Cochlear Implants to Treat Deafness Caused by Vestibular Schwannomas

Mukherjee, Payal; Ramsden, James D.; Donnelly, Nick; Axon, Patrick; Saeed, Shakeel R; Fagan, Paul; Irving, Richard

doi:10.1097/mao.0b013e31829763a7

Cited by 37 publications

(39 citation statements)

References 22 publications

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“…Lloyd et al [33] have recently published results of this type of approach using either retrosigmoid or translabyrinthine surgery and have demonstrated that it is possible to gain significant benefit from a cochlear implant in the majority of patients. It seems that cochlear implantation alone in patients with profound hearing loss and stable tumours is a further option and has been shown to produce effective hearing rehabilitation with post implantation speech discrimination scores of around 60 % [34,35]. Outcomes of cochlear implantation following growth stabilization with radiosurgery are poorer, however [34,35].…”

Section: Discussionmentioning

confidence: 96%

“…It seems that cochlear implantation alone in patients with profound hearing loss and stable tumours is a further option and has been shown to produce effective hearing rehabilitation with post implantation speech discrimination scores of around 60 % [34,35]. Outcomes of cochlear implantation following growth stabilization with radiosurgery are poorer, however [34,35]. Finally, ABI is an option if a tumour requires removal and cochlear nerve preservation is not possible [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Progress of hearing loss in neurofibromatosis type 2: implications for future management

Kontorinis

Nichani²,

Freeman³

et al. 2014

Eur Arch Otorhinolaryngol

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The objective of this study was to describe changes in hearing over time in patients with neurofibromatosis type 2 (NF2) treated conservatively. A retrospective case review was conducted in a tertiary referral centre. Pure tone audiometry, speech discrimination scores, serviceable hearing (American Academy of Otolaryngology class A or B) and measurement of vestibular schwannoma (VS) size on magnetic resonance imaging were evaluated in 56 patients (89 ears) with NF2 with at least one conservatively managed VS. Over a mean follow-up period of 7 years (range 0.8-21 years) pure tone average thresholds increased gradually with a mean annual rate of 1.3 dB for the right ear (p = 0.0003) and 2 dB for the left ear (p = 0.0009). Speech discrimination scores dropped with an average annual rate of 1.3 and 0.34% in the right and left ear, respectively. Patients maintained serviceable hearing for an average of 7.6 years (range 2.7-19.3 years). The average annual VS growth was 0.4 mm without any correlation with hearing loss. There was a correlation between patients' age and pure tone threshold increase (p < 0.05 for both ears). In this selected population of patients with NF2, hearing threshold increases were very slow. In NF2 patients with indolently behaving tumours, serviceable hearing can be maintained for a significant length of time, making conservative management an attractive option.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Progress of hearing loss in neurofibromatosis type 2: implications for future management

Kontorinis

Nichani²,

Freeman³

et al. 2014

Eur Arch Otorhinolaryngol

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“…In fact, a cochlear implant can be a valid therapeutic option only if cochlear nerve function is preserved in the first place. There are several reports, which show how cochlear implantation can be an effective solution for hearing restoration in patients with VS either as hearing loss treatment without removing the tumour 3 or after VS resection, although they deal with severe bilateral hearing loss patients affected by neurofibromatosis 2 or by sporadic VS in the only hearing ear 4 5 . The presented case was treated as a single-sided deafness in order to relieve the patient's severe tinnitus and to restore binaural hearing.…”

Section: Discussionmentioning

confidence: 99%

Acta Otorhinolaryngologica Italica

Dagna

Murri

Albera

et al. 2016

Acta Otorhinolaryngol Ital

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Presentiamo un caso di posizionamento di impianto cocleare in un uomo di 50 anni che, dopo aver subito tre anni prima un intervento per via retrosigmoidea per un neurinoma dellacustico in stadio 1, è stato colpito da ipoacusia improvvisa ipsilaterale sviluppando un intenso acufene. Dopo lattivazione dellimpianto lacufene è sceso da un grado 4 ad un grado 2 secondo il THI. Sono migliorate le capacità di localizzazione. Lascolto nel rumore (S/R + 7 dB) con il segnale proveniente dal lato operato è migliorato da 38 a 100%. Abbiamo inoltre verificato un significativo incremento dei punteggi relativi a spazialità e linguaggio del questionario Speech, spatial and qualities of sounds. In conclusione limpianto cocleare è una soluzione praticabile ed efficace in caso di insorgenza di ipoacusia ritardata dopo chirurgia conservativa del neurinoma dellacustico.

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“…Actually, CI may provide new options for hearing restoration with limited morbidity in this circumstance [4,17]. For patients with VS in the only hearing ear, significant hearing deterioration on the tumor side with no evidence of tumor growth is an indication that ipsilateral CI is likely to be successful, given that nearly two-thirds of tumors, especially stable ones, do not grow [18,19].…”

Section: Discussionmentioning

confidence: 99%

Hearing Restoration for Adults with Vestibular Schwannoma in the Only Hearing Ear: Ipsilateral or Contralateral Cochlear Implantation?

Huo

Zhang²,

Huang³

et al. 2016

ORL

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Objective: To explore auditory outcomes following cochlear implantation (CI) in patients with vestibular schwannoma (VS) in the only hearing ear. Methods: Three patients, all with a long history of hearing loss on one side and with newly diagnosed VS on the other side, underwent ipsilateral or contralateral CI. Their clinical data were collected retrospectively. Postoperative hearing outcomes were measured during follow-up and compared with the preoperative test results. A thorough search of the English-language literature was performed. Results: Patients 1 and 2 underwent CI in the ipsilateral and contralateral ear, respectively, without tumor removal; patient 3 underwent CI after tumor resection. At the last follow-up, the result of pure-tone audiometry was 25, 45, and 25 dB, respectively. An open-set speech discrimination score was achieved in all 3 patients, with monosyllabic word recognition of 60, 30, and 75%, respectively. Besides the patients included in our study, 28 CI cases with VS in the only hearing ear have been reported up to now. Conclusions: In patients with VS in the only hearing ear, significant hearing deterioration with no obvious tumor growth is a good indication for ipsilateral CI. Long-term deafness in the tumor-free ear is not an absolute contraindication for CI.

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Cochlear Implants to Treat Deafness Caused by Vestibular Schwannomas

Abstract: Patients with unilateral VS (sporadic or those affected with NF2) whose tumor status was stable, benefited from cochlear implantation in their tumor-affected ear. Patients who had radiotherapy also benefited from CI, but their outcomes were variable.

Cited by 37 publications

References 22 publications

Progress of hearing loss in neurofibromatosis type 2: implications for future management

Progress of hearing loss in neurofibromatosis type 2: implications for future management

Acta Otorhinolaryngologica Italica

Hearing Restoration for Adults with Vestibular Schwannoma in the Only Hearing Ear: Ipsilateral or Contralateral Cochlear Implantation?

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