title: Intralabyrinthine schwannomas: diagnosis, management, and a new classification system.
abstract: OBJECTIVE
  To outline the diagnosis and management of intralabyrinthine schwannomas and to propose a new classification system to further define them.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Tertiary referral center at a university hospital.
  
  
  METHODS
  Twenty-eight patients seen at the institution with intralabyrinthine schwannomas between 1996 and 2002 were included in the study.
  
  
  METHODS
  Diagnosis was made with magnetic resonance imaging in all but one case. Our ability to detect these tumors has been greatly enhanced by the introduction of high-resolution T2-weighted magnetic resonance imaging. Treatment options were observation with serial magnetic resonance imaging versus complete surgical removal via a translabyrinthine or transotic approach. Surgery was indicated for dizziness caused by the tumor or extralabyrinthine growth.
  
  
  METHODS
  Clinical features, audiology, radiology, and management outcomes were evaluated.
  
  
  RESULTS
  Eight patients have undergone successful surgery with removal of their tumors and resolution of symptoms. One patient chose to have stereotactic radiotherapy. Of the 20 patients who were managed with observation and serial magnetic resonance imaging, only 1 has shown significant growth requiring surgical removal.
  
  
  CONCLUSIONS
  Intralabyrinthine schwannomas are uncommon tumors that mimic the clinical features of many other neurotologic conditions. A high index of suspicion and precise imaging are often required to detect these tumors. Surgical treatment is indicated for specific indications and will be needed in the minority of patients with this disorder. The classification system that we propose is helpful in both the diagnosis and the management of these tumors.
authors.affiliation: Department of Otolaryngology, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kennedy
authors.forename: Clough
authors.initials: C
authors.lastname: Shelton
authors.forename: Karen L
authors.initials: KL
authors.lastname: Salzman
authors.forename: H Christian
authors.initials: HC
authors.lastname: Davidson
authors.forename: H Ric
authors.initials: HR
authors.lastname: Harnsberger
mesh_terms: D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D004428:Ear Neoplasms / Q000145:classification* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007759:Labyrinth Diseases / Q000145:classification* / Q000175:diagnosis / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000145:classification* / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies