Trans-labyrinthine approach for a huge vestibular schwannoma in a patient with neurofibromatosis 2: our experience

Dhirendra Singh Kushwah; Nitish Aggarwal

doi:10.18203/issn.2454-5929.ijohns20250124

Authors

Dhirendra Singh Kushwah Department of ENT, Head and Neck Surgery, ORL International Hospital, Delhi, India
Nitish Aggarwal Department of ENT, Head and Neck Surgery, ORL International Hospital, Delhi, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20250124

Keywords:

Cerebellopontine angle tumours, Neurofibromatosis 2, Translabyrinthine surgical approach, Vestibular schwannoma

Abstract

Vestibular schwannoma is a schwann cell-derived tumour arising from the vestibulocochlear nerve. These tumours represent 85% of intracranial growths arising at the cerebellopontine angle 1. Various surgical techniques exist for removing it, the most common of which are trans-labyrinthine and retro-sigmoid approaches. The common presenting symptoms include progressive hearing loss and tinnitus which are reported in over 60% of patients. Larger tumours can cause hydrocephalus and brainstem compression leading to symptoms such as facial paraesthesia, vertigo and headache. Here were present a 25 year old male with neurofibromatosis 2 with a huge 4.5 cm vestibular schwannoma successfully removed using trans-labyrinthine approach in our hospital.

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References

Singh K, Singh MP, Thukral CL, Rao K, Singh K, Singh A. Role of magnetic resonance imaging in evaluation of cerebellopontine angle schwannomas. Indian J of Otolaryngol and Head & Neck Surg. 2015;67:21-7. DOI: https://doi.org/10.1007/s12070-014-0736-0

Miller AB, Morgan LL, Udasin I, Davis DL. Cancer epidemiology update, following the 2011 IARC evaluation of radiofrequency electromagnetic fields (Monograph 102). Environmental Res. 2018;1;167:673-83. DOI: https://doi.org/10.1016/j.envres.2018.06.043

Koo M, Lai JT, Yang EY, Liu TC, Hwang JH. Incidence of ves tibular Schwannoma in Taiwan from 2001 to 2012: a population based national health insurance study. Ann Otol Rhinol Laryngol. 2018;127(10):694–7. DOI: https://doi.org/10.1177/0003489418788385

Nikolopoulos TP, Fortnum H, O'Donoghue G, Baguley D. Acoustic neuroma growth: a systematic review of the evidence. Otol & Neurotol. 2010;1;31(3):478-85. DOI: https://doi.org/10.1097/MAO.0b013e3181d279a3

Suryanarayanan R, Ramsden RT, Saeed SR, Aggarwal R, King AT, Rutherford SA, et al. Vestibular schwannoma: role of conservative management. J Laryngol Otol. 2010;124(3):251-7. DOI: https://doi.org/10.1017/S0022215109992362

Gupta VK, Thakker A, Gupta KK. Vestibular schwannoma: what we know and where we are heading. Head and Neck Pathol. 2020;14(4):1058-66. DOI: https://doi.org/10.1007/s12105-020-01155-x

Matthies C, Samii M. Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation. Neurosurg. 1997;1;40(1):1-10. DOI: https://doi.org/10.1097/00006123-199701000-00001

Halliday J, Rutherford SA, McCabe MG, Evans DG. An update on the diagnosis and treatment of vestibular schwannoma. Expert Rev Neurotherap. 2018;2;18(1):29-39. DOI: https://doi.org/10.1080/14737175.2018.1399795

Ansari SF, Terry C, Cohen-Gadol AA. Surgery for vestibular schwannomas: a systematic review of complications by approach. Neurosurgical Focus. 2012;1;33(3):14. DOI: https://doi.org/10.3171/2012.6.FOCUS12163

Irving RM, Jackler RK, Pitts LH. Hearing preservation in patients undergoing vestibular schwannoma surgery: comparison of middle fossa and retrosigmoid approaches. J Neurosurg. 1998;1;88(5):840-5. DOI: https://doi.org/10.3171/jns.1998.88.5.0840