Endoscopic fenestration of a cerebellopontine angle arachnoid cyst resulting in complete recovery from sensorineural hearing loss and facial nerve palsy

Abstract

<jats:p>Cerebellopontine angle arachnoid cysts are usually asymptomatic, but are frequently found incidentally because of increased use of neuroimaging. Nevertheless, as these cysts enlarge, they may compress surrounding structures and cause neurological symptoms. Patients may present with vague, nonspecific symptoms such as headache, nausea, vomiting, and vertigo. Cranial nerve palsies, including sensorineural hearing loss and facial weakness, although rare, have also been reported in association with posterior fossa arachnoid cysts. Although surgery for these entities is controversial, arachnoid cysts can be treated surgically with open craniotomy for cyst removal, fenestration into adjacent arachnoid spaces, shunting of cyst contents, or endoscopic fenestration. Reversal of sensorineural hearing loss following open craniotomy treatment has been described in the literature in only 1 adult and 1 pediatric case. Improvement in facial weakness has also been reported after open craniotomy and arachnoid cyst fenestration. The authors report the first case of complete recovery from sensorineural hearing loss and facial weakness following endoscopic fenestration in a patient with a cerebellopontine angle arachnoid cyst.</jats:p>

Main Congenital Cerebral Anomalies: How Prenatal Imaging Aids Counseling

“…Arachnoid cysts of the posterior fossa are commonly diagnosed at prenatal imaging and information given to the parents has to be reassuring: the great majority of arachnoid cysts remains stable and does not require surgical treatment [37]. If the cyst interferes with the CSF circulation, due to its location, and if the patient is symptomatic, surgery is required: when possible, endoscopic fenestration is performed rather than extra- or intracranial shunting [38,39] (fig. 8).…”

Recovery of Tinnitus and Sensorineural Hearing Loss Due to Lysis of Arachnoid Adhesions in the Posterior Cranial Fossa: Is There a Novel Etiology in Neurotological Disorders?

“…Recovery of hearing loss secondary to posterior fossa arachnoid cyst surgery in a pediatric patient has been reported [11] . It was reported that even the fenestration of the arachnoid cyst lead to recovery from sensorineural hearing loss in an adult patient [1,12] . According to another case report, cyst decompression could stop progression of hearing loss and render tinnitus more tolerable [13] .…”

“…However, the recovery of hearing loss is also possible in some patients who undergo posterior fossa surgery. Arachnoid cyst drainage is one of the interventions, which may result in the recovery of the sensorineural hearing loss [1] . One of the rarely reported reasons might be arachnoid adhesions or arachnoiditis.…”

Disequilibrium in patients with posterior fossa arachnoid cysts

“…Case reports indicate that arachnoid cyst may affect neurological function in the posterior fossa, causing symptoms such as vertigo/dizziness , reversible sensorineural hearing loss or facial palsy . Most likely, these symptoms are caused by direct pressure from the cyst on the cranial nerves or the stretching of them.…”