Cochlear Implantation Outcomes in Patients With Retrocochlear Pathology: A Systematic Review and Pooled Analysis

Schlacter, Jamie; Kay‐Rivest, Emily; Nicholson, Joseph; Santacatterina, Michele; Zhang, Yan; Jethanamest, Daniel; Friedmann, David R.; McMenomey, Sean O.; Roland, J. Thomas

doi:10.1097/mao.0000000000003648

Cited by 6 publications

(6 citation statements)

References 72 publications

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“…The reviews focused on outcomes in cochlear-implanted adults with tinnitus (Ramakers et al 2015; Peter et al 2019; Yuen et al 2021), Meniere disease (Desiato et al 2021; Selleck et al 2021; Villavisanis et al 2021), Usher syndrome (Davies et al 2021), vestibular schwannoma (Borsetto et al 2019; Schlacter et al 2022), and otosclerosis (Assiri et al 2022; Kondo et al 2023; Teaima et al 2023). Overall, CIs are generally safe and efficacious for these patients.…”

Section: Resultsmentioning

confidence: 99%

“…For other retrocochlear pathologies, 82% of the 171 adults included in the review by Schlacter et al (2022) demonstrated improvements in speech perception 6 months to 1 year after implantation with change in consonant-nucleus-consonant word scores ranging from 25.6 to 78% and change in AzBio sentences scores ranging from 36.5 to 51%. In adults with otosclerosis, Assiri et al (2022) reviewed 21 studies with extractable data (n = 2 to 36) and showed that all studies reported audiological improvement postimplantation.…”

Section: Review Of the Literaturementioning

confidence: 99%

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The Benefits of Cochlear Implantation for Adults: A Systematic Umbrella Review

Tang,

Tran,

et al. 2024

Ear &Amp; Hearing

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Objectives: The uptake of cochlear implants among adults who could benefit (based on pure-tone audiometry) in developed countries is estimated to be less than 10%. Concerns about potential surgical complications, fear of losing residual hearing, and limited awareness about the benefits of this intervention contribute to the low adoption rate. To enhance quality of life and improve the uptake of cochlear implants, it is essential to have a clear understanding of their benefits. Design: This umbrella review aims to summarize the major benefits of cochlear implant usage in adults, by synthesizing findings from published review articles. A comprehensive search of databases including MEDLINE, EMBASE, PsycINFO, and Google Scholar, was conducted. The search was limited to English-language review articles published between 1990 and 2022, focusing on cochlear implant outcomes in at least 5 adults (aged ≥18 years). Two independent reviewers screened titles, abstracts, and full-text articles, and conducted a quality assessment using the Joanna Briggs Checklist for Systematic Reviews and Research Syntheses. Results: Forty-two articles were included in this review. There were 15 systematic reviews with meta-analysis, 25 systematic reviews without meta-analysis, and 2 systematic scoping reviews. All 42 articles underwent quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses, of which 40% (n = 17) satisfied 9 out of 11 quality criteria. This umbrella review shows that cochlear implants are associated with improvements in speech perception and recognition as well as improved quality of life and cognition. These benefits are observed in a significant proportion of adults undergoing the procedure, highlighting its effectiveness as a viable intervention for individuals with severe to profound hearing loss. Conclusions: The potential benefits of cochlear implantation appear to outweigh the risks and complications associated with the procedure. It is recommended that adults with severe to profound hearing loss in particular, engage in informed discussions with healthcare professionals to consider cochlear implantation as a viable treatment option.

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Section: Resultsmentioning

confidence: 99%

Section: Review Of the Literaturementioning

confidence: 99%

The Benefits of Cochlear Implantation for Adults: A Systematic Umbrella Review

Tang,

Tran,

et al. 2024

Ear &Amp; Hearing

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“…19,35,49 In more than half the patients with good postimplantation performance and stable tumors, hearing was preserved for long periods, consistent with published findings. 35,38,50,51 In meta-analyses considering the prognostic factors for speech intelligibility, the NF2 population has generally been split into 2 categories: good-to-intermediate performers (34%-100%) and poor performers (0%-33%). 19,49 The prognostic factors for poor performers have not fully been clarified, although some authors have reported associations between poor performance and large tumors, a shorter duration of profound HL, and lower preimplantation audiometric scores.…”

