This case study describes a therapeutic strategy using a cochlear implant for a bilateral acoustic neuroma deafened patient. The cochlear nerve had previously been sacrificed on one side during tumour removal, but on the remaining side a functioning cochlear nerve was assessed by electric promontory stimulation in spite of a neuroma extending into the vestibular labyrinth. The patient was successfully stimulated with a Nucleus 22- channel implant after removal of the intracanalicular portion of the neuroma via a middle fossa approach.

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Background/Purpose: Previous FDG-PET studies have indicated neuroplasticity in the adult auditory cortex in cases of postlingual deafness. In the mature brain, auditory deprivation decreased neuronal activity in primary auditory and auditory-related cortices. In order to reevaluate these issues, we used statistical analytic software, namely a three-dimensional stereotaxic region of interest template (3DSRT), in addition to statistical parametric mapping (SPM; Institute of Neurology, University College of London, UK). MaterialsandMethods:¹⁸F-FDG brain PET scans were performed on 7 postlingually deaf patients and 10 healthy volunteers. Significant increases and decreases of regional cerebral glucose metabolism in the patient group were estimated by comparing their PET images with those of healthy volunteers using SPM analysis and 3DSRT. Results: SPM revealed that the glucose metabolism of the deaf patients was lower in the right superior temporal gyrus, both middle temporal gyri, left inferior temporal gyrus, right inferior lobulus parietalis, right posterior cingulate gyrus, and left insular cortex than that of the control subjects. 3DSRT data also revealed significantly decreased glucose metabolism in both primary auditory cortices of the postlingually deaf patients. Conclusion: SPM and 3DSRT analyses indicated that glucose metabolism decreased in the primary auditory cortex of the postlingually deaf patients. The previous results of PET studies were confirmed, and our method involving 3DSRT has proved to be useful.