubMedSuche in Google Scholar
  • 12 Arriaga MA, Lin J. Translabyrinthine approach: indications, techniques, and results. Otolaryngol Clin North Am 2012; 45 (02) 399-415 , ix
    CrossrefPubMedSuche in Google Scholar
  • 13 Kai S, Wei J, Suojun Z. et al. The concomitant occurrence of schwannoma and meningioma mimicking unilateral solitary cerebellopontine angle mass. Clin Neurol Neurosurg 2012; 114 (09) 1277-1279
    CrossrefPubMedSuche in Google Scholar
  • 14 Graffeo CS, Perry A, Copeland III WR. et al. Synchronous tumors of the cerebellopontine angle. World Neurosurg 2017; 98: 632-643
    CrossrefPubMedSuche in Google Scholar
  • 15 Fransen P, Dozier C, Detribolet N. Kissing neurinomas of the vestibular and vagal nerves. J Clin Neurosci 1996; 3 (04) 379-381
    CrossrefPubMedSuche in Google Scholar
  • 16 Christiansen CB, Greisen O. Reversible hearing loss in tumours of the cerebello-pontine angle. J Laryngol Otol 1975; 89 (11) 1161-1164
    CrossrefPubMedSuche in Google Scholar
  • 17 Vellutini EAS, Cruz OLM, Velasco OP, Miniti A, Almeida GM. Reversible hearing loss from cerebellopontine angle tumors. Neurosurgery 1991; 28 (02) 310-312 , discussion 312–313
    CrossrefPubMedSuche in Google Scholar
  • 18 Francis CC, Kanaya K, Murase H, Hardian RF, Horiuchi T, Ohaegbulam SC. Unexpected recovery from complete deafness to normal hearing post surgical excision of a cerebellopontine angle meningioma: a case report. Surg Neurol Int 2023; 14: 174
    CrossrefPubMedSuche in Google Scholar
  • 19 Neely JG. Reversible compression neuropathy of the eighth cranial nerve from a large jugular foramen schwannoma. Arch Otolaryngol 1979; 105 (09) 555-560
    CrossrefPubMedSuche in Google Scholar
  • 20 Wang S-J, Hsu W-C, Young Y-H. Reversible cochleo-vestibular deficits in two cases of jugular foramen tumor after surgery. Eur Arch Otorhinolaryngol 2004; 261 (05) 247-250
    CrossrefPubMedSuche in Google Scholar
  • 21 Bauman MMJ, Nassiri AM, Driscoll CL, Link MJ. Full recovery of hearing after resection of a large epidermoid tumor at the cerebellopontine angle: 2-dimensional operative video. Oper Neurosurg (Hagerstown) 2024; 27 (05) 672
    CrossrefPubMedSuche in Google Scholar
  • 22 Katsuta T, Inoue T, Uda K, Masuda A. Hearing restoration from deafness after resection of a large cerebellopontine angle meningioma–case report. Neurol Med Chir (Tokyo) 2001; 41 (07) 352-355
    CrossrefPubMedSuche in Google Scholar
  • 23 Monobe H, Morita A, Murofushi T. Remarkable restoration of speech discrimination after removal of jugular foramen schwannoma: a case report. Eur Arch Otorhinolaryngol 2002; 259 (03) 170-171
    CrossrefPubMedSuche in Google Scholar
  • 24 Lekovic GP, Gonzalez LF, Weisskopf P, Smith KA. Hearing improvement after resection of a large jugular foramen schwannoma: case report. Skull Base 2008; 18 (03) 195-199
    Thieme ConnectPubMedSuche in Google Scholar
  • 25 Kadri PA, Al-Mefty O. Surgical treatment of dumbbell-shaped jugular foramen schwannomas. Neurosurg Focus 2004; 17 (02) E9
    CrossrefPubMedSuche in Google Scholar
  • 26 Jammal H. Jugular foramen schwannomas. In: Kountakis SE. ed. Encyclopedia of Otolaryngology, Head and Neck Surgery. Springer Berlin Heidelberg;; 2013: 1397-1404
    Suche in Google Scholar