Article
Cavernomas of the internal auditory canal
Kavernome des inneren Gehörgangs
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Published: | May 8, 2006 |
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Objective: We describe the symptomatology, radiological features and surgical management of patients with cavernous angiomas within the internal auditory canal (IAC).
Methods: The clinical charts, operative records, histology and follow up records of seven patients with cavernous angiomas in the IAC operated from 1983 to 2005 were reviewed.
Results: All patients presented with sensorineural hearing loss, four patients suffered from tinnitus. Four patients referred also facial symptoms like facial hemispasm or paresis. One patient among them presented with a sudden facial paresis due to intrameatal tumor hemorrhage. Radiologically, they produced enlargement of the IAC on computed tomography (CT). Features of Magnetic resonance imaging (MRI) was variable, which made differentiation from intrameatal vestibular schwannomas sometimes impossible. The lesions were totally removed in all patients through the suboccipital retrosigmoid approach. They could be dissected away from the facial nerve in five cases, whereas in two cases the seventh cranial nerve could not be preserved and had to be repaired with sural nerve graft. Transient worsening of the seventh cranial nerve occurred in 2 patients, with postoperative improvement in all of them. There were no other postoperative complications.
Conclusions: Cavernous angiomas of the internal auditory canal (IAC) are very uncommon lesions which can simulate the symptomatology of vestibular schwannomas. Facial nerve symptoms were more commonly encountered. MRI does not show specific findings, which enables reliable differentiation from other lesions.