Chorda tympani neuroma masquerading as cholesteatoma

Abstract

Facial nerve neuromas occur throughout the course of the facial nerve and its branches, however lesions occurring on the chorda tympani branch are exceptionally rare. We present a case where the diagnosis was made intra-operatively; the patient was pre-operatively thought to have had a cholesteatoma. Total resection is the treatment of choice for these cases. Early diagnosis, aided by high resolution computed tomography (CT) scanning, will facilitate complete excision without damage to the facial nerve itself or the ossicular chain. The slow growing nature of the neuroma is likely to allow compensatory mechanisms to occur without the patient experiencing dysgeusia. As with any rarity the diagnosis can only be made with a high index of suspicion.

Clinical and Histological Features of Chorda Tympani Tumors

“…Depending on the size and location of the tumour, there may exist hearing loss, as reported in 10 previous cases [2][3][4][5][6][7][8][9][10][11] and in our patient (Table 1). Interestingly, seven patients showed a mass in the external ear canal [3][4][5][6][7][8]10] . Only two cases were associated with neurofibromatosis [2,14] .…”

Endoscopic resection of a chorda tympani schwannoma: A novel approach for an exceedingly rare entity

“…In this case report, we describe the clinical course of a patient presenting with a chorda tympani schwannoma and the surgical resection using a transcanal, endoscopic approach. Although many patients with such a lesion have historically presented with either a conductive or mixed hearing loss, our patient's chief complaints were tinnitus and episodic vertigo. Our patient was also found to have normal hearing pre‐ and postoperatively.…”

“…Chorda tympani schwannomas are exceedingly rare, with only 10 reported cases in the English literature. Conductive hearing loss is the most common presenting symptom, whereas otorrhea, dysgeusia, and facial paresis are not routinely observed …”

“…Conductive hearing loss is the most common presenting symptom, whereas otorrhea, dysgeusia, and facial paresis are not routinely observed. [2][3][4][5][6][7][8][9][10]…”

Bitter sweet tympani

“…There is a published case of a chorda tympani neuroma masquerading as a cholesteatoma, but without taste disturbance. 6 It appears that chronic loss of gustatory function is well compensated for.…”