Pediatric Intracochlear Schwannoma: Case Series and Review of the Literature

Background: Intracochlear schwannomas (ICSs) are a subtype of intralabyrinthine schwannomas, completely located in the cochlear lumen. ICSs are particularly rare in the pediatric population. Putative diagnosis is made on the basis of magnetic resonance findings with signal characteristics that shoul...

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Main Authors: Enrico Liaci, Maurizio Negri, Francesco Maccarrone, Silvia Piccinini, Enrico Pasanisi, Andrea Bacciu, Filippo Di Lella
Format: Article
Language:English
Published: AVES 2024-11-01
Series:Journal of International Advanced Otology
Online Access:https://www.advancedotology.org/en/pediatric-intracochlear-schwannoma-case-series-and-review-of-the-literature-131963
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author Enrico Liaci
Maurizio Negri
Francesco Maccarrone
Silvia Piccinini
Enrico Pasanisi
Andrea Bacciu
Filippo Di Lella
author_facet Enrico Liaci
Maurizio Negri
Francesco Maccarrone
Silvia Piccinini
Enrico Pasanisi
Andrea Bacciu
Filippo Di Lella
author_sort Enrico Liaci
collection DOAJ
description Background: Intracochlear schwannomas (ICSs) are a subtype of intralabyrinthine schwannomas, completely located in the cochlear lumen. ICSs are particularly rare in the pediatric population. Putative diagnosis is made on the basis of magnetic resonance findings with signal characteristics that should remain the same at follow-up imaging. Methods: A retrospective review was performed searching for pediatric patients affected by ICS treated at the Otolaryngology Department, Ospedale Ramazzini, Carpi (Italy), and Otolaryngology and Otoneurosurgery Department, Azienda Ospedaliero-Universitaria di Parma, (Italy). A scoping literature review of the period January 2000 - June 2024 was performed. Results: Two cases of ICS in pediatric patients are described. Neither family history nor genetic signs of neurofibromatosis type II were found. A single report was identified in the literature review. Data analysis resumes the pooled data of the latter case and the authors’ patients. The most common symptom at presentation was progressive sensorineural hearing loss (66%). Mean pure tone average at diagnosis was 74.2 dB. Intracochlear location was in the basal turn in 2 cases and in the apical and middle turns in the third patient. All cases initially underwent a “wait and scan” strategy. The mean follow-up time was 23.3 months. Conclusion: Management planning of pediatric ICSs should be accurate as surgical removal may require partial or total cochlear demolition, resulting in vestibular dysfunction and precluding future positioning of a cochlear implant. Close clinical and radiological follow-up with serial MRI scans allows to evaluate both symptom progression and rate of growth, in order to provide patients with the best therapeutic option.
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spelling doaj-art-9c32fffe641d4af1af57c90de67e50712025-01-30T08:41:14ZengAVESJournal of International Advanced Otology2148-38172024-11-0120648448810.5152/iao.2024.241645Pediatric Intracochlear Schwannoma: Case Series and Review of the LiteratureEnrico Liaci0https://orcid.org/0000-0001-5543-3899Maurizio Negri1https://orcid.org/0000-0003-4546-6464Francesco Maccarrone2https://orcid.org/0000-0003-0508-519XSilvia Piccinini3https://orcid.org/0000-0002-0335-8740Enrico Pasanisi4https://orcid.org/0000-0003-1256-3321Andrea Bacciu5https://orcid.org/0000-0001-7977-7258Filippo Di Lella6https://orcid.org/0000-0003-3266-5069The Department of Medicine and Surgery, University of Parma, Parma, Italy ; Department of Otolaryngology and Otoneurosurgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy The Department of Otolaryngology-Head and Neck Surgery, Azienda USL di Modena, Ospedale “B. Ramazzini” di Carpi, Carpi, ItalyThe Department of Otolaryngology-Head and Neck Surgery, Azienda USL di Modena, Ospedale “B. Ramazzini” di Carpi, Carpi, ItalyThe Department of Neuroradiology, Azienda Ospedaliero-Universitaria di Modena, Modena, ItalyThe Department of Medicine and Surgery, University of Parma, Parma, Italy ; Department of Otolaryngology and Otoneurosurgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy The Department of Medicine and Surgery, University of Parma, Parma, Italy ; Department of Otolaryngology and Otoneurosurgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy The Department of Medicine and Surgery, University of Parma, Parma, Italy ; Department of Otolaryngology and Otoneurosurgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy Background: Intracochlear schwannomas (ICSs) are a subtype of intralabyrinthine schwannomas, completely located in the cochlear lumen. ICSs are particularly rare in the pediatric population. Putative diagnosis is made on the basis of magnetic resonance findings with signal characteristics that should remain the same at follow-up imaging. Methods: A retrospective review was performed searching for pediatric patients affected by ICS treated at the Otolaryngology Department, Ospedale Ramazzini, Carpi (Italy), and Otolaryngology and Otoneurosurgery Department, Azienda Ospedaliero-Universitaria di Parma, (Italy). A scoping literature review of the period January 2000 - June 2024 was performed. Results: Two cases of ICS in pediatric patients are described. Neither family history nor genetic signs of neurofibromatosis type II were found. A single report was identified in the literature review. Data analysis resumes the pooled data of the latter case and the authors’ patients. The most common symptom at presentation was progressive sensorineural hearing loss (66%). Mean pure tone average at diagnosis was 74.2 dB. Intracochlear location was in the basal turn in 2 cases and in the apical and middle turns in the third patient. All cases initially underwent a “wait and scan” strategy. The mean follow-up time was 23.3 months. Conclusion: Management planning of pediatric ICSs should be accurate as surgical removal may require partial or total cochlear demolition, resulting in vestibular dysfunction and precluding future positioning of a cochlear implant. Close clinical and radiological follow-up with serial MRI scans allows to evaluate both symptom progression and rate of growth, in order to provide patients with the best therapeutic option. https://www.advancedotology.org/en/pediatric-intracochlear-schwannoma-case-series-and-review-of-the-literature-131963
spellingShingle Enrico Liaci
Maurizio Negri
Francesco Maccarrone
Silvia Piccinini
Enrico Pasanisi
Andrea Bacciu
Filippo Di Lella
Pediatric Intracochlear Schwannoma: Case Series and Review of the Literature
Journal of International Advanced Otology
title Pediatric Intracochlear Schwannoma: Case Series and Review of the Literature
title_full Pediatric Intracochlear Schwannoma: Case Series and Review of the Literature
title_fullStr Pediatric Intracochlear Schwannoma: Case Series and Review of the Literature
title_full_unstemmed Pediatric Intracochlear Schwannoma: Case Series and Review of the Literature
title_short Pediatric Intracochlear Schwannoma: Case Series and Review of the Literature
title_sort pediatric intracochlear schwannoma case series and review of the literature
url https://www.advancedotology.org/en/pediatric-intracochlear-schwannoma-case-series-and-review-of-the-literature-131963
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