Intracochlear Vestibular Schwannoma Presenting with Mixed Hearing Loss

Area of Science:

• Neuro-otology
• Audiology
• Neurosurgery

Background:

• Vestibular schwannomas typically present with sensorineural hearing loss.
• Intracochlear schwannomas are rare and can present atypically.
• Conductive or mixed hearing loss is more commonly associated with lateral ear pathology.

Observation:

• A patient presented with mixed, partly pseudo-conductive hearing loss due to an intracochlear schwannoma.
• This presentation is highly unusual for an intralabyrinthine schwannoma.
• The patient was initially misdiagnosed with otosclerosis, leading to an unsuccessful stapedotomy.

Findings:

• The intracochlear schwannoma caused a rare mixed hearing loss.
• The Gellé test and vestibular system testing are important diagnostic tools.
• Imaging is essential for identifying differential diagnoses in conductive hearing loss.

Implications:

• Highlights the importance of considering rare differential diagnoses for conductive hearing loss.
• Emphasizes the need for comprehensive audiological and vestibular assessments.
• Underscores the limitations of initial diagnoses when atypical presentations occur.