INTRODUCTION AND HISTORY

Mrs S, presented with reduced hearing in the right ear with imbalance while walking. Both symptoms were gradually progressing but she took no serious note of it. Then she began developing numbness over the right side of her face. This time, consulted a doctor

Vestibular Schwannoma case studybrain tumour Preoprerative Scan

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DIAGNOSIS

After a thorough examination and tests such as an MRI of the brain she was diagnosed as having a tumor of the vestibular nerve – the nerve that controls balance and which closely associated with the nerve of hearing. These tumors, known as vestibular schwannomas, are common benign brain tumors which can be treated safely with good outcomes.

TREATMENT

Although histologically benign (no malignant growth) vestibular schwannomas grow in a critical location, adjacent to vital brain structures, nerves and blood vessels. One of the most critical of these is called the facial nerve (or the seventh cranial nerve) which controls movement of the facial muscles. The facial nerve often closely adheres to the capsule of the tumour resulting in it being extremely stretched and thinned out. This makes surgery on vestibular schwannomas very delicate as the facial nerve is very susceptible to damage during surgery. Thus, it is critical to use special surgical techniques to preserve the function of the facial nerve.

Facial nerve preservation in Mrs S was enabled through the use of intra-operative facial nerve monitoring. This is a technique which utilises tiny electrodes placed into the facial muscles at the commencement of the procedure. Using special anesthetic techniques and a nerve stimulator the position and course of the entire facial nerve was accurately plotted. This enabled doctors to ensure preservation of Mrs S’ facial nerve during the excision of the tumour.

OUTCOME

Mrs S successfully underwent a microsurgical excision of the tumor with facial nerve preservation. She made a rapid recovery and was discharged from hospital just 4 days after the surgery.

brain tumour post operative scanMrs S. after the tumour surgery

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Vestibular Schwannoma is a slow-growing brain tumor that develops in vestibulocochlear nerve. It is non- cancerous and benign, and is formed due to the abnormal growth of Schwann cells. As the tumor develops in the hearing and balancing nerves, the main symptoms will be hearing loss, ringing in the ears and loss of balance. Larger tumors can compress on neighbouring cranial nerves and the surrounding brain leading to hydrocephalus(collection of fluid in the brain), numbness or pain over the face and difficulty in swallowing or speaking. left untreated the compression on the brainstem can be fatal.

SBHS has an impeccable record of treating this tumor with excellent results. Almost all our patients, even those with very large tumors have undergone total or near total excision with anatomical preservation of the facial nerve which is at risk of injury in large tumors.

Book appointment with a neurosurgeon to know more about the treatment and diagnosis of Vestibular Schwannoma – http://www.sbshospital.com/get-in-touch/