Dysgeusia as a Presenting Complaint of Vestibular Schwannoma

Vestibular schwannoma (VS) is a benign primary intracranial tumor growth arising from Schwann cells of the myelin sheath on the vestibular nerve. It usually arises within the internal auditory meatus and extends into the posterior fossa to occupy the space within the cerebellopontine angle (CPA). Due to local compressive effect within the CPA, surrounding cranial nerves (5, 6, 9, 10) can be affected. The facial nerve (7) is often spared.

In this case report, we describe an interesting case of VS with a patient presenting with dysgeusia. A 68-year-old woman with no significant past medical history presented with worsening right hearing loss, difficulty in balance, and right trigeminal numbness affecting all three distributions. She also described a history of loss of taste and right-sided tongue numbness, which later progressed to become an extreme salty taste sensation especially at the tip of her tongue. She subsequently underwent an uneventful retrosigmoid resection of her VS. Except for her hearing, all her symptoms improved markedly postoperatively including her dysgeusia.

Gradual growth of her VS compressing onto her right facial nerve is most likely the cause of her altered taste. Dysgeusia is a possible, though rare, symptom of VS and, in theory, any lesion within the CPA.