CASE 12.5
HEARING LOSS AND DIZZINESS
PATIENT PRESENTATION
A 41-year-old woman was referred to
an otolaryngologist for dizziness and
progressive hearing loss in the left ear.
CASE 12.5 Hearing Loss and Dizziness
KEY SYMPTOMS AND SIGNS
• Decreased hearing in the left ear, with air
conduction greater than bone conduction
• Episodes of mild dizziness
• Left facial pain and decreased left corneal reflex
• Decreased taste on the left side of the tongue
CASE 12.5 Hearing Loss and Dizziness
RELEVANT ANATOMICAL & CLINICAL CONCEPTS
• Surface Anatomy of the Brainstem and Cranial
Nerves
• Skull Foramina Serving as Cranial Nerve Exit
Points
• Trigeminal Nerve (CN V), Facial Nerve (CN VII),
Vestibulocochlear Nerve (CN VIII)
• Central Auditory Pathways
• Intracranial Neoplasms in Adults
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CASE IMAGE 12.5 Left Acoustic Neuroma (Vestibular Schwannoma)
CASE IMAGE 12.5 Left Acoustic Neuroma (Vestibular Schwannoma)
CASE 12.5 Hearing Loss and Dizziness
FINAL DIAGNOSIS
Left acoustic neuroma (vestibular schwannoma)
OUTCOME
Schwannoma resected via left suboccipital approach.
Postoperatively, she had complete left facial paralysis,
which resolved over the course of several months.