Cochlear implantation improves hearing and vertigo in patients after removal of vestibular schwannoma

Roemer, Ariane; Lenarz, Thomas; Lesinski‐Schiedat, Anke

doi:10.5935/0946-5448.20170002

Cited by 4 publications

(5 citation statements)

References 33 publications

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“…The mean WRS65 for monosyllables after 6 months (52%) was still similar to results for other patients having CI [18,24,43], especially compared to patients with implants for single-sided deafness [1,13,16,40,55]. These results are also similar to or better than those reported in small case series with CI after translabyrinthine resection of classical VS (IAC ± CPA) [4,17,22,42,57]. The WRS65 values, however, were not as good and consistent as those reported for patients with CI after removal of solely intracochlear and intravestibulocochlear schwannomas [35,36,56].…”

Section: Discussionsupporting

confidence: 83%

“…Several case reports, case series and first systematic reviews have illustrated that after surgical removal of sporadic VS or VS associated with NF2, CI can lead to good hearing results, even though not all patients will achieve good speech understanding. The CI may be performed in one stage with tumor removal [3,45,50,57] or in a second surgery [3,4,17,22,42]. Similar initial results for hearing rehabilitation are available for CI after radiotherapy [9,28,31] and with a wait and test and scan strategy [5].…”

Section: Introductionmentioning

confidence: 99%

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Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation

Plontke

Cayé‐Thomasen

Strauß

et al. 2020

HNO

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Introduction Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). Methods This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. Results Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80–100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1–36 months (65–85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. Conclusions Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation

Plontke

Cayé‐Thomasen

Strauß

et al. 2020

HNO

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“…In mehreren Fallberichten, Fallserien und ersten systematischen Übersichtsarbeiten konnte gezeigt werden, dass nach operativer Entfernung sporadischer Vestibularisschwannome oder bei Patienten mit NF2 mittels CI prinzipiell gute Hörergebnisse erzielt werden können, auch wenn nicht alle Patienten ein gutes Sprachverstehen erreichten. Dabei kann die Cochleaimplantation einzeitig mit der Operation [3,45,50,57] oder zweizeitig [3,4,17,22,42] erfolgen.…”

Section: Einführungunclassified

“…5c), Pat. #9: zusätzlich Schwindel "klassischer" intrameataler (± KHBW) Vestibularischwannome [4,17,22,42,57]. Die Ergebnisse im Sprachverstehen waren jedoch nicht so konsistent und gut wie nach operativer Entfernung intracochleärer und intravestibulocochleärer Schwannome [35,36,56].…”

Section: Management Of Transmodiolar and Transmacular Cochleovestibulunclassified

Management transmodiolärer und transmakulärer Vestibularis- und Cochlearisschwannome mit und ohne Cochleaimplantation

Plontke

Cayé‐Thomasen

Strauß

et al. 2020

HNO

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Zusammenfassung Einführung Die Hörrehabilitation mittels Cochleaimplantat (CI) ist auch für Patienten mit cochleovestibulären Schwannomen von zunehmendem Interesse. Berichtet wird über Erfahrungen bezüglich des chirurgischen Managements von Tumoren mit einer seltenen transmodiolären oder transmakulären Ausdehnung und über die Ergebnisse bei Hörrehabilitation mit CI. Methode In die retrospektive Fallserie wurden 9 Patienten mit primären intralabyrinthären Schwannomen oder mit sekundärer Invasion des Tumors vom inneren Gehörgang in das Innenohr eingeschlossen. Primärer Zielparameter bei CI-Patienten war das Sprachverstehen bei 65 dB SPL („sound pressure level“), sekundäre Zielparameter waren intra- und postoperative elektrophysiologische Parameter: elektrisch ausgelöste Summenaktionspotenziale eCAP, Impedanzmessungen, das Vorhandensein einer Welle V in den elektrisch (über das CI) evozierten Hirnstammpotenzialen (eBERA), Besonderheiten bei der postoperativen CI-Programmierung und unerwünschte Ereignisse. Ergebnisse Alle 6 implantierten Patienten erreichten ein gutes Sprachverstehen für Zahlwörter in Ruhe (80–100 % bei 65 dB SPL, spätestens 12 Monate nach Erstanpassung). Im Zeitraum von einem bis 36 Monaten erreichten 4 der 6 Patienten mit CI gute bis sehr gute Ergebnisse im Freiburger Einsilbertest in Ruhe (65–85 % bei 65 dB SPL), 2 erreichten 6 Monate nach Erstanpassung nur geringe Werte (25 und 15 % bei 65 dB SPL) mit im weiteren Verlauf abnehmendem Zahlen- und Einsilberverstehen. Schlussfolgerungen Cochleovestibuläre Schwannome mit transmodiolärer und transmakulärer Ausdehnung stellen eine sehr seltene und bezüglich des Managements besondere Entität dar. Das therapeutische Vorgehen erfordert eine differenzierte Abwägung. Auch bei diesen Tumoren stellt die Cochleaimplantation prinzipiell eine Option zur Hörrehabilitation dar.

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“…[7][8][9] After RS and MCF resection of a VS, when hearing is not preserved, CI has been found to be a viable option for hearing treatment when the cochlear nerve remains intact. 10 TL excision of a VS with simultaneous or sequential CI has also been reported recently with promising results; however, there is limited prospective data regarding simultaneous implantation. 11 The purpose of this study is to evaluate the early audiologic results of TL resection of a VS and simultaneous placement of a CI to expand the relatively limited evidence currently available for this procedure.…”

Section: Introductionmentioning

confidence: 99%

Early Outcomes of Simultaneous Translabyrinthine Resection and Cochlear Implantation

Conway

Sioshansi

et al. 2021

The Laryngoscope

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Objectives/Hypothesis: Hearing rehabilitation after translabyrinthine resection of a vestibular schwannoma (VS) has largely been based on the transfer of acoustic stimulus to the contralateral ear, typically through a contralateral routing of signal hearing aid or bone-anchored hearing aid (BAHA). Cochlear implant, either as a subsequent surgery or simultaneously, has become a more common treatment option; however, there is still relatively limited data available on its success. The purpose of this study is to evaluate the early outcomes of simultaneous cochlear implantation in patients with sporadic VS undergoing translabyrinthine resection.Study Design: Prospective, nonrandomized study. Methods: A prospective study of nonrandomized patients was completed at a tertiary care neurotology center. Audiologic outcomes, primarily based on AzBIO in quiet and background noise, as well as consonant-nucleus-consonant (CNC) testing of the affected ears were utilized. Tinnitus, dizziness, and spatial hearing questionnaries were also completed. Audiologic outcomes and questionnaires were compared between the pre-and postoperative groups.Results: Ten patients were included in the study with 3 month follow-up data. There was statistically significant improvement in AzBO with +10 and +5 signal to noise ratio and in quiet, as well as in CNC testing (P < .05). There was a significant improvement in Tinnitus Handicap Inventory between the two groups.Conclusions: Simultaneous cochlear implantation is a viable treatment for hearing loss after translabyrinthine approach to VS. These patients have improved hearing in background noise and tinnitus compared to their preoperative state. Further prognostic data are required to determine which patients are the best candidates.

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Cochlear implantation improves hearing and vertigo in patients after removal of vestibular schwannoma

Cited by 4 publications

References 33 publications

Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation

Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation

Management transmodiolärer und transmakulärer Vestibularis- und Cochlearisschwannome mit und ohne Cochleaimplantation

Early Outcomes of Simultaneous Translabyrinthine Resection and Cochlear Implantation

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