Intracochlear swannomas represent a rare differential diagnosis of hearing loss. The
first symptom of intracochlear swannoma is usually asymmetric hearing loss. In the
film we report about a 48-year-old patient who complained about a sudden surdity of
the left side for 1 year; vertigo, tinnitus as well as otorrhoea and otalgia were
denied. Cranial magnetic resonance imaging (cMRI) showed a contrast-enhancing lesion
in the basal turn of the left cochlea.
Transcochlear resection of the intracochlear swannoma with simultaneous cochlear implantation
was performed. ECAP threshold measurements and EBERA with reproducible responses were
performed intraoperatively. Four weeks after initial fitting of the cochlear implant,
the patient was free of vertigo and already achieved audiologically useful results
(Freiburg speech audiometry at 65 dB: numbers 85%, monosyllable 60%; Oldenburg sentence
test (OLSA): at rest 91%, and an SNR of -1.0 dB in the adaptive test in noise).
The film illustrates the surgical removal of the intracochlear swannoma with simultaneous
cochlear implantation and intraoperative auditory monitoring for hearing rehabilitation.
