[Intracochlear schwannoma as a cause of a deafness: a case report]

Inner ear extension caused by schwannomas, which can cause hearing loss, tinnitus and vertigo, is an extremely rare finding. We report a male patient who presented with progressive hearing loss as well as tinnitus in the right ear. Despite rheologic infusion therapy with glucocorticosteroids at another hospital, the patient showed an explicit hearing loss and vertigo related to the right ear. In the pure tone audiogram, we found complete deafness of the right ear, the equilibriometry with caloric testing showed complete loss of the labyrinth. In the HR-MRI, a structure appeared in ranges of the basal and middle cochlea with enhancement of the contrast medium. From the MRI aspect, this appeared to be a small intracochlear schwannoma. As a differential diagnosis, a chronic granulation is also possible. In agreement with the patient, we decided to control the structure clinically every 6 months using MRI; no further growth of the structure appeared. A precise imaging via HR-MRI is required to detect intracochlear schwannomas. Observation is an appropriate option for patients who have serviceable hearing. Surgical exploration can be recommended in cases of progressive diseases and growth into the inner ear with recurrent vertigo attacks. The option of radiotherapy for the treatment of intrameatal acoustic neurinomas should be considered.