scholarly journals Acoustic Neuroma Mimicking Orofacial Pain: A Unique Case Report

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Praveenkumar Ramdurg ◽  
Naveen Srinivas ◽  
Vijaylaxmi Mendigeri ◽  
Surekha R. Puranik
Keyword(s):  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Orofacial Pain ◽  
Temporomandibular Disorder ◽  
Diagnostic Testing ◽  
Cranial Nerves ◽  
Radiographic Evaluation ◽  
Unique Case ◽  
Acoustic Neuromas ◽  
Joint Disorder

Acoustic neuroma (AN), also called vestibular schwannoma, is a tumor composed of Schwann cells that most frequently involve the vestibular division of the VII cranial nerve. The most common symptoms include orofacial pain, facial paralysis, trigeminal neuralgia, tinnitus, hearing loss, and imbalance that result from compression of cranial nerves V–IX. Symptoms of acoustic neuromas can mimic and present as temporomandibular disorder. Therefore, a thorough medical and dental history, radiographic evaluation, and properly conducted diagnostic testing are essential in differentiating odontogenic pain from pain that is nonodontogenic in nature. This article reports a rare case of a young pregnant female patient diagnosed with an acoustic neuroma located in the cerebellopontine angle that was originally treated for musculoskeletal temporomandibular joint disorder.

Translabyrinthine Approach for Acoustic Neuroma

Neurosurgery ◽  
2004 ◽  
Vol 54 (2) ◽  
pp. 391-396 ◽  
Author(s):  
John Diaz Day ◽  
Douglas A. Chen ◽  
Moises Arriaga
Keyword(s):  
Surgical Treatment ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Hearing Preservation ◽  
Retrosigmoid Approach ◽  
The Past ◽  
Translabyrinthine Approach ◽  
Acoustic Neuromas

Abstract THE TRANSLABYRINTHINE APPROACH has been popularized during the past 30 years for the surgical treatment of acoustic neuromas. It serves as an alternative to the retrosigmoid approach in patients when hearing preservation is not a primary consideration. Patients with a tumor of any size may be treated by the translabyrinthine approach. The corridor of access to the cerebellopontine angle is shifted anteriorly in contrast to the retrosigmoid approach, resulting in minimized retraction of the cerebellum. Successful use of the approach relies on a number of technical nuances that are outlined in this article.

Asymmetry of the Internal Auditory Canals without Acoustic Neuroma

1978 ◽  
Vol 87 (6) ◽  
pp. 815-820 ◽  
Author(s):  
Kenneth D. Dolan ◽  
Richard W. Babin ◽  
Charles G. Jacoby
Keyword(s):  
Posterior Fossa ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Clinical Presentation ◽  
Internal Auditory Canal ◽  
Internal Auditory Meatus ◽  
Radiographic Appearance ◽  
The Past ◽  
Acoustic Neuromas ◽  
Normal Architecture

During the past five years, nine patients with “significant” unilateral enlargement of one internal auditory canal by polytomography were subsequently found to have freely filling canals on contrast posterior fossa myelography. The radiographic appearance of the enlarged canals varied greatly and included all the various configurations usually suggestive of acoustic neuroma. Likewise, the clinical presentation varied greatly from asymptomatic to highly suggestive of cerebellopontine angle tumor. This series underscores the essential nature of posterior fossa studies in the evaluation of potential acoustic neuromas and the variability of the normal architecture of the internal auditory meatus.

scholarly journals Impact of Balance Training and Co-ordination Exercises in Post-Operative Left Cerebellopontine Angle Tumor: A Case Report

2021 ◽  
pp. 413-416
Author(s):  
Aditi Akhuj ◽  
Snehal Samal ◽  
Rakesh Krishna Kovela ◽  
Ragini Dagal ◽  
Rebecca Thimoty
Keyword(s):  
Case Report ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Balance Training ◽  
Case Presentation ◽  
Cerebellopontine Angle Tumor ◽  
Acoustic Neuromas ◽  
Tumor Management ◽  
Mild Impairment

