Intracochlear schwannoma

Last revised by Dr Ali Alsmair on 16 Mar 2022

An intracochlear schwannoma is a subtype of an intralabyrinthine schwannoma which is a schwannoma arising in relation to the 8th cranial nerve. 

Patients may present with unilateral sensorineural hearing loss.

Schwannomas that are confined exclusively to the cochlea are extremely rare.

Schwann cells of the cochlear axons in the cochlear nerve are present in the modiolus, proximal to the spiral ganglion. An intracochlear schwannoma could arise in the modiolus and could then grow from the modiolus, occupy the cochlear basal turn, then erode the cribriform area of the internal auditory canal, and spread into the vestibule.

Their diagnosis is primarily based on high-resolution magnetic resonance imaging (MRI).

Typically seen as a small intracochlear nodular lesion in the modiolus

  • T1: isointense on T1
  • T1 C+ (Gd): high contrast enhancement is usually seen

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Cases and figures

  • Case 1: on left
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