PMC10027481_01
Right-ear unilateral profound sensorineural hearing loss.
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Pure-tone audiometry revealed right-ear unilateral profound sensorineural hearing loss ( Fig. 1 ).
T1-weighted gadolinium-enhanced MRI showing heterogeneous gadolinium-enhanced lesion in the distal portion of the internal acoustic canal. (
A
) Axial image. (
B
) Coronal image. MRI, magnetic resonance imaging.
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Magnetic resonance imaging (MRI) showed a 5 mm lesion in the lateral portion of the right internal auditory canal with contrast-enhancement to gadolinium, suggestive of vestibular schwannoma ( Fig. 2 ).
Intraoperative images. (
A
) Translabirinthyne approach. (
B
) Tumor resection. (
C
) Hypoglossal-facial nerve anastomosis. (
D
) Cranial reconstruction with fat and titanium mesh.
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 The patient was then submitted to a translabyrinthine approach and a total tumor resection ( Fig. 3 ).
Anatomopathological study compatible with facial nerve hemangioma. (
A
) Hematoxylin and eosin (H&E) staining showing coarse vessels with conjunctival fibrous thickening. (
B
) CD31 marker emphasizes the vascular nature of the lesion.
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Anatomopathological study was compatible with facial nerve hemangioma ( Fig. 4 ).
Postoperative MR showing no residual tumor within the internal acoustic canal. (
A
) T1 weighted gadolinium-enhanced coronal image. (
B
) T1-weighted gadolinium-enhanced axial image. (
C
) T1-weighted image, no gadolinium. Notice signs of mastoid manipulation (petrosectomy). MR, magnetic resonance.
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Postoperative MRI after 6 months showed complete resection ( Fig. 5 ).
Early postoperative facial palsy.
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The patient evolved with HB VI facial paralysis in the immediate postoperative period ( Fig. 6 ) but showed improvement in facial mobility in a 6-month follow-up (HB III), with mild tongue palsy ( Fig. 7 ).