Intralabyrinthine Schwannomas: Management and Hearing Rehabilitation with Cochlea Implants

Plontke, Stefan K.; Pfister, M.; Wickenhauser, Claudia; Kösling, S.; Rahne, Torsten

doi:10.1055/s-0036-1592461

Cited by 17 publications

(48 citation statements)

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“…In addition, at least two of these patients had improved performance from their preoperative state, though still fell within the low-performance category. 28,29 Seven out of the 10 (70%) NF2 patients with open-set recognition reported had at least intermediate to high performance, compared with 5 out of 6 (83%) of those with sporadic tumors.…”

Section: Discussionmentioning

confidence: 99%

“…29 This patient did not gain improvement in openset speech scores, but reportedly was very satisfied with her cochlear implant, uses it daily, and has improvement with the implant in conjunction with lip reading. The final subject in the low-performance category was reported by Plontke et al 28 Word recognition score using the German Freiburger monosyllable test in quiet at 65 dB preoperatively was 5% which improved modestly to 25% postoperatively.…”

Section: Low Performersmentioning

confidence: 96%

“…Plontke et al reported two subjects that could be categorized to the intermediate performance group. 28 German Freiburger monosyllable test was performed at 65 dB SPL. Both subjects had scores of 0% preoperatively.…”

Section: Intermediate Performersmentioning

confidence: 99%

“…There were four subjects included in the case studies that were identified as low performers. 13,18,28,29 Carlson et al detailed a subject with a postoperative CNC score of 22% and AzBio in quiet score of 32%. 13 One of the subjects detailed in the case series by Lloyd et al showed speech discrimination scores at 12 months postoperatively of 30% for BKB in quiet and 16% in noise, though gains in subjective benefit and daily implant use were noted by the authors.…”

Section: Low Performersmentioning

confidence: 99%

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Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation: Systematic Review

2019

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Objectives Hearing rehabilitation is an important management aspect of patients undergoing excision of vestibular schwannomas. Studies have shown cochlear implantation (CI) is possible at the time of tumor excision via a translabyrinthine approach. Primary objectives of this report are (1) to review prospective studies pertaining to outcomes of concurrent CI and translabyrinthine tumor removal in detail and (2) perform an aggregate analysis of outcomes for case reports and series. Design Systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Setting Review of literature using PubMed and Cochrane databases. Participants Eligibility included patients undergoing translabyrinthine excision of vestibular schwannoma with concurrent CI. Main Outcome Measures Open-set speech discrimination scores, sound localization, patient-reported outcome measures. Results Forty-one subjects were identified. Two prospective studies have been performed, which showed improvement in speech localization and patient-reported outcome measures. While the majority of patients achieved open set speech recognition, data pertaining to improvement in speech perception were variable. Approximately 85% of subjects had audibility with their CI. Of those that achieved open-set speech discrimination, 75% could be classified as either intermediate or high performers. The majority of low performers in open-set speech either endorsed subjective benefit or demonstrated improvement compared to preoperative measures. There was a high risk of selection and reporting bias. Conclusions The majority of patients undergoing translabyrinthine excision of vestibular schwannoma with concurrent CI achieve open set speech perception, with 75% of these patients meeting criteria for being intermediate to high performers. Additional benefits include improved subjective hearing measures, decreased tinnitus, and improved sound localization.

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Section: Discussionmentioning

confidence: 99%

Section: Low Performersmentioning

confidence: 96%

Section: Intermediate Performersmentioning

confidence: 99%

Section: Low Performersmentioning

confidence: 99%

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Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation: Systematic Review

2019

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“…Usually, patients might experience complete loss, which might occur acutely or progressively, balance problems (dizziness, vertigo, postural instability) or tinnitus [16]. Clinical diagnosis is usually made by ENT-specific examination, including ear microscopy, audiological assessment, neuro-otological diagnosis with testing of the semicircular canal and the otolith organs [16]. The former is classically completed by the gold standard high-resolution magnetic resonance imaging (MRI) [1].…”

Section: Introductionmentioning

confidence: 99%

Gamma Knife radiosurgery for intravestibular and intracochlear schwannomas

et al. 2018

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Intralabyrinthäre Schwannome

Plontke

Rahne

Pfister³

et al. 2017

HNO

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Intralabyrinthine schwannomas (ILS) are a rare differential diagnosis of sudden hearing loss and vertigo. In an own case series of 12 patients, 6 tumors showed an intracochlear, 3 an intravestibular, 1 a transmodiolar including the cerebello-pontine angle (CPA), 1 a transotic including the CPA and 1 a multilocular location. The tumors were removed surgically in 9 patients, whereas 3 patients opted for a "wait-and-test-and-scan" strategy. Of the surgical patients, 3 underwent labyrinthectomy and cochlear implant (CI) surgery in a single stage procedure; 1 patient received extended cochleostomy with CI surgery; 3 underwent partial or subtotal cochleoectomy, with partial cochlear reconstruction and CI surgery (n = 1) or implantation of electrode dummies for possible later CI following repeated MRI follow-up (n = 2); and in 2 patients, the tumors of the internal auditory canal and cerebellopontile angle exhibiting transmodiolar or transmacular growth were removed by combined translabyrinthine-transotic resection. For the intracochlear tumors, vestibular function could mostly be preserved after surgery. In all cases with CI surgery, hearing rehabilitation was successful, although speech discrimination was limited for the case with subtotal cochleoectomy. Surgical removal of intracochlear schwannomas via partial or subtotal cochleoectomy is, in principle, possible with preservation of vestibular function. In the authors' opinion, radiotherapy of ILS is only indicated in isolated cases. Provided performed early enough, cochlear implantation after surgical removal of ILS is an option for auditory rehabilitation, thus representing-in contrast to the "wait-and-test-and-scan" strategy-a therapeutic approach.

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Intralabyrinthine Schwannomas: Management and Hearing Rehabilitation with Cochlea Implants

Cited by 17 publications

References 0 publications

Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation: Systematic Review

Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation: Systematic Review

Gamma Knife radiosurgery for intravestibular and intracochlear schwannomas

Intralabyrinthäre Schwannome

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