Cochlear implantation as a successful rehabilitation for radiation-induced deafness

Formanek, Michael; Czerny, Christian; Gstœttner, Wolfgang; Kornfehl, Johannes

doi:10.1007/s004050050038

Cited by 39 publications

(31 citation statements)

References 17 publications

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“…In the current literature, there are only a handful of case reports and case series that suggest cochlear implantation as an effective rehabilitative tool in mitigating hearing loss in patients who received RT to the head and neck (4-7). These observations were consistent with the finding that the retro-cochlear pathways were functionally spared in modern day radiotherapy of head and neck cancers (1).…”

Section: Introductionmentioning

confidence: 99%

Cochlear Implant Outcomes: A Comparison between Irradiated and Non-irradiated Ears

Soh

D'Souza

Sarepaka

et al. 2012

Clin Exp Otorhinolaryngol

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ObjectivesRadiotherapy for head and neck tumors is known to potentially induce sensorineural hearing loss, which is possibly due to damage to the cochlear and/or auditory pathways. Since the success of cochlear implantation depends on a functional auditory nerve, this paper aims to study the hearing outcomes of cochlear implantation in irradiated ears.MethodsA retrospective study of cochlear implant recipients from our institution who had previously received radiotherapy for head and neck cancers was performed. A control group with cochlear implants who did not receive radiotherapy was recruited. A review of case records, speech discrimination scores (SDS), and a validated subjective questionnaire in the form of the Abbreviated Profile of Hearing Aid Benefit (APHAB) was administered to the study group who fulfilled the inclusion criteria. Global and category scores in both groups were averaged and statistically compared via non-inferiority (NI) testing.ResultsWith the control group (n=8) as the reference, the -ΔNI was defined, and a one-tailed lower 95% confidence interval was used for the irradiated group (n=8). The APHAB degree of improvement (%) results were as follows: global, 28.9% (19.32%, -ΔNI=16.3%); ease of communication, 67.0% (58.36%, -ΔNI=37.5%); background noise, 53.2% (44.14%, -ΔNI=26.8%); reverberation, 41.7% (28.85%, -ΔNI=32.7%); and aversiveness, -46.2% (-67.80%, -ΔNI=-56.9%). The SDS was 66.9% (56.02%, -ΔNI=51.0%). From the results, lower 95% confidence interval limits of global APHAB, SDS, ease of communication, and background noise scores of the irradiated group were within the defined -ΔNI boundary and hence are not inferior to the control. The categories of reverberation and aversiveness could not be proven, however.ConclusionThis study demonstrated marked improvements in hearing measured both objectively and subjectively. The overall hearing outcomes after cochlear implantation for post-irradiated patients were not worse than patients who have had no prior irradiation to ear structures.

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Section: Introductionmentioning

confidence: 99%

Cochlear Implant Outcomes: A Comparison between Irradiated and Non-irradiated Ears

Soh

D'Souza

Sarepaka

et al. 2012

Clin Exp Otorhinolaryngol

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“…Cochlear implants are effective when the auditory nerve is functionally intact. When treating nasopharyngeal carcinoma with RT, it has been reported that the retrocochlear pathway could remain intact despite the cochlea receiving greater than 60 Gy (Marangos et al 2000;Formanek et al 1998). Due to the risk of significant retrocochlear pathology after radiation damage, patients who receive high doses of radiation may be worse off than other deaf patients (Jereczek-Fossa et al 2003).…”

Section: Inner Earmentioning

confidence: 98%

Radiation-Induced Ototoxicity

Bhandare

Eisbruch

Antonelli

et al. 2013

ALERT • Adverse Late Effects of Cancer Treatment

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“…Although radiotherapy and radiosurgery are no longer factors for primary exclusion from ABI trial, overall results are less favorable after previous radiation. After radiosurgery, patients with previously implanted devices obtained some environmental sound recognition, but never any open speech recognition, either with cochlear implants 16 or with ABIs.…”

Section: Nonresponder Statusmentioning

confidence: 99%

Auditory brainstem implants in neurofibromatosis Type 2: is open speech perception feasible?

Matthies¹,

Brill²,

Várallyay

et al. 2014

JNS

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Object Patients with bilateral auditory nerve destruction may perceive some auditory input with auditory brainstem implants (ABIs). Despite technological developments and trials in new stimulation sites, hearing is very variable and of limited quality. The goal of this study was to identify advantageous and critical factors that influence the quality of auditory function, especially speech perception. Methods The authors conducted a prospective study on ABI operations performed with the aid of multimodality neuromonitoring between 2005 and 2009 in 18 patients with neurofibromatosis Type 2. Outcome was evaluated by testing word recognition (monotrochee-polysyllabic word test at auditory-only mode [MTPa]) and open speech perception (Hochmair-Schulz-Moser [HSM] sentence test), both in pure auditory mode. The primary outcome was the HSM score at 24 months. The predictive meaning of general clinical data, tumor volume, number of active electrodes, duration of deafness, and early hearing data was examined. Results In 16 successful ABI activations the average score for MTPa was 89% (SD 13%), and for HSM it was 41% (SD 32%) at 24 months. There were 2 nonresponders, 1 after radiosurgery and the other in an anatomical variant. Direct facial nerve reconstruction during the same surgery was followed by successful nerve recovery in 2 patients, with a simultaneous very good HSM result. Patients' age, tumor extension, and tumor volume were not negative predictors. There was an inverse relationship between HSM scores and deafness duration; 50% or higher HSM scores were found only in patients with ipsilateral deafness duration up to 24 months. The higher the deafness sum of both sides, the less likely that any HSM score will be achieved (p = 0.034). In patients with total deafness duration of less than 240 months, higher numbers of active electrodes were significantly associated with better outcomes. The strongest cross-correlation was identified between early MTPa score at 3 months and 24-month HSM outcome. Conclusions This study documents that open-set speech recognition in pure auditory mode is feasible in patients with ABIs. Large tumor volumes do not prevent good outcome. Positive preconditions are short ipsilateral and short bilateral deafness periods and high number of auditory electrodes. Early ability in pure auditory word recognition tests indicates long-term capability of open speech perception.

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Cochlear implantation as a successful rehabilitation for radiation-induced deafness

Cited by 39 publications

References 17 publications

Cochlear Implant Outcomes: A Comparison between Irradiated and Non-irradiated Ears

Cochlear Implant Outcomes: A Comparison between Irradiated and Non-irradiated Ears

Radiation-Induced Ototoxicity

Auditory brainstem implants in neurofibromatosis Type 2: is open speech perception feasible?

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