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DOI: 10.1055/s-2007-1016960
© Thieme Medical Publishers
Hearing Improvement after Resection of a Large Jugular Foramen Schwannoma: Case Report
Publication History
Publication Date:
07 January 2008 (online)
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ABSTRACT
Although hearing improvement after surgery for small tumors of the cerebellopontine angle has been reported, the mechanism by which surgery leads to the improvement in hearing remains controversial. We report a patient who sought treatment for progressive tinnitus and hearing loss. Magnetic resonance imaging showed a large (5-cm) schwannoma in the cerebellopontine angle. At surgery the lesion was found to originate from rootlets of cranial nerve X at the jugular foramen. The patient underwent gross total resection of the tumor. Immediately after surgery, his hearing improved dramatically. We believe that our patient represents an example of hearing impairment at least in part referable to direct compression of the brainstem. Importantly, the patient's hearing deficit was completely reversible. Some authors claim that surgery to preserve hearing may be contraindicated in patients with speech discrimination scores below 50%. However, when extrinsic brainstem compression may contribute to the cause of such a hearing decrement, postoperative improvement in hearing may be a reasonable expectation.
KEYWORDS
Jugular foramen schwannoma - hearing - retrosigmoid craniotomy - cerebellopontine angle
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Kris A SmithM.D.
c/o Neuroscience Publications, Barrow Neurological Institute
350 W. Thomas Road, Phoenix, AZ 85013
Email: neuropub@chw.edu