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76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

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Intralabyrinthine Schwannoma – a diagnostic dilemma?

Meeting Abstract

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  • corresponding author Christian Sartorius - Clinic for ORL, Head- and Necksurgery, Klinikum Wuppertal GmbH, Wuppertal, Germany
  • Bernd Plechata - Clinic for ORL, Head- and Necksurgery, Klinikum Wuppertal GmbH, Wuppertal, Germany
  • B. Kempkes - Dept. of Radiology, Klinikum Wuppertal GmbH, Wuppertal, Germany
  • Hans-Georg Kempf - Clinic for ORL, Head- and Necksurgery, Klinikum Wuppertal GmbH, Wuppertal, Germany

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno503

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno137.shtml

Published: September 22, 2005

© 2005 Sartorius et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: We outline the diagnosis and management of intralabyrinthine schwannomas and hope proposing a guideline to the treatment policy for patients.

Methods/Case reports: Diagnosing two male patients, both after sudden hearing loss on their right ear ( pure tone audiogram, caloric testing, ABR, otoacoustic emissions, HR – MRI ), we found the presence of very small intralabyrinthine schwannomas.

The first patient, 44 years old, who showed normal hearing at the concerning (left) ear, but presenting a 3mm tumour projecting to the vestibule. The cochlea was patent.

Patient 2, 59 years old, showed severe hearing loss in high frequencies without vertigo. HR –MRI revealed a 3mm intracochlear schwannoma on this ear. ABR potentail were lost, caloric reaction was diminuished on the affected side

Conclusion: Intralabyrinthine schwannomas are uncommon tumours that mimic clinical features of many other neurootological conditions. Observation is an appropriate option for patients with serviceable hearing. In cases of vertigo a translabyrinthine or transotic approach can be used to remove the lesion. Our patients are recommended to perform regular MRI diagnostics according a wait-and-see policy.

Outline

References

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Kennedy RJ, Shelton C, Salzmann KL, Davodson HC, Harnsberger HR. Intralabyrinthine schwannomas: diagnosis, management, and a new classification system. Otol Neurootol. 2004;25:160-7.
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Meyer O. Ein Fall von multiplen Tumoren in den Endausbreitungen des Akustikus. Z Ohrenheilkunde. 1917;75:95-113.
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Neff BA, Willcox TO, Sataloff RT. Intralabyrinthine schwannomas. Otol Neurootol. 2003;24:299-307.