Introduction: Acoustic neuromas are most common tumors of CP angle, accounting more than 90% of all such tumors. Meningioma, primary cholesteratoma and facial nerve schwanoma are the different type of tumors. Acoustic neuroma is a benign tumor situates in CP angle which has a fibrous growth and originates from the division of vestibulochochlear nerve. Aim: Impact of Balance Training and Co-ordination Exercises in Post-Operative Left Cerebellopontine Angle Tumor Case Presentation: A 40 year old male with right hand dominance was referred to physiotherapy department. On examination he presented mild impairment in balance and co-ordination, assisted walking. Discussion: This case report is an important to the published literature on rehabilitation of a patient witha CPA tumor, as it presents the sequential management in the patients post CPA tumor. Conclusion: Acoustic neuroma is most common CPA tumor. Management of CPA tumor is important to improve quality of life. As per the reference articles and the exercises planned can progressively improve balance and co-ordination of patients.

Staged Stereotactic Irradiation for Acoustic Neuroma

Neurosurgery ◽  
2005 ◽  
Vol 56 (6) ◽  
pp. 1254-1263 ◽  
Author(s):  
Steven D. Chang ◽  
Iris C. Gibbs ◽  
Gordon T. Sakamoto ◽  
Elizabeth Lee ◽  
Adetokunbo Oyelese ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Acoustic Neuroma ◽  
Clinical Investigation ◽  
Cranial Nerves ◽  
Hearing Preservation ◽  
Tumor Control ◽  
Tumor Diameter ◽  
Acoustic Neuromas ◽  
Class 1

Abstract OBJECTIVE: Stereotactic radiosurgery has proven effective in the treatment of acoustic neuromas. Prior reports using single-stage radiosurgery consistently have shown excellent tumor control, but only up to a 50 to 73% likelihood of maintaining hearing at pretreatment levels. Staged, frame-based radiosurgery using 12-hour interfraction intervals previously has been shown by our group to achieve excellent tumor control while increasing the rate of hearing preservation at 2 years to 77%. The arrival of CyberKnife (Accuray, Inc., Sunnyvale, CA) image-guided radiosurgery now makes it more practical to treat acoustic neuroma with a staged approach. We hypothesize that such factors may further minimize injury of adjacent cranial nerves. In this retrospective study, we report our experience with staged radiosurgery for managing acoustic neuromas. METHODS: Since 1999, the CyberKnife has been used to treat more than 270 patients with acoustic neuroma at Stanford University. Sixty-one of these patients have now been followed up for a minimum of 36 months and form the basis for the present clinical investigation. Among the treated patients, the mean transverse tumor diameter was 18.5 mm, whereas the total marginal dose was either 18 or 21 Gy using three 6- or 7-Gy fractions. Audiograms and magnetic resonance imaging were obtained at 6-months intervals after treatment for the first 2 years and then annually thereafter. RESULTS: Of the 61 patients with a minimum of 36 months of follow-up (mean, 48 mo), 74% of patients with serviceable hearing (Gardner-Robinson Class 1–2) maintained serviceable hearing at the last follow-up, and no patient with at least some hearing before treatment lost all hearing on the treated side. Only one treated tumor (2%) progressed after radiosurgery; 29 (48%) of 61 decreased in size and 31 (50%) of the 61 tumors were stable. In no patients did new trigeminal dysfunction develop, nor did any patient experience permanent injury to their facial nerve; two patients experienced transient facial twitching that resolved in 3 to 5 months. CONCLUSION: Although still preliminary, these results indicate that improved tumor dose homogeneity and a staged treatment regimen may improve hearing preservation in acoustic neuroma patients undergoing stereotactic radiosurgery.

