title: Intracochlear schwannomas confined to the otic capsule.
abstract: OBJECTIVE
  To determine the natural history and management for patients with intracochlear schwannomas.
  
  
  METHODS
  Retrospective case series of intracochlear schwannomas confined to the otic capsule.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Ten patients were found to have schwannomas limited to the cochlea from 1998 to 2009.
  
  
  METHODS
  All subjects underwent at least 1 magnetic resonance imaging (MRI) study and had at least 1 audiogram. Two patients underwent a transotic excision for intractable symptoms.
  
  
  METHODS
  Presenting symptoms, initial and follow-up MRI findings, audiometric testing results, and need for surgical intervention were recorded for each subject.
  
  
  RESULTS
  Hearing loss was present in all 10 patients at their initial presentation. Tinnitus was present in 50% of patients, and vertigo was present in 30% of patients. No patient presented with aural fullness or facial weakness. The pattern of hearing loss seemed to correlate with the location of the lesion within the cochlea. Of the 9 patients that had follow-up MRIs, 3 patients showed tumor growth. Two of the 10 patients underwent surgical excision for intractable vertigo that resulted in resolution of symptoms.
  
  
  CONCLUSIONS
  Hearing loss is the most common finding in patients with intracochlear schwannomas, followed by tinnitus and vertigo. If the patient does not have symptoms of intractable vertigo, observation with serial MRI scans is indicated. Surgical excision should be reserved for patients with intractable vertigo or with significant tumor growth.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas-Southwestern Medical Center, Dallas, Texas 7528, USA.
authors.forename: Zi Yang
authors.initials: ZY
authors.lastname: Jiang
authors.forename: Joe Walter
authors.initials: JW
authors.lastname: Kutz
authors.forename: Peter Sargent
authors.initials: PS
authors.lastname: Roland
authors.forename: Brandon
authors.initials: B
authors.lastname: Isaacson
mesh_terms: D000328:Adult; D000368:Aged; D001299:Audiometry; D003051:Cochlea / Q000473:pathology* / Q000601:surgery; D004428:Ear Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D034381:Hearing Loss / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies