Intravestibular Lipoma with Intracochlear Extension: A Case Report on Surgical Management and Cochlear Implantation

Intracochlear and intravestibular lipomas are rare benign lesions that may clinically and radiologically mimic retrocochlear pathologies such as vestibular schwannomas. They typically present with progressive sensorineural hearing loss, tinnitus, or dizziness. Due to their rarity, optimal management strategies, particularly in pediatric patients, remain challenging and require individualized decision-making.

We report the case of an 8-year-old girl who presented with progressive right-sided sensorineural hearing loss. Magnetic resonance imaging (MRI) revealed an intravestibular lipoma extending into the cochlea. Considering the patient's young age and the potential for tumor growth, surgical excision was performed via a translabyrinthine approach. Simultaneous cochlear implantation was undertaken to facilitate auditory rehabilitation. Histopathological analysis was conducted to confirm the diagnosis.

Histopathological examination confirmed the lesion as a lipoma. The postoperative course was uneventful. The cochlear implant was successfully activated and provided effective hearing restoration.

Intravestibular lipomas are rare entities that require careful radiological evaluation to ensure accurate diagnosis and differentiation from other retrocochlear lesions. Management should be individualized, particularly in pediatric patients, balancing surgical risks against the benefits of tumor removal and hearing rehabilitation. Simultaneous cochlear implantation may represent a viable strategy for auditory restoration in selected cases.