Full Recovery of Hearing After Resection of a Large Epidermoid Tumor at the Cerebellopontine Angle: 2-Dimensional Operative Video

Abstract

Epidermoid tumors are benign, slow-growing lesions, originating from misplaced ectodermal cells that become trapped during neural tube closure. 1 The cerebellopontine angle (CPA) is the most common intracranial location for epidermoid tumors, accounting for approximately 60% of cases. 2 Treatment of epidermoid tumors consists of surgical resection, with the goal of gross total resection. 3 Here, we describe the case of a patient with a large epidermoid tumor at the CPA causing near-complete hearing loss, who remarkably experienced full recovery of hearing after resection of the tumor. The patient is a 37-year-old woman who presented to our clinic with a CPA tumor causing severe hearing loss consisting of class D hearing and a word recognition score of 5% on audiological examination. Radiographically, the tumor demonstrated significant mass effect on the right cranial nerves VII and VIII with prominent extension into the internal auditory canal. Given the patient's profound hearing loss, she consented to receive a right retrosigmoid craniotomy for resection of the lesion. Although cranial nerves VII and VIII were heavily invested in the tumor, we were able to systematically resect the lesion from the CPA and internal auditory canal, and achieve a gross total resection. Histological examination confirmed the diagnosis of an epidermoid tumor. Remarkably, the patient's audiogram at 3-month follow-up demonstrated complete recovery of hearing in her right ear with a word recognition score of 100% and normal hearing sensitivity across all tested frequencies.