Section: Discussionmentioning

confidence: 99%

“…However, it remains challenging to confirm the presence of a functionally intact cochlear nerve before or during surgery 31 . Given the rarity of NF2, most of the studies performed include only limited numbers of patients or a mixture of patients with sporadic and NF2‐related VS, leading to discrepancies in the results obtained 19,37,38 . Moreover, little is known about long‐term hearing outcomes in NF2 patients.…”

mentioning

confidence: 99%

Cochlear Implantation in Neurofibromatosis Type 2‐Related Schwannomatosis: Long‐Term Hearing Outcomes

Grenier,

Mosnier,

Ferrary

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo evaluate long‐term hearing outcomes following cochlear implantation in patients with neurofibromatosis type 2 and ipsilateral vestibular schwannoma.Study DesignRetrospective study.SettingTertiary general hospital.MethodsTwenty‐two patients undergoing cochlear implantation between 2004 and 2018 with at least 1 year of follow‐up were included. Patients were categorized as “users” or “nonusers” of their cochlear implant (CI). For users, speech perception (disyllabic words) without lip‐reading was assessed in quiet conditions 1‐year postimplantation, and annually thereafter. CI users were classified into 2 groups on the basis of speech intelligibility (≥40% or <40%). Demographic data, treatment options, and tumor size were also recorded.ResultsOne year after implantation, 16 (73%) patients used their CI daily. Twelve of these patients had a speech intelligibility ≥40% (mean: 74 ± 21.9%). Three had a Koos stage IV tumor. At the last visit (mean duration of follow‐up: 6 ± 5 years), 12 of these 16 patients were still using their implant daily, and 6 had a speech intelligibility ≥40%. No predictive factors for good performance at 1 year or performance stability were identified.ConclusionNeurofibromatosis type 2 is a complex disease profoundly affecting patient quality of life, and cochlear implantation should always be considered on a case‐by‐case basis. In some individuals, cochlear implantation can provide good speech intelligibility for extended periods, even posttreatment or in cases of large tumors.

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“…Studies meeting overall appraisal criteria for inclusion using the Joanna Briggs Institute Critical Appraisal Checklist and the Cochrane Risk of Bias Assessment Tool were included and are listed in Table 2 (11)(12)(13)(14)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) with their respective Oxford Level of Evidence (15,16). Eighty-eight articles were excluded after full text review (Supplemental Content: Appendix Table 1, http://links.lww.com/MAO/ B815).…”

Section: Systematic Reviewmentioning

confidence: 99%

Cochlear Implantation After Head and Neck Radiation: A Case Series, Systematic Review, and Meta-analysis

Ahmad,

Lovin,

Lee

et al. 2024

Otol Neurotol

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Objective To determine if cochlear implant (CI) is safe and effective in patients with radiation therapy (XRT)-induced sensorineural hearing loss and to discuss considerations in this population through a retrospective cohort review, systematic review, and meta-analysis. Databases Reviewed PubMed, Cochrane Library, and Embase. Methods We retrospectively reviewed all CI cases after head and neck (HN) XRT at our institution, noting intraoperative findings, postoperative complications, and hearing outcomes. Change in speech discrimination scores (SDSs) was the primary outcome measure. Systematic review was performed to identify all cases of CI after HNXRT. A meta-analysis was performed to assess SDS change. Results The retrospective cohort review identified 12 patients who underwent CI after HNXRT. One patient with HN cancer (HNC) and one with central nervous system pathology (CNSP) received bilateral implants. Six had HNC, three had CNSP, and one had Langerhans cell histiocytosis. Eleven had abnormal findings during CI. There were no postoperative complications. Twenty articles with an additional 97 patients were suitable for systematic review inclusion. Of the 109 patients, 67 (61.5%) had HNC and 18 (16.5%) had CNSP. Abnormal intraoperative findings were common (30.3%), most frequently in the mastoid (66.7%). Postoperative complications, including wound dehiscence and infection with some requiring explantation, occurred in 10.1% of patients. Sixty-six patients were included in the meta-analysis. All demonstrated SDS improvement (mean increase, 56.2%). Conclusion Patients with prior HNXRT benefit from CI. Paying careful attention to surgical planning and technique, postoperative care, and patient expectations is imperative, as complications are not uncommon.

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Cochlear Implantation Outcomes in Patients With Retrocochlear Pathology: A Systematic Review and Pooled Analysis

Cited by 6 publications

References 72 publications

The Benefits of Cochlear Implantation for Adults: A Systematic Umbrella Review

The Benefits of Cochlear Implantation for Adults: A Systematic Umbrella Review

Cochlear Implantation in Neurofibromatosis Type 2‐Related Schwannomatosis: Long‐Term Hearing Outcomes

Cochlear Implantation After Head and Neck Radiation: A Case Series, Systematic Review, and Meta-analysis

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