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A Case of Calcification Discovered Within the Membranous Labyrinth During Resection of a Vestibular Schwannoma
Syed Ameen Ahmad1, Haley Zawitoski2, Hakim Hiel1
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Objective:
To report a case of calcification discovered in the membranous labyrinth of a patient with a vestibular schwannoma after transtemporal labyrinthectomy.
Study Design:
Clinical capsule report.
Setting:
Tertiary academic referral center.
Patient:
An adult male with a 3-year history of left-sided hearing loss and balance issues was confirmed by MRI to have a cystic vestibular schwannoma.
Interventions:
Transtemporal labyrinthectomy.
Main Outcome Measures:
Appearance of the membranous labyrinth on CT imaging and immunohistochemistry.
Results:
A patient presented with a 3-year history of left-sided hearing loss and balance issues. MRI revealed a heterogeneously enhancing mass in the left cerebellopontine angle, consistent with a cystic vestibular schwannoma. After a transtemporal labyrinthectomy, a gross examination revealed calcification within the membranous labyrinth. Retrospective review of imaging identified a preoperative ring of calcification, confirmed with visual inspection of the removed tissue via light microscope. Immunohistochemical analysis demonstrated a reduced number of nuclei in the hypertrophied crista compared with the unaffected crista.
Conclusions:
Calcification in the membranous labyrinth may reflect underlying inner ear pathology. Further research is warranted to establish reliable methods for detecting this calcification to enhance our understanding of inner ear disorders.
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