A small vestibular schwannoma with preoperative facial palsy treated via retrolabyrinthine approach

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Auris Nasus Larynx Pub Date : 2025-03-21 DOI:10.1016/j.anl.2025.03.002

Sae Hatomi, Makoto Hosoya, Masafumi Ueno, Marie N Shimanuki, Takanori Nishiyama, Hiroyuki Ozawa, Naoki Oishi

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引用次数: 0

Abstract

Facial nerve paralysis caused by a vestibular schwannoma is a rare but critical symptom; however, few reports have focused on preoperative facial nerve palsy from the viewpoint of treatment. In addition, its mechanism is not fully understood. We report a rare case of preoperative facial nerve palsy that improved after the surgical resection of a small vestibular schwannoma with hearing preservation. A small vestibular schwannoma within the internal auditory canal caused acute deafness and facial paralysis in a 51-year-old woman. Conservative treatment was initially administered, but severe hearing loss and facial paralysis persisted for 3 months after onset. Subsequently, we performed tumor resection using the retrolabyrinthine approach. The tumor, which compressed the cochlear and facial nerves, was almost completely removed under continuous intraoperative monitoring to preserve the facial nerve function. “Wait and scan” is generally recommended for vestibular schwannomas within the internal auditory canal. However, this case suggests that early successful surgery, at least in selected cases, can improve paralysis without hearing deterioration and maintain the patient's quality of life.

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小前庭神经鞘瘤术前面瘫经迷路后入路治疗

由前庭神经鞘瘤引起的面神经麻痹是一种罕见但关键的症状；然而，很少有报道从治疗的角度关注术前面神经麻痹。此外，其机制尚未完全了解。我们报告一例罕见的术前面神经麻痹，手术切除小前庭神经鞘瘤后，听力得到改善。内耳道内的小前庭神经鞘瘤引起了一名51岁妇女的急性耳聋和面瘫。最初给予保守治疗，但发病后持续3个月的严重听力损失和面瘫。随后，我们采用迷路后入路行肿瘤切除术。肿瘤压迫耳蜗和面神经，术中持续监测几乎完全切除，保留面神经功能。对于内耳道内的前庭神经鞘瘤，一般建议“等待并扫描”。然而，这个病例表明，至少在某些病例中，早期成功的手术可以改善瘫痪而不导致听力下降，并维持患者的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Auris Nasus Larynx 医学-耳鼻喉科学

CiteScore

3.40

自引率

5.90%

发文量

169

审稿时长

30 days

期刊介绍： The international journal Auris Nasus Larynx provides the opportunity for rapid, carefully reviewed publications concerning the fundamental and clinical aspects of otorhinolaryngology and related fields. This includes otology, neurotology, bronchoesophagology, laryngology, rhinology, allergology, head and neck medicine and oncologic surgery, maxillofacial and plastic surgery, audiology, speech science. Original papers, short communications and original case reports can be submitted. Reviews on recent developments are invited regularly and Letters to the Editor commenting on papers or any aspect of Auris Nasus Larynx are welcomed. Founded in 1973 and previously published by the Society for Promotion of International Otorhinolaryngology, the journal is now the official English-language journal of the Oto-Rhino-Laryngological Society of Japan, Inc. The aim of its new international Editorial Board is to make Auris Nasus Larynx an international forum for high quality research and clinical sciences.