Recovery of hearing after removal of a large jugular foramen schwannoma: report of two cases.

BACKGROUND

Although hearing loss is a common presenting symptom of jugular foramen schwannoma (JFS), recovery of hearing after tumor removal has rarely been reported. We report two cases of a large JFS presenting with severe hearing loss and recovering normal hearing after tumor removal.

METHODS AND

RESULTS

Two patients complaining of progressive hearing loss each proved to have a large JFS involving the posterior fossa. The hearing losses, which exceeded 90 dB, were not associated with dysfunction of the 9th, 10th, or 11th cranial nerves. Schwannomas were removed by a suboccipital retrosigmoid approach, preserving labyrinthine structures. The vestibulocochlear nerve, stretched and displaced rostrally by the tumor, was preserved with surrounding arachnoidal tissue. Soon after surgery, recovery of hearing began; normal hearing was restored within 3 months.

CONCLUSIONS

In a case of JFS with severe hearing loss, normal hearing may be attainable by tumor removal using a retrosigmoid approach that preserves labyrinthine structures. The arachnoidal tissue separating the vestibulocochlear nerve from the schwannoma is important to hearing preservation.