Pain after Surgery for Acoustic Neuroma

1992 ◽  
Vol 107 (3) ◽  
pp. 424-429 ◽  
Author(s):  
David A. Schessel ◽  
Julian M. Nedzelski ◽  
David Rowed ◽  
Joseph G. Feghali
Keyword(s):  
Postoperative Pain ◽  
Surgical Technique ◽  
Acoustic Neuroma ◽  
Tumor Size ◽  
Cerebellopontine Angle ◽  
Significant Morbidity ◽  
Tumor Excision ◽  
Acoustic Neuromas ◽  
Age And Sex ◽  
Suboccipital Approach

Postoperative pain after surgery in the cerebellopontine angle (CPA) is acknowledged to occur, but is rarely taken into account as a factor in the analysis of morbidity of such surgery. It is widely acknowledged that some patients, having undergone such surgery, particularly by means of the suboccipital approach, report significant postoperative pain and headache. This study was undertaken to determine the incidence and severity of pain after excision of acoustic neuromas and to establish whether this differed between the suboccipital and translabyrinthine routes. Ninety-one percent of all patients (n = 58), who had the suboccipital approach used for removal of their tumor, were surveyed. A smaller group (n = 40), MAtched for tumor size, age, and sex, but in whom the translabyrinthine approach was used, was similarly studied. A standard questionnaire, designed to detect and quantify postoperative pain, was administered to each patient. Of patients who underwent tumor excision by means of the suboccipital approach, 63.7% experienced significant local discomfort and headache, whereas this was notably absent in all those who had undergone translabyrinthine excision. In view of the significant morbidity noted to follow the suboccipital approach, several modifications of the surgical technique used were devised.

Fractionated Proton Beam Radiotherapy for Acoustic Neuroma

Neurosurgery ◽  
2002 ◽  
Vol 50 (2) ◽  
pp. 270-275 ◽  
Author(s):  
David A. Bush ◽  
Calvin J. McAllister ◽  
Lilia N. Loredo ◽  
Walter D. Johnson ◽  
James M. Slater ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Proton Beam ◽  
Acoustic Neuroma ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Proton Beam Therapy ◽  
Tumor Control ◽  
Resonance Imaging ◽  
Acoustic Neuromas

ABSTRACT OBJECTIVE This study evaluated proton beam irradiation in patients with acoustic neuroma. The aim was to provide maximal local tumor control while minimizing complications such as cranial nerve injuries. METHODS Thirty-one acoustic neuromas in 30 patients were treated with proton beam therapy from March 1991 to June 1999. The mean tumor volume was 4.3 cm3. All patients underwent pretreatment neurological evaluation, contrast enhanced magnetic resonance imaging, and audiometric evaluation. Standard fractionated proton radiotherapy was used at daily doses of 1.8 to 2.0 cobalt Gray equivalent: patients with useful hearing before treatment (Gardner-Robertson Grade I or II) received 54.0 cobalt Gray equivalent in 30 fractions; patients without useful hearing received 60.0 cobalt Gray equivalent in 30 to 33 fractions. RESULTS Twenty-nine of 30 patients were assessable for tumor control and cranial nerve injury. Follow-up ranged from 7 to 98 months (mean, 34 mo), during which no patients demonstrated disease progression on magnetic resonance imaging scans. Eleven patients demonstrated radiographic regression. Of the 13 patients with pretreatment Gardner-Robertson Grade I or II hearing, 4 (31%) maintained useful hearing. No transient or permanent treatment-related trigeminal or facial nerve dysfunction was observed. CONCLUSION Fractionated proton beam therapy provided excellent local control of acoustic neuromas when treatment was administered in moderate doses. No injuries to the Vth or VIIth cranial nerves were observed. A reduction in the tumor dose is being evaluated to increase the hearing preservation rate.

