Intracochlear schwannoma: transcochlear resection, intraoperative monitoring and simultaneous cochlear implantation

Intracochlear swannomas represent a rare differential diagnosis of hearing loss. The first symptom of intracochlear swannoma is usually asymmetric hearing loss. In the film we report about a 48-year-old patient who complained about a sudden surdity of the left side for 1 year; vertigo, tinnitus as well as otorrhoea and otalgia were denied. Cranial magnetic resonance imaging (cMRI) showed a contrast-enhancing lesion in the basal turn of the left cochlea.

Transcochlear resection of the intracochlear swannoma with simultaneous cochlear implantation was performed. ECAP threshold measurements and EBERA with reproducible responses were performed intraoperatively. Four weeks after initial fitting of the cochlear implant, the patient was free of vertigo and already achieved audiologically useful results (Freiburg speech audiometry at 65 dB: numbers 85%, monosyllable 60%; Oldenburg sentence test (OLSA): at rest 91%, and an SNR of -1.0 dB in the adaptive test in noise).

The film illustrates the surgical removal of the intracochlear swannoma with simultaneous cochlear implantation and intraoperative auditory monitoring for hearing rehabilitation.

Publication History

Publication Date:
23 April 2019 (online)