407 Vestibular Schwannoma in a teenager: case report

RelevanceVestibular Schwannoma (VS) – is a benign encapsulated tumor, initially arises in the inner auditory canal from the neurolemma of the vestibular nerve with further growth towards the base of the skull. Basically, they are associated with neurofibromatosis type 2 (NF2). In children sporadic cases of VS are uncommon. We report a case of VS in teenager.MethodsA 15-year-old girl with a viral infection was diagnosed with unilateral acute sensorineural hearing loss (SNHL). There was no NF2 family history. General medical examination revealed no ENT-pathology. MRI showed no tumor and vascular malformations in the brain and temporal region. After the standard course of dexamethasone effect was not obtained. SNHL progressed over the next 9 months. Evaluation of advanced hearing tests showed: tympanometry (probe-ton 226 Hz) demonstrated Type A bilateral, TEOAE were documented as ‘Pass’ bilateral, pure tone audiometry determined profound hearing loss on the right, Auditory Brainstem Response (ABR) was defined wave V latency on the right, ABR thresholds were detected with intensity stimulus level 85 dB SPL on the right and 30 dB SPL on the left. At the series X-ray CT images of temporal region were determined inner auditory canal deformation and extension. A second MRI scan revealed a bulky tumor coming from the inner auditory canal. The tumor was removed with Stereotactic Radiosurgery (Gamma Knife system).ConclusionsUnilateral hearing loss in a child is a reason for an extended examination in order to exclude retrocochlear pathology.