A Rare Case of Intra Auditory Canal Cavernous Hemangioma in a Young Girl

A Rare Case of Intra Auditory Canal Cavernous Hemangioma in a Young Girl | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report A Rare Case of Intra Auditory Canal Cavernous Hemangioma in a Young Girl Guive Sharifi, Esmaeil Mohammadi, Ava Rajabidooki, Ali Eftekharian This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7353690/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Cavernous hemangiomas are uncommon intracranial vascular malformations, with rare presentations in the cerebellopontine angle (CPA) or internal auditory canal (IAC). We present a case of an 18-year-old female with progressive right-sided hearing loss, tinnitus, and vertigo. Audiometry revealed sensorineural hearing loss, and imaging showed a heterogeneous mass within the right IAC. Surgical resection via a retrosigmoid approach was performed with intraoperative monitoring. The mass was completely excised, identified histologically as a cavernous hemangioma, with preservation of all cranial nerves except the cochlear nerve as she was completely deaf. At six-month follow-up, hearing loss persisted, but no other neurological deficits were present. This case highlights the diagnostic complexities of IAC cavernous hemangiomas, often mimicking vestibular schwannomas. Thorough radiological evaluation and meticulous surgical techniques, including intraoperative neuromonitoring, are crucial. While familial forms exist, our patient had no family history. This rare case highlights the need for high suspicion and careful surgical planning for IAC lesions in pediatric population. Figures Figure 1 Figure 2 Figure 3 Introduction The cavernous angioma of the central nervous system usually occurs in supratentorial areas of the brain followed by spinal cord and pons. (1) This entity rarely occurs in cerebellopontine angle (CPA) or intra auditory canal (IAC) and presents with auditory signs such as tinnitus and hearing loss or facial nerve involvement. (2) Due to their rarity, they could mimic vestibular schwannomas. (3) Here we present clinical features, radiological investigations, and surgical nuances of an IAC cavernous angioma in a young girl. Case presentation An 18-year-old female was referred due to right-sided hearing loss that began 3.5 years before admission. She also reported persistent tinnitus, vertigo, and neck pain. There was no family history of hearing loss or cavernous hemangioma. Audiometry revealed right-sided sensorineural hearing loss. Leftward horizontal and rotatory nystagmus was observed. Facial movements were normal. Computed tomography (CT) showed dilation of the right internal auditory canal (Figure 1). Subsequent magnetic resonance imaging (MRI) demonstrated a small, heterogeneous, but iso-to-high intense mass within the right IAC (Figure 2). Due to the worsening hearing, surgical removal of the lesion was undertaken via a right retrosigmoid approach with the patient in a semi-sitting position, and neurophysiological monitoring of the facial and cochlear nerves. Following opening of the IAC, the mass was completely excised, preserving the anatomical and functional integrity of all cranial nerves except the right cochlear nerve (Figure 3). Histological examination confirmed a cavernous hemangioma. At six-month follow-up, the patient’s deafness in the right ear persisted, but there was no facial nerve paralysis or other complaints. Discussion Cavernous angiomas arising within the internal auditory canal (IAC) are exceedingly rare in the pediatric population. To our knowledge, only one other case report exists of such an occurrence in a teenager. ( 4 ) Most reported cases involve adult patients, suggesting that this condition is present at a significantly lower rate in younger individuals. ( 1 ) Our case presented primarily with hearing loss which is ascribed to be the most common presenting feature. ( 1 ) Her hearing loss progressed to complete deafness like the other pediatric case that has also progressed to complete deafness, suspecting that younger patients could be more prone to auditory damage. ( 4 ) In addition, facial nerve damage and vestibular symptoms follow as other subsequent common presentations. In the current patient no facial movement deterioration was discovered, however she complained of vestibular vertigo which resolved after surgery. ( 2 ) Total resection is the final goal of surgery however it should be balanced with the risks of nerve damage and bleeding. Intraoperative neuromonitoring is a vital modality that should be utilized for close monitoring and prevention of nerve damage. ( 5 ) Moreover, stereotactic surgery could be utilized to reduce the risks of bleeding in selected cases, however, it was not used in our case. Cavernous hemangiomas could be sporadic or familial with mutations in CCM1, CCM2, and CCM3 genes. 