Cavernous hemangioma of the internal auditory canal arising from the inferior vestibular nerve: Case report and review of the literature

Objective: To describe a case of cavernous hemangioma arising from the inferior vestibular nerve, limited to the internal auditory canal. Study Design: Retrospective case review and review of literature. Setting: A tertiary referral clinic. Interventions: Extended middle cranial fossa surgery. Results:The hemangioma was completely resected through the extended middle cranial fossa approach. No serious complications occurred, and the hearing and the facial nerve function were preserved. Conclusions: Originating from the capillary plexus surrounding Scarpa's ganglion, this hemangioma has to be differentiated from intratemporal hemangioma at the geniculate ganglion. Because of extrinsic growth pattern, the potential for preservation of the facial nerve function is high if surgery is performed early. Complete resection through the extended middle fossa approach is the treatment of choice for cavernous hemangioma with limited extension into the cerebellopontine angle. It remains difficult to distinguish preoperatively from the more common tumors, and surgery is usually planned on assumption of vestibular schwannoma.