Extension patterns of vestibular schwannomas towards the middle ear: three new cases and review of the literature

  • Aina VenkatasamyEmail author
  • Caroline Nicolas-Ong
  • Hella Vuong
  • Anne Charpiot
  • Francis Veillon
Review Article



Middle ear extension of vestibular schwannomas is not a common occurrence, and only a few cases have been described so far in past publications. We report three new cases of vestibular schwannomas extending to the middle ear and reviewed the literature to specify the patterns of such an extension.

Materials and methods

We analysed databases of previously published articles to search for additional cases of middle ear extension of vestibular schwannomas and compared them to the cases we have documented. Extension patterns of the tumours were analysed, especially focusing on the extension through the round and oval windows.

Results and conclusion

Middle ear vestibular schwannomas are uncommon tumours and only 13 cases have been published so far. The vestibular schwannoma (internal auditory canal or intralabyrinthine) has to invade the labyrinth first (complete invasion in 88% of the cases, n = 14), before reaching the middle ear. In the majority of cases (69%, n = 11/16), internal auditory canal vestibular schwannomas or intralabyrinthine schwannomas extended in the middle ear though the round window.


Vestibular schwannomas Middle ear Round window CT MRI 



The authors would like to thank Mr. Siju Koshy for his precious help during the manuscript revision.


No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

This is a review article of cases from the literature.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Service de Radiologie 1, Hôpital de HautepierreHôpitaux Universitaires de StrasbourgStrasbourg CEDEXFrance
  2. 2.Service de chirurgie ORLHôpitaux Universitaires de StrasbourgStrasbourgFrance
  3. 3.Université de Strasbourg, Inserm IRFAC UMR_S1113, Laboratory Stress Response and Innovative Therapies “Streinth”StrasbourgFrance

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