Dr. Sidharth Ghosh

Acoustic neurinoma/vestibular schwannoma

Vestibular Schwannomas – commonly known as acoustic neuroma – A benign slow-growing tumor that develops from the balance and hearing nerves supplying the inner ear. Usually occurs in older than 40 years of age.

Unilateral/asymmetric hearing loss and loss of balance/dizziness are early signs of a vestibular schwannoma. When tumors grow, they begin to cause injury to the hearing nerve and balance nerve, by compressing them. Patients may experience severe hearing loss. Once the symptoms appear, a thorough ear examination and hearing test (audiogram) are essential for proper diagnosis. CT and MRI scans will reveal its size and position.

This is treated with surgical removal of the tumor. The removal of tumors affecting the hearing, balance, or facial nerves because sections of these nerves may also need to be removed with the tumor.

Case -1

This 72 year old lady was admitted with complaints of loss of hearing in right side since 2 years with associated loss of taste sensation in the right half of the tongue since 1 year and imbalance while walking,  numbness in right half of the face since 6 months. Symptoms were gradual  in onset and progressive in nature.

She was diagnosed to have cerebellopontine angle space occupying lesion, bilateral acoustic schwannoma and was treated by fractionated radiotherapy earlier.

Diagnosis : Bilateral acoustic schwannoma

Surgery : Right translabyrinthine approach and total excision of tumour

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MRI axial image shows cerebellopontine angle space occupying lesion.
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Postoperative CT scan shows complete excision of the tumor.

 

Case -2

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MRI axial image shows cerebellopontine angle space occupying lesion.
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MRI coronal image shows cerebellopontine angle space occupying lesion.
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Postoperative CT scan shows complete excision of the tumor.
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Postoperative CT scan shows complete excision of the tumor.
Case -3
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MRI axial image shows cerebellopontine lesion measuring 3.95 cm.
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MRI coronal image shows cerebellopontine angle space occupying lesion.
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Sagittal MR image shows big space occupying lesion
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Postoperative CT scan shows complete excision of the tumor.
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Postoperative CT scan shows complete excision of the tumor.
Case – 4
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Post GADO MR axail shows images huge huge lesion in cerebellopontine angle space.
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Post GADO MR coronal shows images huge huge lesion in cerebellopontine angle space.
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Post GADO MR sagittal shows images huge huge lesion in cerebellopontine angle space.
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Postoperative contrast CT scan shows complete excision of the tumor.
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Postoperative contrast CT scan shows complete excision of the tumor.