No abstract

A 48-year-old woman presented with progressive right-sided hearing loss, chronic dysphonia and tinnitus. These signs were associated with chronic headache and dizziness for two years. On physical examination, the eardrums were normal. There was a right facial nerve dysfunction classified grade III according to House Brackmann grading system. Oral examination found a left side deviating uvula (curtain sign), tongue weakness with mild atrophy and abolition of gag reflex. Cervical examination showed a right shoulder weakness without palpable cervical mass. Laryngeal endoscopic exam found right vocal cord paralysis. There were no other significant cranial nerve findings. A finger-to-nose examination showed mild ataxia of the right upper limb. The gait was normal. An audiogram demonstrated a 60 dB sensorineural hearing loss. The stapedius reflex was absent. A CT scan was performed and found an enlargement of the jugular foramen and moderate enhancement with contrast medium (Figure 1). Magnetic resonance imaging (MRI) showed an isointense tumor on T1 weighted images (WI), hyperintense on T2 WI and enhance with gadolinium, this tumor extended to the internal auditory meatus (Figure 2). The patient was treated with GKS with a good clinical evolution.