A Case of Intralabyrinthine Schwannoma that Mimicked Meniere's Disease

Intralabyrinthine schwannomas are rare benign tumors that arise from the terminal ends of the eighth cranial nerve. These may involve the cochlea, vestibule, or semicircular canals. These tumors are uncommon, and were diagnosed incidentally either during labyrinthectomy or at autopsy. The increasing use of the MRI in the diagnostic assessment of patients with unilateral sensorineural hearing loss or tinnitus has led to the diagnosis of intralabyrinthine schwannomas. Because the clinical symptoms of intralabyrinthine schwannomas and other otologic disorders, particularly Meniere's disease, are so similar, diagnosis of intralabyrinthine schwannomas is challenging. We report a patient with intralabyrinthine schwannoma, who had been misdiagnosed as having Meniere's disease. With the aid of MRI, intralabyrinthine schwannoma was detected and removed successfully by translabyrinthine approach.

CT Finding of Tuberculous Cervical Lymphadenitis and Management / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There are controversies in the management of tuberculous cervical lymphadenitis in spite of high prevalence. This study was performed to investigate clinical findings of the patients indicated for surgery and to analyze clinical efficacies of surgery and antituberculous chemotherapy. Materials and METHODS: Fourty patients who had been pathologically confirmed to have cervical tuberculous lymphadenitis were analyzed retrospectively. We classified them into 4 groups according to CT findings and checked their clinical and laborotary findings, as well as efficacies of treatment used. RESULTS: The Type 4 was the most common. All patients were treated with antituberculous medication. In Type 1 and 2, 11 patients among 13 patients were treated with antituberculous medication alone, whereas in Type 3 and 4, 21 patients among 27 patients were treated with the combined method of surgery and antituberculous medication. Most complicated cases were Type 3 and 4, where two cases had recurrence, but most of the cases had local wound problems. All of these complicated cases had recovered to nearly normal state. Two recurrent cases were treated with the combined methods completely. CONCLUSION: For cases that fall into type 1 and 2 tuberculous cervical lymphadenopathys, Antituberculous medication can serve as the first line of treatment. For cases that fall into type 3 and 4 tuberculous cervical lymphadenopathy, the combined method of surgery and antituberculous medication can be the first choice of treatment. For the initial treatment of type 3, 4, applying antituberculous medication for a period of 1-2 months before surgical intervention would be a more effective treatment.