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DOI: 10.1055/a-2516-7311
Complete Hearing Recovery after Retrosigmoid Resection of Jugular Foramen Schwannoma with Concurrent Ipsilateral Vestibular Schwannoma
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.
Publication History
Received: 23 October 2024
Accepted: 27 December 2024
Accepted Manuscript online:
15 January 2025
Article published online:
06 February 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
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