引言第八脑神经鞘瘤是良性肿瘤,通常发生在内耳道或桥小脑角池。很少,这些肿瘤可能起源于前庭内的神经细胞,耳蜗,或半规管,被称为行内神经鞘瘤。耳蜗内神经鞘瘤(ICSs)占这些肿瘤的一小部分,它们的诊断基于高分辨率磁共振成像(MRI)。目的报告在22个月的随访期后,一名48岁男性的ICS的临床和放射学特征以及听力测试结果。复诊报告有8年右耳持续性耳鸣病史的患者,合并同侧进行性听力损失和听觉丰满。测听法显示左耳听力正常,右耳中度至重度感音神经性听力损失,随着语音接收阈值和单词识别得分的降低,与5年前进行的考试相比。MRI显示耳蜗内小结节病变,在T1上具有等强度,在T1后g图像上具有高对比度增强。在后续期间,影像学检查没有放射学改变.因此,我们选择了等待和扫描政策,因为病变保持稳定,没有明显的增长,并且患者仍然存在残余听力.结论一旦确诊,并非所有ICS患者都需要手术。ICS的治疗选择包括立体定向放射治疗和重新扫描政策,根据肿瘤的大小,肿瘤生长的证据,听力损失程度,顽固性前庭症状,关注病理诊断,和病人的其他医疗条件。
Introduction Schwannomas of the eighth cranial nerve are benign tumors that usually occur in the internal auditory canal or the cerebellopontine angle cistern. Rarely, these tumors may originate from the neural elements within the vestibule, cochlea, or semicircular canals and are called intralabyrinthine schwannomas. Intracochlear schwannomas (ICSs) represent a small percentage of these tumors, and their diagnosis is based on high-resolution magnetic resonance imaging (MRI). Objectives To report the clinical and radiologic features and audiometric testing results of an ICS in a 48-year-old man after a 22-month follow-up period. Resumed Report A patient with an 8-year history of persistent tinnitus in his right ear, combined with ipsilateral progressive hearing loss and aural fullness. Audiometry revealed normal hearing in the left ear and a moderate to severe sensorineural hearing loss in the right ear, with decreased speech reception threshold and word recognition score, compared with the exam performed 5 years previously. MRI showed a small intracochlear nodular lesion in the modiolus, isointense on T1 with a high contrast enhancement on T1 postgadolinium images. During the follow-up period, there were no radiologic changes on imaging studies. Thus, a wait-and-scan policy was chosen as the lesion remained stable with no considerable growth and the patient still presents with residual hearing. Conclusions Once diagnosed, not all ICS patients require surgery. Treatment options for ICS include stereotactic radiotherapy and rescanning policy, depending on the tumor\'s size, evidence of the tumor\'s growth, degree of hearing loss, intractable vestibular symptoms, concern about the pathologic diagnosis, and the patient\'s other medical conditions.