CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 02): S243-S244
DOI: 10.1055/s-0042-1746851
Poster
Otology / Neurootology / Audiology: Inner ear

Case Report: Surdity on the right side in completely extracochlear (solely intravestibular) schwannoma

Patricia Bott
1   Evangelisches Krankenhaus Oldenburg, Universitätsklinik HNO Oldenburg
,
Andreas Radeloff
1   Evangelisches Krankenhaus Oldenburg, Universitätsklinik HNO Oldenburg
,
Wiebke Laffers
1   Evangelisches Krankenhaus Oldenburg, Universitätsklinik HNO Oldenburg
› Institutsangaben
 
 

    Introduction 

    A 65-year-old female patient with a 7-year history of right surdity presented to our clinic for a cochlear implant. The surdity had subjectively developed from normacusis within 6 months. There was a tinnitus of the right side and an unsteadiness of gait in the dark.

    Material and Methods 

    Tone audiometry confirmed right surdity. Speech understanding on the right side was not achievable in the Freiburger speech audiogram. DPOAEs, TEOAEs, a wave I in electrocochleography and a wave V in the BERA were not derivable on the right side. In the promontorial test auditory impression was reported without threshold fading and with frequency discrimination. Surprisingly, cMRI revealed a contrast-medium enhanced mass in the right vestibule compatible with a schwannoma.

    Results 

    Following surgery revealed that the schwannoma was indeed completely within the vestibule and had also grown into the posterior arch. It could be removed in toto. Subsequently, a cochlear implant was inserted without complications. Intraoperative telemetry measurements showed regular values.

    Conclusion 

    After wound healing and adaptation, speech understanding of up to 45% at 65dB was achieved two months postoperatively. Interestingly, despite the solely vestibular location of the schwannoma, the patient was neurootologically most likely to have cochlear deafness on the right side. This suggests that, contrary to previous assumptions, hearing loss is not only caused by destruction of the cochlea or pressure on the cochlear nerve, but also by other pathomechanisms such as the production of ototoxic substances.


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    Conflict of Interest

    The author declares that there is no conflict of interest.

    Publikationsverlauf

    Artikel online veröffentlicht:
    24. Mai 2022

    © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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