75% of isolated cases in a French cohort had the familial form and some form of genetic variation. ( 6 ) Nevertheless, in our case no familial history of cavernous hemangiomas or other types of vascular anomalies were reported. There are different masses that arise from the petrosal bone and internal auditory canal and usually present with hearing deterioration. The most common etiology has been reported to be vestibular schwannoma that was primarily suspected in this case as well. ( 7 ) But on imaging investigation heterogenous mass with iso-to-high intensity presentation was not the typical imaging finding of a schwannoma. Therefore, other differential diagnoses were taken into account. In such context not only vestibular or facial schwannoma, but also cavernous hemangiomas, meningioma, aneurysmal malformations and arteriovenous fistula need to be differentiated. One main limitation of the current work is low sample size and prior surgical experience of cavernous hemangiomas in pediatric patients. Future works with emphasis on lesions within IAC are required to better understand these rare conditions in pediatric patients. In conclusion, we presented a rare case of a cavernous angioma within the internal auditory canal of a young female, highlighting the diagnostic challenges and surgical considerations associated with this unusual presentation. While hearing loss is considered the primary symptom, mimicking common lesions like vestibular schwannomas, careful radiological evaluation revealed atypical features that prompted consideration of alternative diagnoses. Complete surgical resection was achieved with preservation of facial nerve function, underscoring the importance of meticulous surgical technique and intraoperative neuromonitoring. Given the potential for familial forms of cavernous hemangiomas, genetic counseling and screening could be considered, although no family history was present in our patient. This case adds to the limited literature on this rare entity, emphasizing the need for clinicians to maintain a high index of suspicion for atypical lesions in the cerebellopontine angle and intra auditory canal, particularly in younger patients presenting with auditory and vestibular symptoms. Abbreviations IAC: Intra auditory canal CPA: cerebellopontine angle MRI: magnetic resonance imaging CT: computed tomography Declarations Acknowledgement Supervised assistance of OpenAI's ChatGPT 4.0 was used for providing insights and improving the writing and readability of the current work. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Consent for publication Written informed consent was obtained from the parent for publication of clinical details and images. Clinical trial number Not applicable. Ethical considerations This case involves a patient who has reached the age of majority and has preserved cognitive function. The patient is fully aware of the nature, benefits, and risks of the research, as well as the academic interest of publishing his medical history. Informed consent procedures were carried out by the directives of the International Medical Ethics Committee. Ethics committee approval was waived for individual cases with no further interventions than regular treatment measures. Funding source This study did not receive funding from any commercial, academic, or governmental entity. Author Contribution GSh: Conceptualization, Writing – review and editing EM: Writing – Original draft AR: Writing – review and editing AF: Supervision, Writing – review and editing References Samii M, Nakamura M, Mirzai S, Vorkapic P, Cervio A. Cavernous angiomas within the internal auditory canal. Journal of neurosurgery. 2006 Oct 1;105(4):581-7. Di Rocco F, Paterno V, Safavi-Abbasi S, El-Shawarby A, Samii A, Samii M. Cavernous malformation of the internal auditory canal. Acta neurochirurgica. 2006 Jun;148:695-7. Zhu WD, Huang Q, Li XY, Chen HS, Wang ZY, Wu H. Diagnosis and treatment of cavernous hemangioma of the internal auditory canal. Journal of Neurosurgery. 2016 Mar 1;124(3):639-46. Hyakusoku H, Tanaka Y, Tsuchiya Y, Nakayama M. Pediatric internal auditory canal cavernous hemangioma with rapid progression of sensorineural hearing loss: illustrative case. Journal of Neurosurgery: Case Lessons. 2023 May 29;5(22). Bubenikova A, Skalicky P, Benes Jr V, Benes Sr V, Bradac O. Overview of cerebral cavernous malformations: comparison of treatment approaches. Journal of Neurology, Neurosurgery & Psychiatry. 