1/18. Haemorrhagic acoustic neuroma with features of a vascular malformation. A case report.A 55-year-old man with hearing loss presented with vertigo and vomiting. CT tomography and MRI demonstrated a cerebellopontine angle mass with foci of haemorrhage. An angiomatous tumour, with large abnormal veins adhering to the capsule, was completely removed. Histologically, the tumour was an acoustic neuroma with abnormal vascularisation and limited intratumoral haemorrhage.- - - - - - - - - - ranking = 1keywords = acoustic neuroma, neuroma (Clic here for more details about this article) |
2/18. Unsuspected intravestibular schwannoma.The intravestibular schwannoma is physically minute and will often elude preoperative diagnosis. From time to time, such a tumor will be unexpectedly encountered during transcanal labyrinthectomy. A review of pathologic and surgical literature suggests that the lesion can be well managed by the transcanal route. A standard labyrinthectomy may be sufficient, but the translabyrinthine approach may be necessary for more extensive tumors.- - - - - - - - - - ranking = 3.6056085182781keywords = vestibular schwannoma, schwannoma (Clic here for more details about this article) |
3/18. Relationship between cystic change and rotatory vertigo in patients with acoustic neuroma.Acoustic neuromas are benign neoplasms that most often arise from the vestibular nerve. Many patients with this tumor experience some degree of vestibular symptoms. However, patients rarely complain of rotatory vertigo. Acoustic neuromas are known to exhibit a cystic appearance in some patients. It was hypothesized that cystic change might be a causative factor for rotatory vertigo. A retrospective study of 178 patients with unilateral acoustic neuroma who underwent surgery in the Department of otolaryngology at tokyo Medical and Dental University was carried out. The cystic appearance of the tumors was detected preoperatively by magnetic resonance imaging and confirmed at surgery. The relationship between cystic change of the tumor and presentation with rotatory vertigo was examined. Of the 178 patients studied, only 10 had both cystic change of the tumor and rotatory vertigo, and 120 had neither cystic tumor nor rotatory vertigo. Of the remaining 48 patients, 24 experienced rotatory vertigo with negative findings for cystic tumor and the other 24 had evidence of cystic tumor but no rotatory vertigo. Tumor with cystic change was observed in 34 patients, accounting for 19.1% of all patients studied. Rotatory vertigo was also experienced in 34 patients (19.1%). Of the 34 patients with cystic lesions, 29.4% (10) had rotatory vertigo. The difference in percentage of the two groups did not reach statistical significance. It is suggested that there may be other factors causing rotatory vertigo in patients with acoustic neuromas than cystic change of the tumor.- - - - - - - - - - ranking = 1.2263421745356keywords = acoustic neuroma, neuroma (Clic here for more details about this article) |
4/18. Intermittent vertebral artery compression caused by C1-root schwannoma: case report.Extradural schwannomas of the C1-root are extremely rare. As the tumor grows in size, it may compress surrounding neurovascular structures and cause symptoms. In the present case report, the left vertebral artery (VA) was severely compressed by the tumor, eliciting severe vertigo on turning the head to the right side and with neck extension. We report a 52-year-old man who presented with a history of intermittent episodes of severe vertigo on head movement that was caused by a C1-root schwannoma. The lesion was exposed through an extreme lateral transcondylar approach. At exposure the lesion was yellowish in color and was extradural in location lying between the markedly eroded C1-posterior arch and the compressed vertebral artery (V3) on the left side. The medial portion of the tumor was attached to the C1-nerve root. The tumor was excised enbloc with decompression of the VA. The patient's symptoms completely resolved immediately following surgery, with no recurrence of the symptoms at one year follow up. The vertebral artery may frequently be compressed by osteophytes in cervical spondylosis or due to other causes in the cervical spinal canal, but compression of the artery by C1 extradural schwannoma with vascular insufficiency is rare. Removel of the tumor and the resultant decompression of the artery can be facilitated by the extreme lateral approach as demonstrated by this case.- - - - - - - - - - ranking = 0.61242883110499keywords = schwannoma (Clic here for more details about this article) |
5/18. Acoustic neuroma presenting as exercise-induced vertigo.We present two subjects with previously undiagnosed acoustic neuromas who complained of vertigo whenever they ran. One had normal hearing while the other already had a unilateral sensorineural deafness. hyperventilation for 30 seconds provoked an ipsilateral beating nystagmus and reproduced the vertiginous sensation in both subjects. hyperventilation is a simple bedside test that should be performed when assessing a subject with vertigo or when there is a clinical suspicion of an acoustic neuroma.- - - - - - - - - - ranking = 0.4526843490712keywords = acoustic neuroma, neuroma (Clic here for more details about this article) |
6/18. Intralabyrinthine schwannomas.OBJECTIVE: To describe the patient presentation, radiographic findings, and treatment results in a series of eight patients with a diagnosis of intralabyrinthine schwannoma, and to review the presentation of other cases of intralabyrinthine schwannoma in the English otolaryngologic literature. methods: Retrospective review of patient records, operative reports, and radiologic studies, and review of the literature. RESULTS: Eight patients with a variety of otologic symptoms including progressive hearing loss, episodic vertigo, and tinnitus were found to have a schwannoma involving the vestibule or cochlea. Surgery was performed to remove the tumors from four patients with nonserviceable hearing. The patients experienced significant improvement in their vertigo and tinnitus after surgery. observation and serial magnetic resonance imaging were adequate treatment of the four patients with serviceable hearing. In the literature review, 447 cases of intralabyrinthine schwannoma were identified, and the presentations were similar to those in the cases described here. CONCLUSION: Intralabyrinthine schwannomas are rare tumors that arise from the distal portion of either the vestibular nerve or the cochlear nerve. Consequently, the cochlea, the semicircular canals, the vestibule, or a combination of these structures may become involved with these lesions. Transmastoid labyrinthectomy or a transotic approach can be used to remove intralabyrinthine tumors from patients with nonserviceable hearing and severe vertigo or tinnitus. In addition, these surgical approaches should be used if the tumor grows to involve the internal auditory canal. observation is an appropriate option for patients who have serviceable hearing.- - - - - - - - - - ranking = 0.78740849713498keywords = schwannoma (Clic here for more details about this article) |
