Recovery from deafness after removal of a large acoustic neurinoma.

Abstract

The LaryngoscopeVolume 110, Issue 7 p. 1239-1239 Letters to the EditorFree Access Recovery From Deafness After Removal of a Large Acoustic Neurinoma First published: 02 January 2009 https://doi.org/10.1097/00005537-200007000-00036Citations: 1AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat To the Editor, I read with great interest the article by Roberson et al. 1 on acoustic neuroma surgery in the June 1999 issue of The Laryngoscope. I would like to share my experience by reporting a case similar to the one described by Roberson et al. This is a case of combined acoustic and jugular foramen neurinoma in a patient with neurofibromatosis type 2. Hearing was sufficiently restored after successful tumor removal through a suboccipital retrosigmoid approach. The patient first began to suffer from left acoustic neurinoma 10 years previously. After the first surgical resection, he lost the hearing function in his left ear. He almost lost the hearing in his right ear as well. He also presented with progressive right cerebellar signs and symptoms of increased intracranial pressure. Magnetic resonance imaging with Gd-DTPA enhancement revealed the presence of a right large combined acoustic and jugular foramen neurinoma (Fig. 1). The preoperative auditory brainstem response showed diminished waves, but 3 weeks after surgery he exhibited a return of waves III and V. Pure-tone audiometry showed significant postoperative improvement. Figure Fig. 1.Open in figure viewerPowerPoint Preoperative magnetic resonance imaging, coronal cut, T1-weighted image with Gd-DTPA ehancement demonstrating a large acoustic and jugular foramen neurinoma compressing the brain stem and resulting in obstructive hydrocephalus. The preservation of hearing in patients with neurofibromatosis type 2 has been reported to be difficult with both microsurgical and radiosurgical techniques. 2, 3 Encouraged by the article by Roberson et al., my colleagues and I attempted to restore the patient's left hearing function and had good results. We believe that to preserve or restore the hearing function when a large acoustic neurinoma compressing the brain stem develops, a radical intracapsular removal is useful even if no discernible waves are found in the preoperative auditory brainstem response. BIBLIOGRAPHY BIBLIOGRAPHY 1 Roberson JB, Jackson LE, McAuley JR. Acoustic neuroma surgery: absent auditory brainstem response does not contraindicate attempted hearing preservation. Laryngoscope 1999; 109: 904– 910. Wiley Online LibraryPubMedWeb of Science®Google Scholar 2 Samii M. Hearing preservation in bilateral acoustic neurinomas. Br J Neurosurg 1995; 9(3): 412– 424. Google Scholar 3 Subach BR, Kondziolka D, Lunsford LD, et al. Stereotactic radiosurgery in the management of acoustic neuromas associated with neurofibromatosis type 2. J Neurosurg 1999; 90(5): 815– 822. CrossrefGoogle Scholar Hiroshi Nawashiro MD*, * Japan. Citing Literature Volume110, Issue72000Pages 1239-1239 FiguresReferencesRelatedInformation