Affiliation:
1. Division of Otolaryngology, Department of Surgery, University of Nevada, Reno School of Medicine, Reno, NV
Abstract
Abstract
Background Intracranial schwannomas are
most commonly associated with the
vestibulocochlear nerve, often leading to hearing
loss, tinnitus, and vestibular dysfunction. Much
less often, a schwannoma can arise from the
trigeminal nerve which can lead to facial pain,
numbness, and weakness.
Purpose We explored a case of a patient
with an magnetic resonance imaging (MRI)-confirmed
trigeminal schwannoma that was mistaken for a
vestibulocochlear schwannoma because of a myriad
of ipsilateral vestibulocochlear
symptoms.
Research Design This is a retrospective
chart review and case study, with no statistics
applied.
Results This diagnostic error led to
clinical confusion and inaccurate medical
record-keeping. Radiologists and radiation
oncologists deemed the patient's symptoms to be
unrelated to the asymptomatic trigeminal
schwannoma, and she was referred to an
otolaryngologist following complaints of ear
fullness, ear pain, and hearing loss. The
patient's audiogram showed ipsilateral, asymmetric
sensorineural hearing loss, and she was diagnosed
with concurrent Meniere's disease. Alternative
explanations, such as an additional schwannoma or
external compression of the vestibulocochlear
nerve, were considered, but not apparent on
MRI.
Conclusions From this case, we see that
symptoms do not always concur with imaging results
and that multiple etiologies, especially when one
is rare, can confuse a clinical picture.
Cited by
1 articles.
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