Sajjad Muhammad1, Rokuya Tanikawa2, Mika Niemelä3. 1. Department of Neurosurgery, Helsinki University and Helsinki University Hospital, Helsinki, Finland. Electronic address: ext-sajjad.muhammad@hus.fi. 2. Sapporo Teishinkai Hospital, Sapporo, Japan. 3. Department of Neurosurgery, Helsinki University and Helsinki University Hospital, Helsinki, Finland.
Abstract
OBJECTIVES: Cochleovestibular nerve compression syndrome due to intrameatal anterior inferior cerebellar artery (AICA) that causes tinnitus is an extremely rare condition with special therapeutic challenges and implications. Here we present the first surgically treated paediatric case of tinnitus showing microvascular conflict of cochleovestibular nerve and intrameatal AICA loop. METHODS: A paediatric case of tinnitus is described and a surgical technique is elaborated with video material. A Pubmed literature search was performed to identify surgically treated paediatric cases of intrameatal compression of eighth nerve with AICA loop. RESULTS: Tinnitus was completely resolved and hearing was intact immediately after surgical decompression. The patient was free from further symptoms after a short follow up of 12 weeks. Microsurgical decompression, including opening of IAC and transposition of AICA, was an effective treatment option in this case. CONCLUSION: Decompression of the cochleovestibular nerve including opening of IAC and transposition of AICA appears to be an effective treatment option for cases with radiologically confirmed intrameatal vascular compression of eighth nerve causing unilateral pulsatile tinnitus.
OBJECTIVES:Cochleovestibular nerve compression syndrome due to intrameatal anterior inferior cerebellar artery (AICA) that causes tinnitus is an extremely rare condition with special therapeutic challenges and implications. Here we present the first surgically treated paediatric case of tinnitus showing microvascular conflict of cochleovestibular nerve and intrameatal AICA loop. METHODS: A paediatric case of tinnitus is described and a surgical technique is elaborated with video material. A Pubmed literature search was performed to identify surgically treated paediatric cases of intrameatal compression of eighth nerve with AICA loop. RESULTS:Tinnitus was completely resolved and hearing was intact immediately after surgical decompression. The patient was free from further symptoms after a short follow up of 12 weeks. Microsurgical decompression, including opening of IAC and transposition of AICA, was an effective treatment option in this case. CONCLUSION: Decompression of the cochleovestibular nerve including opening of IAC and transposition of AICA appears to be an effective treatment option for cases with radiologically confirmed intrameatal vascular compression of eighth nerve causing unilateral pulsatile tinnitus.