# Complete Hearing Recovery after Retrosigmoid Resection of Jugular Foramen Schwannoma with Concurrent Ipsilateral Vestibular Schwannoma

## TL;DR

A patient with two types of nerve tumors regained full hearing after surgery to remove one tumor, without touching the other.

## Contribution

Demonstrates complete hearing recovery after jugular foramen schwannoma resection with a concurrent vestibular schwannoma.

## Key findings

- A 46-year-old woman regained full hearing six weeks after surgery for a jugular foramen schwannoma.
- Postoperative vestibular testing showed a subtle caloric response and improved central oculomotor findings.
- The case supports hearing-preservation surgery for similar tumors without manipulating concurrent vestibular schwannomas.

## Abstract

Introduction
 Cerebellopontine angle (CPA) tumors frequently present with hearing loss, which influences whether a hearing-preservation versus hearing ablative surgical approach is chosen. We discuss a case of complete hearing recovery after resection of a jugular foramen schwannoma (JFS) in a patient who also had a small intracanalicular vestibular schwannoma (VS).

Case
 A 46-year-old woman presented with left ear fullness, tinnitus, and imbalance for 9 months. She had no lower cranial nerve dysfunction. Audiometry demonstrated Class D hearing with 4% word recognition on the left. Vestibular testing showed absent caloric response on the left and subtle central findings. Magnetic resonance imaging demonstrated a left 3.3-cm JFS and separate left 1-cm intracanalicular VS. A retrosigmoid approach was performed for a radical subtotal resection of the JFS, relieving the mass effect on the vestibulocochlear nerve. The small intracanalicular VS was not manipulated. Pathology confirmed schwannoma with neurofibromatosis type 2 (NF2) mutation in the tumor but normal NF2 germline. Postoperative audiometry at 6 weeks showed normal audiometric thresholds with 100% discrimination. Subtle left caloric response was noted on postoperative vestibular testing and central oculomotor findings improved.

Discussion
 The presented case describes the management of concurrent ipsilateral VS and JFS in the absence of NF2 and demonstrates a unique complete and rapid recovery of hearing following JFS resection without manipulation of concurrent VS. This case supports the use of a hearing-preservation approach in similar cases and corroborates previous reports of hearing recovery following resection of non-VS CPA tumors with hearing-preservation approaches.