Response to "Intralabyrinthine schwannomas: a case series with discussion of the diagnosis and management" by Bouchetemplé P, Heathcote K, Tollard E, Choussy O, Dehesdin D, Marie JP. Otol Neurotol 2013;34(5):944-51

To the Editor: We read with great interest the article titled ‘‘Intralabyrinthine Schwannomas: A Case Series With Discussion of the Diagnosis and Management’’ by Bouchetemple´ et al., published in issue 34 of Otology & Neurotology (1). In that article, three cases of intralabyrinthine schwannomas (ILSs) and six cases of internal acoustic canal schwannomas with intralabyrinthine extension (IAC-ILS) are reported, and a literature review is presented to propose a management protocol. The Authors claim that ‘‘frequency of ILS is underestimated because of poor diagnostic criteria’’ and broadly compare ILS with Me´nie`re’s disease. In particular, they discuss a diagnostic routine comprising auditory and vestibular tests. They found a consistent hearing loss of varying degrees in all their patients but state that auditory brainstem responses are not a reliable screening tool because they might be unobtainable because of severe hearing loss and because auditory brainstem responses will not reveal a retrocochlear dysfunction if the lesion is only intralabyrinthine.