2022 May 1;93(5):475-80. Labauge P, Laberge S, Brunereau L, Levy C, Tournier-Lasserve E. Hereditary cerebral cavernous angiomas: clinical and genetic features in 57 French families. The Lancet. 1998 Dec 12;352(9144):1892-7. Holman MA, Schmitt WR, Carlson ML, Driscoll CL, Beatty CW, Link MJ. Pediatric cerebellopontine angle and internal auditory canal tumors. Journal of Neurosurgery: Pediatrics. 2013 Oct 1;12(4):317-24. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 20 Oct, 2025 Reviewers agreed at journal 11 Oct, 2025 Reviewers invited by journal 09 Oct, 2025 Editor invited by journal 18 Sep, 2025 Editor assigned by journal 18 Sep, 2025 Submission checks completed at journal 18 Sep, 2025 First submitted to journal 12 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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15:45:30","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":29901,"visible":true,"origin":"","legend":"\u003cp\u003ePreoperative magnetic resonance imaging (MRI) of the petrosal bone showing a heterogenous iso-to-high intensity mass growing in course of the auditory canal in T1-w (A) and T2-w (B) sequences\u003c/p\u003e","description":"","filename":"222.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7353690/v1/b8a95a6b9731181470bab5ce.jpg"},{"id":94211309,"identity":"2192a436-aded-48fd-a28b-447feb4ebfb2","added_by":"auto","created_at":"2025-10-23 15:45:30","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":21836,"visible":true,"origin":"","legend":"\u003cp\u003ePostoperative magnetic resonance imaging (MRI) demonstrating complete resection of tumor\u003c/p\u003e","description":"","filename":"333.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7353690/v1/0d50d46b1692a5b05de5a8c1.jpg"},{"id":94213374,"identity":"a036428b-55f2-42af-adb0-8d08238f6550","added_by":"auto","created_at":"2025-10-23 16:01:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":340467,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7353690/v1/b3e06a83-92df-41c6-a1f4-de3e16a882a4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eA Rare Case of Intra Auditory Canal Cavernous Hemangioma in a Young Girl \u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe cavernous angioma of the central nervous system usually occurs in supratentorial areas of the brain followed by spinal cord and pons. (1) This entity rarely occurs in cerebellopontine angle (CPA) or intra auditory canal (IAC) and presents with auditory signs such as tinnitus and hearing loss or facial nerve involvement. (2) Due to their rarity, they could mimic vestibular schwannomas. (3) Here we present clinical features, radiological investigations, and surgical nuances of an IAC cavernous angioma in a young girl.\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003eAn 18-year-old female was referred due to right-sided hearing loss that began 3.5 years before admission. She also reported persistent tinnitus, vertigo, and neck pain. There was no family history of hearing loss or cavernous hemangioma. Audiometry revealed right-sided sensorineural hearing loss. Leftward horizontal and rotatory nystagmus was observed. Facial movements were normal. Computed tomography (CT) showed dilation of the right internal auditory canal (Figure 1). Subsequent magnetic resonance imaging (MRI) demonstrated a small, heterogeneous, but iso-to-high intense mass within the right IAC (Figure 2). Due to the worsening hearing, surgical removal of the lesion was undertaken via a right retrosigmoid approach with the patient in a semi-sitting position, and neurophysiological monitoring of the facial and cochlear nerves. Following opening of the IAC, the mass was completely excised, preserving the anatomical and functional integrity of all cranial nerves except the right cochlear nerve (Figure 3). Histological examination confirmed a cavernous hemangioma. At six-month follow-up, the patient’s deafness in the right ear persisted, but there was no facial nerve paralysis or other complaints.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eCavernous angiomas arising within the internal auditory canal (IAC) are exceedingly rare in the pediatric population. To our knowledge, only one other case report exists of such an occurrence in a teenager. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) Most reported cases involve adult patients, suggesting that this condition is present at a significantly lower rate in younger individuals. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eOur case presented primarily with hearing loss which is ascribed to be the most common presenting feature. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) Her hearing loss progressed to complete deafness like the other pediatric case that has also progressed to complete deafness, suspecting that younger patients could be more prone to auditory damage. