Authors Robert J Tibesar 1, Anthony E Brissett, Jon K Shallop, Colin L W Driscoll. Although the role of surgical decompression remains unclear, it appears that patients presenting with vertigo have more favorable response to surgical decompression as compared with those presenting with tinnitus and sensorineural hearing loss. Internal auditory canal decompression and cochlear implantation in Camurati-Engelmann disease Otolaryngol Head Neck Surg. Decompression of internal auditory canal (procedure) Code System Preferred Concept Name: Decompression of internal auditory canal (procedure) Concept Status: Published: Concept Status Date: : Code System Name: SNOMED-CT: Concept Relationships Concept Details. Results Of the 13 patients who underwent surgical decompression, 8 patients had resolution of vertigo symptoms, 10 patients had improvement of tinnitus symptoms, and all patients maintained some level of serviceable hearing.Ĭonclusion IAC exostoses and osteomas are rare lesions that lead to insidious onset of debilitating symptoms from vestibulocochlear nerve dysfunction. A vascular loop was suspected of being present within the internal auditory canal in another patient who complained of tinnitus and vertigo. A total of 26 reported cases were identified, and patient presenting symptoms, management strategies, and response to surgery was obtained when available. Vascular loops were found in 2 patients diagnosed clinically as having Ménières disease. Methods A comprehensive search was conducted using PubMed Central, Web of Science Core Collection, and Google Scholar databases to identify previous reports of IAC exostoses and osteomas. We present two cases of IAC exostoses managed with surgical decompression and review the clinical outcomes of previously reported cases in the literature. 7, 8, 9 Furthermore, in patients with loops of the internal auditory canal (IAC) with a caliber greater than 0.8 mm, tinnitus is strictly correlated with nerve. In general, decompression sickness (DCS) is thought to be caused by the generation of gas bubbles within the vasculature and organ tissues. There is evidence that microvascular decompression (MVD) of the vestibulocochlear nerve can be effective in selected patients who exhibit pulsatile tinnitus or disabling positional vertigo in the setting of a vascular loop within the ipsilateral IAC, but available evidence at this time does not support MVD for SSNHL.Īnterior inferior cerebellar artery Cerebellopontine angle Hearing loss Internal auditory canal Magnetic resonance imaging Microvascular decompression Vascular malformation Vessel loop Vestibular schwannoma.Background Exostoses and osteomas are benign, insidious lesions of the bone involving the internal acoustic canal (IAC). Vascular compression of cranial nerves can lead to neuronal dysfunction, and this has been rarely described in patients involving the vestibulocochlear nerve complex. She was not offered radiosurgery, and she elected conservative management. There was no evidence of a schwannoma on the repeat MRI. Repeat MRI demonstrated a loop of the anterior inferior cerebellar artery (AICA) compressing the vestibulocochlear nerve within the right IAC. She was originally diagnosed with a vestibular schwannoma on magnetic resonance imaging (MRI) and was referred to our institution for Gamma Knife radiosurgery. ![]() The current report represents an attempt to understand this clinical entity as discussed in the current literature.Case summary: A 77-year-old female with a long history of progressive right-sided hearing loss and episodic vertigo developed unilateral right SSNHL, tinnitus, vertigo, and disequilibrium. ![]() Underlying pathophysiologic factors surrounding microvascular compression of the vestibulocochlear nerve are poorly understood and make treatment recommendations, especially the option of microvascular decompression, difficult if not controversial. We present a patient with unilateral sudden sensorineural hearing loss (SSNHL) who was found to have a vascular loop in the ipsilateral internal auditory canal (IAC), and we review the literature regarding this association. Computed tomography (CT) of the ears showed a narrow, duplicated internal auditory canal, one canal containing the facial nerve and the other containing.
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