A case report of two different skull base pathologies causing hearing loss in the same ear: vestibular schwannoma and superior semicircular canal dehiscence

Aaron, Ksenia A.; Lavinsky, Joel; Tuchman, Alexander; Go, John L.; Giannotta, Steven L.; Friedman, Rick A.

doi:10.1016/j.amjoto.2015.02.001

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…T his case was unique because there were multiple confirmed otologic findings-bilateral SSCD, right-sided VS, and right-sided BPPV. To the authors' knowledge, combined SSCD and VS has only been described in the literature once, and in that case, the SSCD was unilateral on the same side as the VS (Aaron et al, 2015). That case apparently did not use vestibular testing to aid in the diagnosis, and the treatment options were quite different from our patient.…”

Section: Discussionmentioning

confidence: 52%

Symptoms, Audiometric and Vestibular Laboratory Findings, and Imaging in a Concurrent Superior Canal Dehiscence Syndrome and Vestibular Schwannoma: A Case Report

et al. 2020

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Dizziness is a common complaint that can arise from multiple systems in the body. Objective vestibular tests are used to understand the underlying function of the vestibular system and whether or not it may be contributing to the dizziness symptoms experienced by the patient. Even when comprehensive case history is consistent with an otologic etiology, audiometric and vestibular tests are ordered to objectively characterize inner ear function to help further refine the differential diagnoses and aid in guiding treatment options. Few reports in the literature describe audiometric and vestibular results in patients with multiple concurrent otologic etiologies.This case provides a description of audiometric, vestibular, and imaging results in a case of concurrent bilateral superior canal dehiscence, right-sided vestibular schwannoma, and right-sided posterior canal benign paroxysmal positional vertigo. The patient’s symptoms and laboratory findings are described in detail and, where appropriate, highlight challenges that may arise in interpretation.A case report.The patient presented for evaluation of dizziness, asymmetric hearing loss, and autophony. Comprehensive audiometric evaluation shows asymmetric sensorineural hearing loss and an air-bone gap at 250 Hz in the right ear. Vestibular evaluation shows right caloric asymmetry along with abnormal cervical vestibular– and ocular vestibular–evoked myogenic potentials, with the left ear showing results consistent with the third-window pathology.Comprehensive assessment of symptoms and critical thinking while performing testing are necessary when examining multiple concurrent otologic etiologies in a patient. Knowledge of anticipated test results and physiology may help the audiologist to synthesize results and make appropriate clinical recommendations as part of the multidisciplinary team.

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Section: Discussionmentioning

confidence: 52%

Symptoms, Audiometric and Vestibular Laboratory Findings, and Imaging in a Concurrent Superior Canal Dehiscence Syndrome and Vestibular Schwannoma: A Case Report

et al. 2020

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“…To our knowledge, both combined pathologies have only been described in the literature twice. Aaron et al (32) first described a patient exhibiting loud sounds/pressure-induced vertigo and left-sided low-frequency mixed-HL, which led authors to ask for an MRI that allowed the detection of an ICVS and a possible concomitant SCD. Nevertheless, neither HRCT nor a complete audiovestibular evaluation were considered.…”

Section: Discussionmentioning

confidence: 99%

Audiovestibular Findings in Patients with Concurrent Superior Canal Dehiscence and Vestibular Schwannoma

Tozzi,

Castellucci,

Ferrulli

et al. 2024

Otol Neurotol

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Objective To describe the clinical-instrumental findings in case of concurrent superior canal dehiscence (SCD) and ipsilateral vestibular schwannoma (VS), aiming to highlight the importance of an extensive instrumental assessment to achieve a correct diagnosis. Study Design Retrospective case review. Setting Tertiary referral center. Patients Five patients with concurrent SCD and VS. Intervention Clinical-instrumental assessment and imaging. Main Outcome Measure Clinical presentation, audiovestibular findings, and imaging. Results The chief complaints were hearing loss (HL) and unsteadiness (80%). Other main symptoms included tinnitus (60%) and pressure-induced vertigo (40%). Mixed-HL was identified in three patients and pure sensorineural-HL in 1, including a roll-over curve in speech-audiometry in two cases. Vibration-induced nystagmus was elicited in all cases, whereas vestibular-evoked myogenic potentials showed reduced thresholds and enhanced amplitudes on the affected side in three patients. Ipsilesional weakness on caloric testing was detected in three patients and a bilateral hyporeflexia in one. A global canal impairment was detected by the video-head impulse test in one case, whereas the rest of the cohort exhibited a reduced function for the affected superior canal, together with ipsilateral posterior canal impairment in two cases. All patients performed both temporal bones HRCT scan and brain-MRI showing unilateral SCD and ipsilateral VS, respectively. All patients were submitted to a wait-and-scan approach, requiring VS removal only in one case. Conclusion Simultaneous SCD and VS might result in subtle clinical presentation with puzzling lesion patterns. When unclear symptoms and signs occur, a complete audiovestibular assessment plays a key role to address imaging and diagnosis.

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A case report of two different skull base pathologies causing hearing loss in the same ear: vestibular schwannoma and superior semicircular canal dehiscence

Cited by 2 publications

References 12 publications

Symptoms, Audiometric and Vestibular Laboratory Findings, and Imaging in a Concurrent Superior Canal Dehiscence Syndrome and Vestibular Schwannoma: A Case Report

Symptoms, Audiometric and Vestibular Laboratory Findings, and Imaging in a Concurrent Superior Canal Dehiscence Syndrome and Vestibular Schwannoma: A Case Report

Audiovestibular Findings in Patients with Concurrent Superior Canal Dehiscence and Vestibular Schwannoma

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