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) In addition, facial nerve damage and vestibular symptoms follow as other subsequent common presentations. In the current patient no facial movement deterioration was discovered, however she complained of vestibular vertigo which resolved after surgery. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eTotal resection is the final goal of surgery however it should be balanced with the risks of nerve damage and bleeding. Intraoperative neuromonitoring is a vital modality that should be utilized for close monitoring and prevention of nerve damage. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) Moreover, stereotactic surgery could be utilized to reduce the risks of bleeding in selected cases, however, it was not used in our case.\u003c/p\u003e\u003cp\u003eCavernous hemangiomas could be sporadic or familial with mutations in CCM1, CCM2, and CCM3 genes. 75% of isolated cases in a French cohort had the familial form and some form of genetic variation. (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) Nevertheless, in our case no familial history of cavernous hemangiomas or other types of vascular anomalies were reported.\u003c/p\u003e\u003cp\u003eThere are different masses that arise from the petrosal bone and internal auditory canal and usually present with hearing deterioration. The most common etiology has been reported to be vestibular schwannoma that was primarily suspected in this case as well. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) But on imaging investigation heterogenous mass with iso-to-high intensity presentation was not the typical imaging finding of a schwannoma. Therefore, other differential diagnoses were taken into account. In such context not only vestibular or facial schwannoma, but also cavernous hemangiomas, meningioma, aneurysmal malformations and arteriovenous fistula need to be differentiated.\u003c/p\u003e\u003cp\u003eOne main limitation of the current work is low sample size and prior surgical experience of cavernous hemangiomas in pediatric patients. Future works with emphasis on lesions within IAC are required to better understand these rare conditions in pediatric patients.\u003c/p\u003e\u003cp\u003eIn conclusion, we presented a rare case of a cavernous angioma within the internal auditory canal of a young female, highlighting the diagnostic challenges and surgical considerations associated with this unusual presentation. While hearing loss is considered the primary symptom, mimicking common lesions like vestibular schwannomas, careful radiological evaluation revealed atypical features that prompted consideration of alternative diagnoses. Complete surgical resection was achieved with preservation of facial nerve function, underscoring the importance of meticulous surgical technique and intraoperative neuromonitoring. Given the potential for familial forms of cavernous hemangiomas, genetic counseling and screening could be considered, although no family history was present in our patient. This case adds to the limited literature on this rare entity, emphasizing the need for clinicians to maintain a high index of suspicion for atypical lesions in the cerebellopontine angle and intra auditory canal, particularly in younger patients presenting with auditory and vestibular symptoms.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eIAC: Intra auditory canal\u003c/p\u003e\n\u003cp\u003eCPA: cerebellopontine angle\u003c/p\u003e\n\u003cp\u003eMRI: magnetic resonance imaging\u003c/p\u003e\n\u003cp\u003eCT: computed tomography\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAcknowledgement\u003c/p\u003e\n\u003cp\u003eSupervised assistance of OpenAI\u0026apos;s ChatGPT 4.0 was used for providing insights and improving the writing and readability of the current work. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDeclaration of Competing Interest \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the parent for publication of clinical details and images.\u003c/p\u003e\n\u003cp\u003eClinical trial number\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eEthical considerations \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis case involves a patient who has reached the age of majority and has preserved cognitive function. The patient is fully aware of the nature, benefits, and risks of the research, as well as the academic interest of publishing his medical history. Informed consent procedures were carried out by the directives of the International Medical Ethics Committee. Ethics committee approval was waived for individual cases with no further interventions than regular treatment measures.