OBJECTIVE: To report a case of schwannoma of the cochlear nerve in a young patient with a progressive evolution of about 12 years. CASE REPORT: F. J. P. P. N., a man 30 years of age, reported sudden tinnitus, ear fullness, and hearing loss in his right ear. Seven years later, he began to experience vertigo, headache, and progressive loss of balance. After 2 years, audiometry showed moderate sensorineural hearing loss in the right ear that has not been investigated. In 2 years, the patient's condition evolved with right facial paralysis. The following year, an MRI of skull was acquired, showing a vestibular schwannoma on the right in the cerebellopontine angle and measuring 4.9 cm in its greatest diameter. Surgery was performed with a partial removal of the tumor, cerebrospinal fluid rhinorrhea was noted, and resolution occurred in 15 days. The patient remains with sequelae, including hearing loss and right facial palsy, and radiosurgery is scheduled. CONCLUSION: A vestibular schwannoma (acoustic neuroma) is the most common tumor of the cerebellopontine angle, corresponding to approximately 9% of intracranial tumors. A Danish study found an incidence of 200 cases per million inhabitants per year. Most often, the initial symptoms are neurotological, including progressive unilateral sensorineural hearing loss, tinnitus, and vertigo as the first complaints. When it reaches larger dimensions, it can also affect the facial or trigeminal nerve or present central neurological manifestations. The core examinations are evoked auditory brainstem response and MRI. In summary, in patients with tinnitus, vertigo, and unilateral sudden hearing loss, vestibular schwannoma should enter into the differential diagnosis, and it is necessary to perform imaging, preferably MRI. Keywords: Neuroma, acoustic; Tinnitus; Audiology.
