Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Jul 8;85(3):e112-e117.
doi: 10.1055/s-0044-1788071. eCollection 2024 Jul.

Hearing Improvement after Radiation Therapy for a Facial Nerve Schwannoma: Report of a Case and Review of Literature

Isabella L Pecorari  1   2 , Sayak R Ghosh  1   2 , Howard S Moskowitz  3   4 , Vijay Agarwal  1   2
Affiliations
Case Reports

Hearing Improvement after Radiation Therapy for a Facial Nerve Schwannoma: Report of a Case and Review of Literature

Isabella L Pecorari et al. J Neurol Surg Rep. .

Abstract

Introduction While facial nerve schwannomas are considered benign, they can impart various significant clinical effects due to pressure on nearby cerebrovascular structures within the cerebellopontine angle (CPA). Although surgical resection and/or radiation therapy often provide definitive treatment of such tumors, posttreatment hearing loss is a common finding. In this report, we present the case of a patient with a facial nerve schwannoma successfully treated with radiotherapy with resultant hearing improvement, an extremely rare clinical finding. Case Presentation A 63-year-old woman presented with a 1-year history of progressively worsening hearing loss and tinnitus. Brain imaging demonstrated an enhancing lesion of the right CPA measuring 2.7 × 2.1 × 3.1 cm. Pretreatment audiometry evaluation revealed sensorineural hearing loss in the right ear with a pure-tone average (PTA) of 74 dB, speech threshold (ST) of 75 dB, and speech discrimination (SD) of 0%. The patient proceeded with attempted surgical resection, aborted due to significant facial nerve stimulation, and ultimately underwent radiation therapy (50.4 Gy, 28 fractions). At the 1-year follow-up visit, the patient reports subjective hearing loss resolution with PTA of 34 dB, 30 dB ST, and 88% SD on audiological evaluation. Conclusion Although radiation therapy for schwannomas within the CPA has historically been associated with hearing loss, fractionated stereotactic radiotherapy (FSRT) may provide improved clinical outcomes compared with high-dose radiosurgery. Given the effectiveness of this treatment modality and improved quality of life offered to patients over surgery, FSRT may be considered an initial management option for patients with facial nerve schwannomas.

Keywords: CPA mass; facial nerve schwannoma; hearing improvement; radiation therapy.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Preoperative coronal ( A ) and axial ( B ) postcontrast T1-weighted fluid-attenuated inversion recovery magnetic resonance imaging.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Samii M, Gerganov V M. Elsevier; 2012. Chapter 41 - Tumors of the cerebellopontine angle; pp. 633–639. - PubMed
    1. Rhoton A L., JrThe cerebellopontine angle and posterior fossa cranial nerves by the retrosigmoid approach Neurosurgery 200047(3, Suppl):S93–S129. - PubMed
    1. Granick M S, Martuza R L, Parker S W, Ojemann R G, Montgomery W W.Cerebellopontine angle meningiomas: clinical manifestations and diagnosis Ann Otol Rhinol Laryngol 198594(1 Pt 1):34–38. - PubMed
    1. Springborg J B, Poulsgaard L, Thomsen J. Nonvestibular schwannoma tumors in the cerebellopontine angle: a structured approach and management guidelines. Skull Base. 2008;18(04):217–227. - PMC - PubMed
    1. Verkhratsky A, Butt A M. Academic Press; 2023. Chapter 14 - Pathology of the peripheral nervous system; pp. 673–690.

Publication types