OBJECTIVES

To highlight the clinical presentation, diagnostic dilemma and proposed management of a case of a transmodiolar intralabyrinthine schwannoma.

METHODS

Design:Case Report

Setting:Tertiary National University Hospital

Patient:One

RESULTS

A 51-year-old woman consulted for a 12-year history of unilateral sensorineural hearing loss and progressively worsening vertigo. Workups revealed a hyperintense lesion approximating the entire right cochlea on Gadolinium-enhanced magnetic resonance imaging and profound hearing loss on the right on pure-tone audiometry, with no recordable response even at maximum intensity levels across all frequencies. Infectious and metastatic workups returned negative results, clinching the radiographic diagnosis of an intralabyrinthine schwannoma.

CONCLUSION

Intralabyrinthine schwannomas (ILS) are rare, benign neoplasms of the 8th cranial nerve, manifesting as progressive unilateral sensorineural hearing loss and worsening vertigo. These neoplasms are mainly detected by MRI; underdiagnosis and lack of standard treatment and diagnostic protocols result in their inaccurate diagnosis and delays in management.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Neurilemmoma ; Schwannoma

Objective: To present a rare case of nasal tip schwannoma and describe its resection and reconstruction using combined cartilage grafts. Methods: Design: Case Report Setting: Tertiary Government Training Hospital Patient: One Results: A 13-year-old boy presented with a progressively enlarging nasal tip and severe left nasal obstruction causing breathing difficulties and psychosocial distress. There was a bulging septal mass obstructing 90% of the left nasal cavity. Septal incision biopsy revealed schwannoma and definitive surgery via open rhinoplasty approach was done. The non-encapsulated schwannoma extended from the subcutaneous nasal tip to the left septal mucosa. There was no evidence of skin or cartilage invasion, but prolonged pressure from the expansile schwannoma caused severe lower lateral cartilage and anterior septal atrophy leading to a collapsed and expanded nasal tip after resection. To correct this, a total reconstruction of the anterior tip complex was done using combined ear cartilage seagull wing graft, shield graft and septal extension graft. Conclusion Nasal tip and septal schwannoma is rare and can cause significant nasal obstruction and deformity. Complete excision is vital to avoid recurrence. Total reconstruction of the lower lateral cartilages using autologous septal and ear cartilage grafts may be a safe and effective technique that yields acceptable aesthetic results.
nasal septum ; schwannoma ; ear cartilage ; rhinoplasty ; nasal cartilages ; esthetics ; neurilemmoma ; adolescent