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Cochlear schwannomas.

M Barbieri, M Bruzzo, R Mora

    Skull Base : Official Journal of North American Skull Base Society ... [Et Al.]
    |December 15, 2006
    PubMed
    Summary
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    Cochlear nerve neuromas are rare cerebellopontine angle tumors. Early detection of sudden hearing loss may indicate these tumors, aiding surgical planning and preserving facial nerve function.

    Area of Science:

    • Neurosurgery
    • Otolaryngology
    • Neuroradiology

    Background:

    • Cerebellopontine angle (CPA) tumors are uncommon, with cochlear nerve neuromas representing a small subset.
    • Accurate preoperative diagnosis and surgical planning are crucial for managing CPA tumors.

    Purpose of the Study:

    • To report the incidence and characteristics of cochlear nerve neuromas within a series of CPA tumors.
    • To identify potential predictive clinical signs for cochlear nerve involvement.
    • To evaluate surgical approaches and outcomes for these specific tumors.

    Main Methods:

    • Retrospective analysis of 179 CPA tumors, identifying nine cases of cochlear nerve neuromas.
    • Review of preoperative magnetic resonance imaging (MRI) findings.
    • Detailed otoneurological assessments and surgical case reviews.

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  • Surgical approaches included middle fossa and retrosigmoid techniques.

    • Main Results:

    • Cochlear nerve neuromas constituted 5% (nine cases) of the studied CPA tumors.
    • MRI confirmed diagnosis in one case and raised suspicion in four; others were found intraoperatively.
    • Facial nerve function was preserved in all patients.
    • Sudden hearing loss without vestibular symptoms or facial paralysis may predict cochlear neuromas.

    Conclusions:

    • Cochlear nerve neuromas are rare CPA tumors requiring specific diagnostic considerations.
    • Sudden hearing loss is a potential key indicator for early detection.
    • The retrosigmoid approach is effective for most cases, preserving facial nerve function.