Neurinoma of the Facial and Acoustic Nerve; A Case Report

Abstract

A 52-year-old female had lost hearing in her right ear in childhood due to middle ear infection. She had sudden left hearing loss in 1980. Idiopathic sudden deafness was diagnosed at that time. Hearing was partially restored but then became gradually worse. In 1983 bilateral total deafness was noted. She visited our clinic to receive a cochlear implant. She had no facial palsy, no cafe-au-lait spots and no family history of neurofibromatosis. CT and MRI showed a tumor in the C-P angle and at the base of middle cranial fossa. Total removal was accomplished through a translabyrinth approach and middle and posterior craniotomy. Two different tumors were found, one of the acoustic nerve and one of the facial nerve. The acoustic neurinoma extended from the internal auditory canal to the CPA, and the facial nerve neurinoma from the geniculate portion to the middle ear, the base of the middle cranial fossa and the CPA. The sural nerve was used as a facial nerve graft.
This is a rare instance of facial and acoustic nerve neurinoma in a patient without neurofibromatosis. Our investigations have turned up only two reports of such cases in the literature.