Simultaneous Translabyrinthine Tumor Removal and Cochlear Implantation in Vestibular Schwannoma Patients

Kim, Jin Won; Han, Ji Hyuk; Moon, In Seok

doi:10.3349/ymj.2016.57.6.1535

Cited by 20 publications

(15 citation statements)

References 11 publications

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“…13,14 There were 5 of the 21 subjects who either did not have open-set recognition tested or were not reported. [18][19][20][21] One of these subjects had subjective recognition, but formal testing was deferred due to the patient only speaking Spanish. 19 A subject detailed by dos Santos Neto et al showed improvement in both Ling Sound Test and identification of vocabulary extension compared to baseline measures.…”

Section: Speech Perception Outcomesmentioning

confidence: 99%

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: Speech Perception Outcomesmentioning

confidence: 99%

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

2019

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“…13 Previous studies show a positive outcome in patients with sporadic VS in the only or better hearing ear, with similar prognosis to that in patients without VS who were treated with CI. 1,6,12,13,27 Cochlear implants after radiosurgery in patients with neurofibromatosis type 2-associated VS have been described, with significant restoration of hearing. 10 However, the lack of knowledge about the benefits of CI in patients with normal contralateral hearing still exists.…”

Section: The Role Of CImentioning

confidence: 99%

Simultaneous cochlear implantation as a therapeutic option in vestibular schwannoma surgery: case report

Neto

Zamponi

Hamerschmidt³

et al. 2018

Neurosurgical Focus

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Hearing loss is the most common symptom of vestibular schwannomas (VSs). The management of these lesions includes observation, radiosurgery, and microsurgical resection. Hearing preservation and rehabilitation are the major challenges after the tumor treatment. A 43-year-old man with previous left-sided profound hearing loss and tinnitus presented with a 2-mm left-sided intracanalicular VS. The decision was made to perform a simultaneous cochlear implantation (CI) and microsurgical resection of the tumor. The patient did well postoperatively, with significant improvement of tinnitus, sound localization, and speech recognition in noise. Previous reports of simultaneous CI and VS resection in patients with neurofibromatosis type 2 and sporadic VS in the only hearing ear have been described. The role of CI in patients with VS and normal contralateral hearing has been recently described, showing positive outcomes due to the binaural benefits. Tinnitus also can be treated by the implantation of the cochlear device. The simultaneous microsurgical removal of VS and implantation of a cochlear device is a feasible approach in patients with unilateral hearing loss and severe tinnitus.

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“…CI performance in our series (n = 19) did not differ from those reported previously (n = 39) as high, moderate, or poor CI benefit observed in 47%, 21%, and 32% of cases in our study and in 46%, 21%, and 33% of cases in those studies reported previously. Altogether considering our series with previous reports, 57 CIs and five ABIs were implanted to rehabilitate hearing in 58 sporadic VSs in the only hearing ear during the last 28‐year period (Table ) . Most of the patients have been operated on mainly by TL, apart from nine patients whose hearing was restored by CI without VS surgery (present study) .…”

Section: Discussionmentioning

confidence: 77%

“…†Performance of CI for hearing rehabilitation in the literature (n = 38) and the present study. Data were not available in three cases published in two articles (Talbot et al and Kim et al ).…”

Section: Discussionmentioning

confidence: 99%

Management of sporadic vestibular schwannoma with contralateral nonserviceable hearing

et al. 2019

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Objectives/Hypothesis: To outline a possible decision-making process for sporadic vestibular schwannoma (VS) with contralateral nonserviceable hearing at diagnosis.Study Design: Retrospective case series. Methods: Diagnosed VS was studied in a tertiary referral center from 1995 to 2013. Results: Twenty-eight patients were included, with a mean follow-up of 6.9 years (range = 0.5-20 years). Ten were stage 1, 10 were stage 2, five were stage 3, and three were stage 4. Ipsilateral hearing levels were A (n = 3), B (n = 10), C (n = 7) and D (n = 8) American Academy of Otolaryngology-Head and Neck Surgery classification. Contralateral hearing levels were C (n = 11) and D (n = 17). Initial VS management included surveillance (n = 12) or surgery (n = 16), and four patients were later treated with surgery (n = 3) or stereotactic irradiation (n = 1). Hearing was improved by hearing aids and/or etiological treatment (n = 8), restored by contralateral (n = 15) or ipsilateral (n = 4) cochlear implants (CIs), or ipsilateral auditory brainstem implants (ABIs) (n = 3). Finally, 18 CIs were active daily; 14 of them presented high or moderate benefit with mean open-set dissyllabic word scores (WRS) of 58.1% and sentence recognition scores (SRS) of 69.7%, but only one ABI was still active (WRS of 70% and SRS of 87% with lip reading).Conclusions: When early removal of VS was not necessary, contralateral CI or etiological treatment for hearing loss might be recommended initially. Ipsilateral CI is proposed, whereas VS should be operated on if previous hearing restoration was not successful. ABI should be reserved for the rare cases where a contralateral CI could not be implanted or the cochlear nerve was sectioned during VS removal.

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Simultaneous Translabyrinthine Tumor Removal and Cochlear Implantation in Vestibular Schwannoma Patients

Cited by 20 publications

References 11 publications

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

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

Simultaneous cochlear implantation as a therapeutic option in vestibular schwannoma surgery: case report

Management of sporadic vestibular schwannoma with contralateral nonserviceable hearing

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