Auditory Brainstem Implantation Improves Speech Recognition in Neurofibromatosis Type II Patients

Matthies, Cordula; Brill, Stefan; Kaga, Kimitaka; Morita, Akio; Kumakawa, Kozo; Skarżyński, Henryk; Claassen, Andre; Hui, Yau; Chiong, Charlotte M.; Müller, J. M.; Behr, Robert

doi:10.1159/000350568

Cited by 29 publications

(23 citation statements)

References 76 publications

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“…Considering the large number of the affected patients, early diagnosis and treatment of the disease is mandatory in order to achieve favourable results. However, the chances to preserve hearing decrease with increasing tumour size despite advanced surgical techniques and a high percentage of the patients experience severe to profound hearing loss [10][11][12][13] . Therefore, the demand for a sufficient hearing supply after surgical removal is rising.…”

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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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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“…In only a very small number of individuals was performance with the ABI comparable to that expected from a cochlear implant, most of whom achieve open-set speech understanding and high sentence scores even in NF2 (9). While these results are comparable to the majority of studies evaluating the ABI5 (4,5,(9)(10)(11)(12)(13)(14), some recent publications have demonstrated a greater proportion of high performing users (15)(16)(17)(18). Explaining the discrepancy between outstanding results and limited audition remains the biggest challenge for teams working with the ABI.…”

Section: Discussionmentioning

confidence: 67%

“…They surmised that the effects of preoperative tumor size and surgical removal caused deleterious effects to the cochlear nucleus. More recently Matthies et al (15,16), and Behr et al (17), have demonstrated similar outcomes with NF2 patients as well, finding that tumor size did not affect their results. The two outstanding patients in our series had large tumors with brain stem compression; the best was in a young man presenting with two 4 cm tumors.…”

Section: Preoperative Factors As Prognostic Indicatorsmentioning

confidence: 76%

“…This is in keeping with the findings of others; Otto AQ8 et al (21), found with the eight channel Cochlear ABI that those with less than three electrodes were non-users and those with six to eight performed much better. Matthies et al (16), found all users had at least five auditory electrodes and Grayeli et al (10), using the 21 channel Cochlear ABI, observed all their best users had at least 10 electrodes and others had at least 4. Behr et al (17), while describing the group of exceptional performers, found that it was the number of electrodes that provided distinct pitch discrimination that was important.…”

Section: Aq7mentioning

confidence: 99%

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Auditory Brainstem Implantation in Neurofibromatosis Type 2

Ramsden¹,

Freeman²,

Lloyd

et al. 2016

Otology &Amp; Neurotology

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Objective: To describe the experience of auditory brainstem implantation (ABI) in patients with Neurofibromatosis type 2 (NF2). Results: There were 50 primary ABI insertions in 49 patients, including 16 inserted at the time of first side tumor removal as a sleeper, and two revision repositionings which failed to improve outcome. Postoperatively three patients had cerebrospinal fluid leaks which did not require reoperation, one patient had meningitis, and eight patients suffered either temporary or permanent lower cranial nerve dysfunction. Twenty-nine patients became full time users; a further 12 patients became non-users. Three patients died while their device was inactive. Five patients retain serviceable contralateral hearing. Audiological open set testing of users showed means of: environmental sounds discrimination 51%; phoneme discrimination: with ABI alone 22%/lip reading (LR) 45%/ABI with LR 65%; sentence testing: with ABI alone 13%/LR 19%/ABI with LR 54%. Conclusions: The majority of patients with NF2 implanted with an ABI find the device a useful aid to communication in conjunction with LR and in recognizing common environmental sounds. A small proportion gain open set discrimination. Almost a third of patients may end up as non-users. There is probably an increased risk of postoperative lower cranial nerve dysfunction so careful preoperative assessment is advised.Key Words: Auditory brainstem implantBilateral deafness-Postoperative complications-SurgeryVestibular schwannoma.Otol Neurotol 37:xxx-xxx, 2016.The auditory brainstem implant (ABI) evolved from cochlear implant technology to rehabilitate those individuals with total bilateral deafness who are unsuitable for cochlear implantation because of non-functional cochlear nerves or unimplantable cochleas. The majority of candidates suffer from the genetic disorder neurofibromatosis type 2 (NF2) which causes bilateral vestibular schwannomas leading to deafness either by direct damage from the tumors themselves or from the surgery to remove them (1). The ABI stimulates the cochlear nucleus complex directly, which is readily accessible after vestibular schwannoma removal.The Manchester programme participated in the original European pilot study (2), and since then has routinely offered it to appropriate patients. This article reviews our experience in NF2 patients. MATERIAL AND METHODS PatientsPatients were included in the study if they met the Manchester criteria for NF2 disease (3), and had been implanted with an ABI and had continued rehabilitation by the Manchester team between 1994 and 2009.

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“…For patients with an anatomically and functionally intact cochlear nerve, CI is the first choice because of the relative simplicity of the surgical procedure and the fewer postoperative complications compared with ABI. ABI, on the other hand, is fitting for patients without an intact cochlear nerve as a result of surgery, trauma, or congenital malformation [5], since such patients are less likely to benefit from CI. Additionally, in China, ABI has not yet been sanctioned for use in clinical treatment, and therefore CI is the only choice for these patients.…”

Section: Introductionmentioning

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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Auditory Brainstem Implantation Improves Speech Recognition in Neurofibromatosis Type II Patients

Cited by 29 publications

References 76 publications

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

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

Auditory Brainstem Implantation in Neurofibromatosis Type 2

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

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