Continuous monitoring of wave V of auditory brainstem response (ABR), also called brainstem auditory evoked potential (BAEP), is the most common method used in intraoperative neuromonitoring (IONM) functionality of cochlear nerve during surgery in cerebellopontine angle (CPA). CE-Chirp® ABR represents a recent development of classical ABR. CE-Chirp® is a new acoustic stimulus used in newborn hearing testing, designed to provide enhanced neural synchronicity and faster detection of larger amplitude wave V. In four cases, CE-Chirp® ABR was performed during cerebellopontine angle (CPA) surgery. CE-Chirp® ABR represented a safe and effective method in neuromonitoring functionality of vestibulocochlear nerve. A faster neuromonitoring feedback to surgical equipe was possible with CE-Chirp ABR®.
Cavernous angiomas originating in the internal auditory canal are very rare. In the available literature, only 65 cases of cavernomas in this location have been previously reported. We describe the case of a 22-year-old woman surgically treated for a cavernous hemangioma in the left internal auditory canal, mimicking on preoperative magnetic resonance imaging MRI an acoustic neuroma. Neurological symptoms were hypoacusia and dizziness. The cavernous angioma encased the seventh and, partially, the eighth cranial nerve complex. A "nearly total" removal was performed, leaving a thin residual of malformation adherent to the facial nerve. Postoperative period was uneventful; hearing was unchanged, but the patient had a moderate inferior left facial palsy (House-Brackmann grade II) slightly improved during the following weeks. On the basis of the observation of this uncommon case, we propose a revision of the literature and discuss clinical features, differential diagnosis, and treatment.
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