7/18. Vestibular schwannoma with contralateral facial pain - case report.BACKGROUND: Vestibular schwannoma (acoustic neuroma) most commonly presents with ipsilateral disturbances of acoustic, vestibular, trigeminal and facial nerves. Presentation of vestibular schwannoma with contralateral facial pain is quite uncommon. CASE PRESENTATION: Among 156 cases of operated vestibular schwannoma, we found one case with unusual presentation of contralateral hemifacial pain. CONCLUSION: The presentation of contralateral facial pain in the vestibular schwannoma is rare. It seems that displacement and distortion of the brainstem and compression of the contralateral trigeminal nerve in Meckel's cave by the large mass lesion may lead to this atypical presentation. The best practice in these patients is removal of the tumour, although persistent contralateral pain after operation has been reported.- - - - - - - - - - ranking = 2.8008142760418keywords = vestibular schwannoma, acoustic neuroma, schwannoma, neuroma (Clic here for more details about this article) |
8/18. Labyrinthine enhancement on gadolinium-enhanced magnetic resonance imaging in sudden deafness and vertigo: correlation with audiologic and electronystagmographic studies.Sudden deafness with or without vertigo presents a difficult diagnostic problem. This article describes 12 patients with enhancement of the cochlea and/or vestibule on gadolinium-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (MRI), correlating the enhancement with the auditory and vestibular function. All patients were studied with T2-weighted axial images taken through the whole brain, enhanced 3-mm axial T1-weighted images taken through the temporal bone, and enhanced T1-weighted sagittal images taken through the whole brain. Cochlear enhancement on the side of hearing loss was found in all the patients. The vestibular enhancement correlated with both subjective vestibular symptoms and objective measures of vestibular function on electronystagmography. In 2 patients, the resolution of symptoms 4 to 6 months later correlated with resolution of the enhancement on MRI. No labyrinthine enhancement was seen in a series of 30 control patients studied with the same MRI protocol. Labyrinthine enhancement in patients with auditory and vestibular symptoms is a new finding and is indicative of labyrinthine disease. While abnormalities on electronystagmograms and audiograms are nonspecific and only indicate a sensorineural problem, enhanced MRI may separate patients with retrocochlear lesions, such as acoustic neuromas, from those in whom the abnormal process is in the labyrinth or the brain.- - - - - - - - - - ranking = 0.2keywords = acoustic neuroma, neuroma (Clic here for more details about this article) |
9/18. Contrast enhancement of the labyrinth on MR scans in patients with sudden hearing loss and vertigo: evidence of labyrinthine disease.The sudden onset of hearing loss and vertigo presents a difficult diagnostic problem. We describe the finding of labyrinthine enhancement on MR images in five patients with sudden unilateral hearing loss or vertigo or both and correlate the MR findings with audiologic and electronystagmographic studies. All patients were studied with T2-weighted axial images through the whole brain, contrast-enhanced 3-mm axial T1-weighted images through the temporal bone, and enhanced T1-weighted sagittal images through the whole brain. Cochlear enhancement, on the side of hearing loss only, was found in all five patients. The presence of associated vestibular enhancement correlates with objective measures of vestibular function on the electronystagmogram. In two patients, the resolution of symptoms 4-6 months later correlated with resolution of the enhancement on gadopentetate dimeglumine-enhanced MR images. Two patients had luetic labyrinthitis. No labyrinthine enhancement was seen in a series of 30 control subjects studied with gadopentetate dimeglumine-enhanced MR using the same protocol. Labyrinthine enhancement in patients with auditory and vestibular symptoms is a new finding and is indicative of labyrinthine disease. While abnormalities on electronystagmograms and audiograms are nonspecific and indicate only a sensorineural problem, gadopentetate dimeglumine-enhanced MR may separate patients with retrocochlear lesions, such as acoustic neuromas, from those in whom the abnormal process is in the labyrinth or is intraaxial. This group of patients underscores the importance of identifying and commenting on the structures of the membranous labyrinth when evaluating MR studies of the internal auditory canal and the cerebellopontine angle in individuals with hearing loss.- - - - - - - - - - ranking = 0.2keywords = acoustic neuroma, neuroma (Clic here for more details about this article) |
10/18. Intralabyrinthine schwannoma.Two cases of unsuspected intralabyrinthine schwannoma are reported and the literature is reviewed. The mean age of the patients was 56 years, with the most common symptoms being hearing loss, dizziness, and tinnitus. All patients demonstrated a profound sensorineural hearing loss with low discrimination scores, and recruitment was elicited in two patients. A radiographic evaluation was negative in all but one case. Five of the six patients had a preoperative diagnosis of Meniere's disease. Transcanal labyrinthectomy was employed to remove tumor in all patients. This review suggests that a patient, presenting with symptoms of atypical Meniere's disease and negative radiographic evaluation, should alert the surgeon to the possibility of an intralabyrinthine schwannoma.- - - - - - - - - - ranking = 0.52493899808999keywords = schwannoma (Clic here for more details about this article) |
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