Abstract
Introduction Cerebellopontine angle (CPA) tumors frequently present with hearing loss, which influences
whether a hearing-preservation versus hearing ablative surgical approach is chosen.
We discuss a case of complete hearing recovery after resection of a jugular foramen
schwannoma (JFS) in a patient who also had a small intracanalicular vestibular schwannoma
(VS).
Case A 46-year-old woman presented with left ear fullness, tinnitus, and imbalance for
9 months. She had no lower cranial nerve dysfunction. Audiometry demonstrated Class
D hearing with 4% word recognition on the left. Vestibular testing showed absent caloric
response on the left and subtle central findings. Magnetic resonance imaging demonstrated
a left 3.3-cm JFS and separate left 1-cm intracanalicular VS. A retrosigmoid approach
was performed for a radical subtotal resection of the JFS, relieving the mass effect
on the vestibulocochlear nerve. The small intracanalicular VS was not manipulated.
Pathology confirmed schwannoma with neurofibromatosis type 2 (NF2) mutation in the
tumor but normal NF2 germline. Postoperative audiometry at 6 weeks showed normal audiometric
thresholds with 100% discrimination. Subtle left caloric response was noted on postoperative
vestibular testing and central oculomotor findings improved.
Discussion The presented case describes the management of concurrent ipsilateral VS and JFS
in the absence of NF2 and demonstrates a unique complete and rapid recovery of hearing
following JFS resection without manipulation of concurrent VS. This case supports
the use of a hearing-preservation approach in similar cases and corroborates previous
reports of hearing recovery following resection of non-VS CPA tumors with hearing-preservation
approaches.
Keywords
hearing recovery - hearing return - retrosigmoid - jugular foramen schwannoma
