Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-09T15:55:32.163Z Has data issue: false hasContentIssue false
  • English
  • Français

Temporal bone pathology of acoustic neuroma correlating with presence of electrocochleography and absence of auditory brainstem response

Published online by Cambridge University Press:  29 June 2007

Kimitaka Kaga ,
Shinichi Iwasaki ,
Akira Tamura ,
Jun-Ichi Suzuki  and
Hideyuki Haebara
Kimitaka Kaga*
Affiliation:
Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo 113, Japan
Shinichi Iwasaki
Affiliation:
Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo 113, Japan
Akira Tamura
Affiliation:
Department of Neurosurgery, School of Medicine, Teikyo University, Tokyo 173, Japan
Jun-Ichi Suzuki
Affiliation:
Department of Neurosurgery, School of Medicine, Teikyo University, Tokyo 173, Japan
Hideyuki Haebara
Affiliation:
Second Department of Pathology, School of Medicine, Teikyo University, Tokyo 173, Japan.
*
Address for correspondence: Dr K. Kaga, Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113, Japan.
Get access Rights & Permissions [Opens in a new window]

Abstract

The temporal bone pathology of a 74-year-old female affected by vestibular schwannoma was compared with findings of auditory brainstem response and electrocochleography. At age 71, she complained of hearing loss in the left ear in which pure tone audiometry revealed threshold elevation in the middle- and high-frequency range. Temporal bone CT scanning revealed a medium-sized cerebellopontine angle tumour in the left ear. ABR showed no response in the left ear, but the electrocochleography showed clear compound action potentials. Three years later, at age 74, she died of metastatic lung cancer and sepsis. The left temporal bone pathology consisted primarily of a large vestibular schwannoma occupying the internal auditory meatus. The organ of Corti was well preserved in each turn. In the modiolus, the numbers of spiral ganglion cells and cochlear nerve fibres in each turn were decreased. These histological findings suggest that clear compound action potentials were recorded from the distal portion of the cochlear nerve in spite of the presence of the vestibular schwannoma, but ABR could not be detected because of the blockade of the proximal portion of the cochlear nerve by the vestibular schwannoma.

Keywords

Schwannoma, vestibularAudiometry, evoked responseTemporal bone, pathology
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 10 , October 1997 , pp. 967 - 972
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Antoni, N. R. E. (1920) Über Ruckenmarkstumoren und Neurofibrome. J. F. Bergmann, Wiesbaden, Germany.Google Scholar
Benitez, J. T., Lopez Rios, G., Novoa, V. (1967) Bilateral acoustic neuroma: A human temporal bone report. Archives of Otolaryngology 86: 25–31.CrossRefGoogle ScholarPubMed
Chandrasekhar, S. S., Brackmann, D. E., Kalpna, K., Devgan, K. K. (1995) Utility of auditory brainstem response audiometry in diagnosis of acoustic neuromas. American Journal of Otology 16: 63–67.Google ScholarPubMed
Dauman, R., Aran, J.-M., Portmann, M. (1988) Limits of ABR and contribution of transtympanic electro-cochleography in the assessment of cerebellopontine angle tumours. Clinical Otolaryngology 13: 107–114.CrossRefGoogle Scholar
De Moura, L. (1967) Inner ear pathology in acoustic neurimoma. Archives of Otolaryngology 85: 125–133.CrossRefGoogle Scholar
Eggermont, J. J., Don, M., Brackmann, D. E. (1980) Electrocochleography and auditory brainstem electric responses in patients with pontine angle tumours. Annals of Otology, Rhinology and Laryngology 89: 1–19.CrossRefGoogle Scholar
Hall, J. W. (1992) Neurodiagnosis: Eighth cranial nerve cerebellopontine angle, and extraaxial pathology. In Handbook of Auditory Evoked Responses. Allyn & Bacon, Needham Heights, Massachusetts, pp 385–418.Google Scholar
Igarashi, M., Jerger, J., Alford, B. R., Stasney, R. (1984) Functional and histological findings in acoustic tumor. Archives of Otolaryngology 99: 379–384.CrossRefGoogle Scholar
Portmann, M., Dauman, R., Duriez, F., Portmann, D., Dhillon, R. (1989) Modern diagnostic strategy for acoustic neuromas. Archives of Otorhinolaryngology 246: 286–291.CrossRefGoogle ScholarPubMed
Selters, W., Brackmann, D. E. (1977) Acoustic tumor detection with brain stem electric response audiometry. Archives of Otolaryngology 103: 181–187.CrossRefGoogle ScholarPubMed
Schuknecht, H. F., McNell, R. A. (1966) Lightmicroscopic observations on the pathology of endolymph. Journal of Laryngology and Otology 80: 1–10.CrossRefGoogle Scholar
Schuknecht, H. F. (1993) Pathology of the Ear. 2nd Edition. Lea and Febiger, Philadelphia, pp 461–468.Google Scholar
Shanon, E., Gold, S., Himmelfarb, M. S. (1981) Auditory brainstem responses in cerebellopontine angle tumors. Laryngoscope 91: 254–259.CrossRefGoogle Scholar
Silverstein, H., Schuknecht, H. F. (1966) Biochemical studies of inner ear fluid in man: Changes in otoscierosis, Menière's disease and acoustic neuroma. Archives of Otolaryngology 84: 395–402.CrossRefGoogle Scholar
Suga, F., Lindsay, J. R. (1976) Inner ear degeneration in acoustic neurimona. Annals of Otology, Rhinology and Laryngology 85: 343–358.CrossRefGoogle Scholar
Ylikoski, J., Collan, Y., Palva, T., Jauhiainen, T. (1978) Cochlear nerve in neurilemomas: audiology and histopathology. Archives of Otolaryngology - Head and Neck Surgery 104: 679–684.CrossRefGoogle ScholarPubMed