Subarachnoid Cyst Simulating an Intracanalicular Acoustic Neuroma

1981 ◽  
Vol 89 (6) ◽  
pp. 1019-1020 ◽  
Author(s):  
Steven M. Parnes ◽  
Louis R. Nelson
Keyword(s):  
Case Report ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Review Of The Literature ◽  
The Third ◽  
Acoustic Neuromas ◽  
Subarachnoid Cyst

Acoustic neuromas are the most common lesions found in the cerebellopontine angle. A subarachnoid cyst rarely involves this area. A review of the literature indicates that this is only the third case report in which the subarachnoid cyst manifested itself clinically and radiographically as an intracanalicular acoustic neuroma.

scholarly journals Anesthesia Dolorosa of Trigeminal Nerve, a Rare Complication of Acoustic Neuroma Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Foad Elahi ◽  
Kwo Wei David Ho
Keyword(s):  
Trigeminal Nerve ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Medical Literature ◽  
Rare Complication ◽  
Spontaneous Pain ◽  
Tumor Removal ◽  
Acoustic Neuromas ◽  
Acoustic Neuroma Surgery ◽  
Acoustic Tumor

Anesthesia dolorosa is an uncommon deafferentation pain that can occur after traumatic or surgical injury to the trigeminal nerve. This creates spontaneous pain signals without nociceptive stimuli. Compression of the trigeminal nerve due to acoustic neuromas or other structures near the cerebellopontine angle (CPA) can cause trigeminal neuralgia, but the occurrence of anesthesia dolorosa subsequent to acoustic tumor removal has not been described in the medical literature. We report two cases of acoustic neuroma surgery presented with anesthesia dolorosa along the trigeminal nerve distribution. The patients’ pain was managed with multidisciplinary approaches with moderate success.

Diagnosis of Cerebellopontine Angle Tumors with Small Quantities of Air

1981 ◽  
Vol 89 (3) ◽  
pp. 457-462 ◽  
Author(s):  
Michael W. Penley ◽  
Henry F. W. Pribram
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Lumbar Puncture ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Neurovascular Bundle ◽  
Acoustic Neuromas ◽  
Cerebellopontine Angle Tumors ◽  
Radiologic Examination ◽  
Accuracy Speed

Difficulty in detecting small acoustic neuromas has encouraged us to study patients suspected of having a tumor by air cisternography augmented with computed tomography. Ninety patients were examined without complication. Five cubic centimeters of air was introduced via lumbar puncture and manipulated into the cerebellopontine angle cisterns. Scanning is commenced immediately. Filling of both internal auditory canals and identification of the neurovascular bundle in the cerebellopontine angle cistern was possible in all patients except those with tumors. The diagnostic accuracy, speed, and lack of morbidity have made this procedure the initial radiologic examination at our institution for patients suspected of having acoustic neuroma.

Not So Benign: A Rare Atypical Ectopic Choroid Plexus Papilloma

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Patel R ◽  
◽  
Lukins D ◽  
Villano JL ◽  
Sudhakar P ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Cerebellopontine Angle ◽  
Radiation Necrosis ◽  
Cranial Nerves ◽  
Choroid Plexus Papilloma ◽  
Seer Database ◽  
Unique Case ◽  
Leptomeningeal Seeding ◽  
Choroid Plexus Papillomas ◽  
Plexus Papilloma

Choroid Plexus Papillomas (CPPs) are rare neoplasms (0.4-0.6 % of all brain tumors) arising from cuboidal epithelial cells of the choroid plexus. Atypical choroid plexus papillomas are even more rare and characterized by aggressive features of increased mitotic activity and frequent metastases even at diagnosis. Atypical choroid plexus papillomas accounted for 9% of choroid plexus tumors in the Surveillance Epidemiology and End Results (SEER) Database from 1978 to 2009. We describe a 56 year-old woman with a rare atypical choroid plexus papilloma ectopically located in the cerebellopontine angle and mistaken for a vestibular schwannoma or glossopharyngeal schwannoma. She demonstrated leptomeningeal seeding involving multiple cranial nerves and spinal cord. Besides papilledema she developed several neuro-ophthalmic features slowly over time from involvement of cranial nerves and subsequent intraparenchymal spread and radiation necrosis in the brainstem. Besides being rare, the cerebellopontine angle location of this tumor is also extremely uncommon making this a very unique case.

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