Cerebellopontine angle tumor presenting as acute audiovestibular syndrome

Abstract

Background

Acute audiovestibular deficits may be a harbinger of vestibular schwannoma (VS).

Objective

To investigate clinical and laboratory features of 25 consecutive patients with VS presenting with acute audiovestibular deficits.

Methods

A symptomatic combination of acute audiovestibular deficits was investigated. Audiometric and vestibular function tests, and internal auditory canal magnetic resonance imaging (IAC MRI) results were evaluated.

Results

Varying combinations of symptoms may develop in VS patients with acute audiovestibular deficits, of whom sudden hearing loss (HL) without acute vertigo or acute facial nerve palsy (FNP) was most common. The most common audiometric configuration was high-tone hearing loss, and no patient showed low-tone hearing loss. IAC MRI demonstrated that the tumor had an intracanalicular portion and attachment to the bony IAC wall in all patients and widened the IAC wall in some patients.

Conclusion

Different symptomatic combinations of acute audiovestibular deficits may develop in patients with VS. Awareness about the possibility of VS as a cause of sudden HL, acute vertigo, and acute FNP, as well as subsequent IAC MRI scanning is vital to earlier diagnosis of VS in these patients.

Chinese Abstract

背景

急性听觉前庭缺陷可能是前庭神经鞘瘤(VS)的先兆。

目的

调查25 例患有急性听觉前庭缺陷的连续VS 患者的临床和实验室特征。

方法

对急性听觉前庭缺陷的症状组合进行研究。 对听力测试和前庭功能测试, 以及内耳道磁共振成像 (IAC MRI) 的结果进行了评估。

结果

患有急性听前庭功能障碍的 VS 患者可能会出现不同的症状组合, 其中不伴有急性眩晕或急性面神经麻痹(FNP)的突发性听力损失(HL)是最常见的。 最常见的听力测试配置是高音听力损失, 并且无一患者表现出低音听力损失。 内耳道MRI 显示, 所有患者的肿瘤有耳道内部分, 附着于骨质内耳道壁, 部分患者的内耳道壁加宽。

结论

急性听觉前庭缺陷的不同症状组合可能发生于VS 患者。 认识到 VS 可能导致突发 HL、急性眩晕和急性 FNP 以及随后的 内耳道 MRI 扫描, 对于这些患者的 VS 早期诊断至关重要。

Keywords:

• Cerebellopontine angle tumor
• vestibular schwannoma
• hearing loss
• vertigo
• facial nerve palsy

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Research Foundation of Korea grant funded by the Korea Government (Ministry of Science, ICT and Future Planning; 2021R1F1A1062019).