Surgical Treatment of Pediatric Unilateral Tinnitus Due to Cochleovestibular Nerve Compression by Intrameatal Anterior Inferior Cerebellar Artery Loop

Objectives: Cochleovestibular nerve compression syndrome due to intrameatal anterior inferior cerebellar artery (AICA) that causes tinnitus is an extremely rare condition with special therapeutic challenges and implications. Here we present the first surgically treated pediatric case of tinnitus showing microvascular conflict of the cochleovestibular nerve and intrameatal AICA loop.

Methods: A pediatric case of tinnitus is described, and a surgical technique is elaborated with video material. A PubMed literature search was performed to identify surgically treated pediatric cases of intrameatal compression of the eighth nerve with an AICA loop.

Results: Tinnitus was completely resolved and hearing was intact immediately after surgical decompression. The patient was free from further symptoms after a short follow-up of 12 weeks. Microsurgical decompression including opening of the internal auditory canal and transposition of the AICA was an effective treatment option in this case.

Conclusion: Decompression of the cochleovestibular nerve including opening of the internal auditory canal and transposition of the AICA appears to be an effective treatment option for cases with radiologically confirmed intrameatal vascular compression of the eighth nerve causing unilateral pulsatile tinnitus.