Sudden deafness in vestibular schwannoma

Moffat, David A.; Baguley, David; Blumenthal, Harvey; Irving, Richard; Hardy, David G.

doi:10.1017/s0022215100126052

Cited by 71 publications

(60 citation statements)

References 12 publications

(12 reference statements)

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“…This report describes a case of medulloblastoma in a 19-year-old man initially presenting with unilateral sudden sensorineural hearing loss. Unilateral sudden sensorineural hearing loss can be recognised as an initial symptom of brain tumor, but is most often associated with vestibular schwannomas 2,5,8,[11][12][13]18) . Sudden sensorineural hearing loss caused by medulloblastoma is extremely rare and, to our knowledge, there have been only three previous reports of medulloblastoma manifesting as sudden sensorineural hearing loss 6,7,9) .…”

Section: Discussionmentioning

confidence: 99%

Medulloblastoma Manifesting as Sudden Sensorineural Hearing Loss

Terakawa

Tsuyuguchi

Takami

et al. 2011

J Korean Neurosurg Soc

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A 19-year-old man presented with a one-year history of dizziness and facial numbness on the right side. His symptoms had begun two years previously with sudden hearing loss on the right side, for which he had consulted an otorhinolaryngologist. The otorhinolaryngologist examined the patient with MR imaging ( Fig. 1) and patient was treated based on a diagnosis of idiopathic sudden hearing loss, but his hearing disturbance did not improve. Details of the treatment were not available. Subsequently, he started suffering from the aforementioned symptoms and consulted our department.On admission, neurological examination revealed decreased facial sensation, absent corneal reflex, slight peripheral-type facial weakness, hearing disturbance on the right side, and horizontal and alternate lateral gaze nystagmus. His motor strength was normal, but limb ataxia was observed on the right side. Pure tone audiometry showed right side sensorineural hearing loss up to 102.5 dB in all frequency bands. MR imaging demonstrated abnormal signals located mainly in the right middle cerebellar peduncle shown as iso to hyperintensity on T1-weighted images and hyperintensity on T2-weighted images. This lesion was faintly enhanced by contrast medium (Fig. 2). A retrospective review of the MR imaging results obtained at the previous INTRODUCTIONSudden sensorineural hearing loss is not a rare condition, and thus may occasionally be encountered by clinicians in daily practice. The incidence of sudden hearing loss has been reported to range from 5 to 20 per 100,000 subjects per year, but the precise incidence is estimated to be higher 14) . The etiology of sudden hearing loss is diverse 4) , and patients with sudden sensorineural hearing loss may show magnetic resonance (MR) imaging abnormalities corresponding to the clinical picture such as labyrinthine hemorrhage, cochlear inflammation, multiple sclerosis, and neoplastic disease 1,16) . Although several previous studies recommended evaluating patients with sudden sensorineural hearing loss by MR imaging to rule out underlying organic disease 1,12,16) , few clinicians seem to be aware that even a small intrinsic lesion has the potential to produce sudden sensorineural hearing loss.We describe a case of medulloblastoma located in the middle cerebellar peduncle that manifested as unilateral sudden sensorineural hearing loss followed by cranial nerves pareses and Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, JapanWe present a rare case of medulloblastoma which presented with unilateral sudden sensorineural hearing loss as an initial symptom. A 19-year-old man was admitted to our hospital with a chief complaint of dizziness and facial numbness on the right side. His illness had begun two years previously with sudden hearing loss on the right side, for which he had been treated as an idiopathic sudden hearing loss. Magnetic resonance imaging demonstrated abnormal signals located mainly in the right middle cerebellar peduncle. We performed partial resection...

