Contralateral Hearing Loss After Resection of Vestibular Schwannoma in a Patient with Neurofibromatosis 2: Case Report and Literature Review.

BACKGROUND

Resection of a vestibular schwannoma may result in facial paralysis and hearing loss on the side of the tumor. We evaluated clinical, audiologic, and intraoperative events and radiologic parameters in a case of contralateral side sensorineural hearing loss. We also performed a literature search using PubMed.

METHODS

A 25-year-old woman with neurofibromatosis 2 developed contralateral side sensorineural hearing loss immediately after resection of vestibular schwannoma. The patient regained partial hearing with a short course (2 months) of steroid therapy over 6 months.

CONCLUSIONS

Literature search yielded 20 cases. We evaluated possible etiology, pattern, extent, recovery, and final outcome in these patients with management options. Several etiologies have been proposed, including development of endolymphatic hydrops, vascular phenomenon, mechanical injury, barotrauma, and autoimmune cochleolabyrinthitis. Sudden release of cerebrospinal fluid seemed to be the most likely explanation in the present case. There is no way to predict this complication beforehand. Operating in supine position, slow release of cerebrospinal fluid, irrigation of the operating field, maintenance of normotension, and judicious use of the drill may help in prevention. A short course of corticosteroids and vasodilators helped in spontaneous recovery in most of the cases.