\u003c/p\u003e\n\u003cp\u003eFunding source \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study did not receive funding from any commercial, academic, or governmental entity. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthor Contribution\u003c/p\u003e\n\u003cp\u003eGSh: Conceptualization, Writing \u0026ndash; review and editing\u003c/p\u003e\n\u003cp\u003eEM: Writing \u0026ndash; Original draft\u003c/p\u003e\n\u003cp\u003eAR: Writing \u0026ndash; review and editing\u003c/p\u003e\n\u003cp\u003eAF: Supervision, Writing \u0026ndash; review and editing\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSamii M, Nakamura M, Mirzai S, Vorkapic P, Cervio A. Cavernous angiomas within the internal auditory canal. Journal of neurosurgery. 2006 Oct 1;105(4):581-7.\u003c/li\u003e\n \u003cli\u003eDi Rocco F, Paterno V, Safavi-Abbasi S, El-Shawarby A, Samii A, Samii M. Cavernous malformation of the internal auditory canal. Acta neurochirurgica. 2006 Jun;148:695-7.\u003c/li\u003e\n \u003cli\u003eZhu WD, Huang Q, Li XY, Chen HS, Wang ZY, Wu H. Diagnosis and treatment of cavernous hemangioma of the internal auditory canal. Journal of Neurosurgery. 2016 Mar 1;124(3):639-46.\u003c/li\u003e\n \u003cli\u003eHyakusoku H, Tanaka Y, Tsuchiya Y, Nakayama M. Pediatric internal auditory canal cavernous hemangioma with rapid progression of sensorineural hearing loss: illustrative case. Journal of Neurosurgery: Case Lessons. 2023 May 29;5(22).\u003c/li\u003e\n \u003cli\u003eBubenikova A, Skalicky P, Benes Jr V, Benes Sr V, Bradac O. Overview of cerebral cavernous malformations: comparison of treatment approaches. Journal of Neurology, Neurosurgery \u0026amp; Psychiatry. 2022 May 1;93(5):475-80.\u003c/li\u003e\n \u003cli\u003eLabauge P, Laberge S, Brunereau L, Levy C, Tournier-Lasserve E. Hereditary cerebral cavernous angiomas: clinical and genetic features in 57 French families. The Lancet. 1998 Dec 12;352(9144):1892-7.\u003c/li\u003e\n \u003cli\u003eHolman MA, Schmitt WR, Carlson ML, Driscoll CL, Beatty CW, Link MJ. Pediatric cerebellopontine angle and internal auditory canal tumors. Journal of Neurosurgery: Pediatrics. 2013 Oct 1;12(4):317-24.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7353690/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7353690/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eCavernous hemangiomas are uncommon intracranial vascular malformations, with rare presentations in the cerebellopontine angle (CPA) or internal auditory canal (IAC). We present a case of an 18-year-old female with progressive right-sided hearing loss, tinnitus, and vertigo. Audiometry revealed sensorineural hearing loss, and imaging showed a heterogeneous mass within the right IAC. Surgical resection via a retrosigmoid approach was performed with intraoperative monitoring. The mass was completely excised, identified histologically as a cavernous hemangioma, with preservation of all cranial nerves except the cochlear nerve as she was completely deaf. At six-month follow-up, hearing loss persisted, but no other neurological deficits were present. This case highlights the diagnostic complexities of IAC cavernous hemangiomas, often mimicking vestibular schwannomas. Thorough radiological evaluation and meticulous surgical techniques, including intraoperative neuromonitoring, are crucial. While familial forms exist, our patient had no family history. This rare case highlights the need for high suspicion and careful surgical planning for IAC lesions in pediatric population.\u003c/p\u003e","manuscriptTitle":"A Rare Case of Intra Auditory Canal Cavernous Hemangioma in a Young Girl","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-23 15:45:25","doi":"10.21203/rs.3.rs-7353690/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-10-20T15:54:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"113470965082053219081065500655190524332","date":"2025-10-11T21:48:37+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-09T16:55:50+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-18T19:50:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-18T09:32:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-18T09:32:03+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2025-08-12T08:58:16+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"31572a3b-ac9c-4d45-ac56-55046e4c98ff","owner":[],"postedDate":"October 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-10-23T15:45:25+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-23 15:45:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7353690","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7353690","identity":"rs-7353690","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}