Management of a large acoustic neuroma involving brain-stem, inner, medium and external ear

Neuromas of the eighth cranial nerve extending to the external auditory canal are unusual. We present a case of a large acoustic neuroma, originated from the inner auditory canal and protruding through the tympanic membrane. We describe clinical presentation and surgical management. Our case demonstrates that a schwannoma of the eighth nerve can grow to erode the structures of the inner and middle ear, and can be seen by otoscopy as a neoformation of the external auditory canal. It is therefore important to put neuromas in differential diagnosis along with the other neoformation of the ear, especially when symptoms like sensorineural hearing loss and vertigo are reported, even though not severe.