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Section: Discussionmentioning

confidence: 99%

Medulloblastoma Manifesting as Sudden Sensorineural Hearing Loss

Terakawa

Tsuyuguchi

Takami

et al. 2011

J Korean Neurosurg Soc

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“…88 The internal auditory artery or the labyrinthine artery (end artery) travels within the internal auditory canal, and it may be possible that vascular insult to it can result in sudden hearing loss. 11,60 However, if only vascular insult was the cause, one would also expect to see vestibular symptoms and cochlear hearing loss, which is not always the case. Further, due to the anatomical distribution of the blood supply to the cochlea, vascular compromise should result in low-frequency hearing loss in these patients, whereas mostly higher-frequency loss is reported in such cases.…”

Section: Sudden Hearing Lossmentioning

confidence: 99%

An update on unilateral sporadic small vestibular schwannoma

Thakur¹,

Banerjee

Khan³

et al. 2012

FOC

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Advances in neuroimaging have increased the detection rate of small vestibular schwannomas (VSs, maximum diameter < 25 mm). Current management modalities include observation with serial imaging, stereotactic radiosurgery, and microsurgical resection. Selecting one approach over another invites speculation, and no standard management consensus has been established. Moreover, there is a distinct clinical heterogeneity among patients harboring small VSs, making standardization of management difficult. The aim of this article is to guide treating physicians toward the most plausible therapeutic option based on etiopathogenesis and the highest level of existing evidence specific to the different cohorts of hypothetical case scenarios. Hypothetical cases were created to represent 5 commonly encountered scenarios involving patients with sporadic unilateral small VSs, and the literature was reviewed with a focus on small VS. The authors extrapolated from the data to the hypothetical case scenarios, and based on the level of evidence, they discuss the most suitable patient-specific treatment strategies. They conclude that observation and imaging, stereotactic radiosurgery, and microsurgery are all important components of the management strategy. Each has unique advantages and disadvantages best suited to certain clinical scenarios. The treatment of small VS should always be tailored to the clinical, personal, and social requirements of an individual patient, and a rigid treatment protocol is not practical.

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“…On the basis of our results with significant predominance of sudden hearing loss in premenopausal women at the time of their period, sudden hearing loss could be caused by vascular insufficiency of the cochlea or the eighth nerve. The most probable explanation of such a vascular cause may be tumour compression of the internal auditory artery (IAA) in the IAC [15,27]. Animal studies demonstrated that vascular occlusion may result in a variable distribution of histological damage in the cochlea and vestibular labyrinth, especially with temporary interruption of flow [26].…”

Section: The Impact Of Different Factors On Auditory Function Before mentioning

confidence: 99%

“…Moreover, * Part of this work was presented at the 2nd International Conference on Acoustic Neuroma Surgery, Paris, France, April 22-26. 1995 vestibular schwannomas were shown to express receptors for the female hormones oestrogen and progesterone [2,15]. Although intriguing, these correlations were not found consistently by all investigators and their significance remains unclear [12,14].…”

Section: Introductionmentioning

confidence: 99%

Different aspects of hearing preservation in surgery of vestibular schwannoma in women and men

et al. 1996

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Pre-operative and postoperative auditory function was reviewed retrospectively in 98 patients with vestibular schwannomas. According to their hormonal status, women were categorized as "premenopausal" and "postmenopausal". Before surgery, 48% of the women (65% premenopausal) and 16% of the men presented with sudden hearing loss. The degree of auditory function before operation was similar for women and men. Preservation of pre-operative hearing was possible for 41% of the women (21% premenopausal) and 59% of the men. Further details of the surgery and the results of histopathological examination were also compared for women and men. Our results support substantial evidence that hearing preservation after surgery of vestibular schwannoma is easier to accomplish for men than for women. The finding of significantly more sudden hearing loss in premenopausal women may suggest a hormonal influence on tumour growth, which may also be partially responsible for the difference in hearing prognosis between women and men.

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Sudden deafness in vestibular schwannoma

Cited by 71 publications

References 12 publications

Medulloblastoma Manifesting as Sudden Sensorineural Hearing Loss

Medulloblastoma Manifesting as Sudden Sensorineural Hearing Loss

An update on unilateral sporadic small vestibular schwannoma

Different aspects of hearing preservation in surgery of vestibular schwannoma in women and men

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