Cochlear implantation in an intralabyrinthine acoustic neuroma patient after resection of an intracanalicular tumour

Tono, Tetsuya; Ushisako, Yasuaki; Morimitsu, Tamotsu

doi:10.1017/s0022215100134292

Cited by 41 publications

(18 citation statements)

References 10 publications

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“…Since this initial study, the cases of 32 patients with NF2 who have received cochlear implants have been reported in the literature. 1,2,7,12,15,16,20–23,29,30,32,34 Our study demonstrates open-set speech recognition in 4 of 7 patients with NF2 who had cochlear implants. We acknowledge that our results represent a retrospective assessment of patients who were available for follow-up at our institution.…”

Section: Discussionmentioning

confidence: 54%

Auditory rehabilitation of patients with neurofibromatosis Type 2 by using cochlear implants

Roehm¹,

Clair²,

Jethanamest³

et al. 2011

JNS

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Object The aim of this study was to determine whether patients with neurofibromatosis Type 2 (NF2) who have intact ipsilateral cochlear nerves can have open-set speech discrimination following cochlear implantation. Methods Records of 7 patients with documented NF2 were reviewed to determine speech discrimination outcomes following cochlear implantation. Outcomes were measured using consonant-nucleus-consonant words and phonemes; Hearing in Noise Test sentences in quiet; and City University of New York sentences in quiet and in noise. Results Preoperatively, none of the patients had open-set speech discrimination. Five of the 7 patients had previously undergone excision of ipsilateral vestibular schwannoma (VS). One of the patients who received a cochlear implant had received radiation therapy for ipsilateral VS, and another was undergoing observation for a small ipsilateral VS. Following cochlear implantation, 4 of 7 patients with NF2 had open-set speech discrimination following cochlear implantation during extended follow-up (15–120 months). Two of the 3 patients without open-set speech understanding had a prolonged period between ipsilateral VS resection and cochlear implantation (120 and 132 months), and had cochlear ossification at the time of implantation. The other patient without open-set speech understanding had good contralateral hearing at the time of cochlear implantation. Despite these findings, 6 of the 7 patients were daily users of their cochlear implants, and the seventh is an occasional user, indicating that all of the patients subjectively gained some benefit from their implants. Conclusions Cochlear implantation can provide long-term auditory rehabilitation, with open-set speech discrimination for patients with NF2 who have intact ipsilateral cochlear nerves. Factors that can affect implant performance include the following: 1) a prolonged time between VS resection and implantation; and 2) cochlear ossification.

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Section: Discussionmentioning

confidence: 54%

Auditory rehabilitation of patients with neurofibromatosis Type 2 by using cochlear implants

Roehm¹,

Clair²,

Jethanamest³

et al. 2011

JNS

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“…Patients with NF-2 with profound hearing loss may be candidates for brainstem implants if the anatomical integrity of the cochlear nerve is not maintained. However, in cases of vestibular schwannoma resection in which the cochlear nerve has been spared, a cochlear implant in the same ear has been used to obtain hearing (Tono et al, 1996). Arriaga and Marks (1995) described a case of successful cochlear implantation simulta-neous with vestibular schwannoma resection in a patient with co-existing otosclerosis in the ear contralateral to the acoustic neuroma.…”

Section: Acoustic Neuroma and Neurofibromatosis Type 2 (Nf2)mentioning

confidence: 99%

Cochlear implant surgery in challenging cases

Nikolopoulos¹,

Kiprouli²

2004

Cochlear Implants Int.

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Expanding selection criteria and increasing numbers of cochlear implantations have revealed several challenging cases with regard to surgery and medical point of view. Cochlear implantation of congenitally deaf children with inner-ear malformations may involve difficulties in preoperative evaluation, surgical approach and postoperative follow-up. Cochlear nerve aplasia (as evidence of only one existing nerve in three dimensional magnetic resonance imaging) and hypoplastic cochleas are among the most difficult cases and sometimes children are considered unsuitable for cochlear implantation. However, there is always the possibility that hypoplastic cochleas may include ganglion cells and the only nerve in the internal auditory canal (facial nerve) may contain auditory fibres as well. A positive history of auditory experience and evidence of electrical auditory brainstem response or response to the promontory or round window electrical stimulation may imply that a functioning auditory system is in place. Malformations like common cavity deformity, isolated bilateral vestibular aqueduct enlargement and Mondini dysplasia are usually less challenging, although cerebrospinal fluid leak and postoperative meningitis may be a possibility. In cases of post-meningitic deaf patients, ossification (or obliteration) may be a serious problem even if computed tomography and MRI scan show a patent cochlea or minimal changes. Acoustic neuromas and neurofibromatosis type 2 are other challenging cases, as there is always the possibility that the sensorineural hearing loss is secondary to cochlear damage by interference of the tumour to cochlear blood supply. In conclusion, challenging cases are becoming more common as we are expanding selection criteria, and we should be prepared for alternative cochlear implant devices (straight electrode arrays, dual arrays, compressed arrays, etc.), increased rate of possible complications at, and following, surgery, and functional outcome that may vary considerably among implantees.

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“…Several studies suggest a very good hearing rehabilitation of acoustic neuroma patients after CI 9,17,18 . However, nearly all studies are limited due to small patient numbers 19,20 -reporting case files or groups of up to 3 patients. Another shortcoming of the studies reported in the literature is the lack of information on improvements regarding impairments associated with an acoustic neuroma, for example tinnitus and vertigo.…”

Section: Introductionmentioning

confidence: 99%

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

Roemer¹,

Lenarz²,

Lesinski‐Schiedat³

2017

The International Tinnitus Journal

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Objective: With rising quality of speech perception in cochlear implant users, the indication widens. Nowadays, cochlear implantation is reasonable even in vestibular schwannoma patients. Speech perception with a cochlear implant is in these patients as promising as in patients with sensorineural hearing loss. However, the impact of cochlear implantation on vertigo and tinnitus after removal of vestibular schwannoma has not been investigated yet. Methods: In a retrospective study, we analysed 12 patients treated with a cochlear implant after removal of vestibular schwannoma. Results: In addition to a promising hearing perception -all patients reported improvement of vertigo. This improvement was also demonstrated by postural analysis. Improvement of tinnitus was achieved in 50% of the patients. Conclusion: Cochlear implantation seems a promising treatment for hearing loss, vertigo and even tinnitus in patients after removal of vestibular schwannoma. However, for successful cochlear implantation with adequate speech perception and improvement of vertigo and tinnitus, functional hearing nerve and intact inner ear anatomy is necessary.

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Cochlear implantation in an intralabyrinthine acoustic neuroma patient after resection of an intracanalicular tumour

Cited by 41 publications

References 10 publications

Auditory rehabilitation of patients with neurofibromatosis Type 2 by using cochlear implants

Auditory rehabilitation of patients with neurofibromatosis Type 2 by using cochlear implants

Cochlear implant surgery in challenging cases

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

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