Cochlear Implant Outcomes in Patients with Intralabyrinthine Schwannoma: A Scoping Review

Abstract

ObjectiveTo evaluate the literature and summarize cochlear implantation (CI) outcomes after intralabyrinthine schwannoma (ILS) excision and tumor observation with CI.Data SourcesOVID Medline, Embase, Web of Science; conception to 2024.Review MethodsA literature review was performed using subject headings, MeSH terms, and keywords. Abstracts and full texts were reviewed by two independent reviewers and adjudicated by a third. Inclusion criteria included studies with ILS and CI with reported audiologic outcomes. Subjects were analyzed into two groups, ILS resection with CI and in situ ILS with CI. Patients with NF2 were included. The main outcome of interest was CI audiometric performance level, with secondary outcomes of CI user status and open‐set speech attainment.ResultsThere were 29 articles with a total of 93 patients who met inclusion criteria. The resection group had 17% low performers, 44% intermediate performers, and 38% high performers. The in situ group had 40% low performers, 32% intermediate performers, 27% high performers. The resection group had 69 patients with 97% maintaining user status and 92% with open‐set speech recognition. The observation group had 24 patients, with 87% user rate and 86% achieving open‐set speech recognition. There was a greater percentage of NF2 diagnosis seen in the in situ group.ConclusionThere is a paucity of literature on CI and ILS. Patients are managed with both resection of tumor and implantation in situ. Early data are limited, with improvement in hearing outcomes and high user rates in both populations.Level of EvidenceN/A Laryngoscope, 2024

A Case Report Demonstrating Preservation of Vestibular Receptor Function after Transcochlear Removal of an Intracochlear Schwannoma with Extension to the Fundus of the Internal Auditory Canal

“…For inner ear schwannomas (IES), which are rare, benign tumors located in the periphery of the eighth cranial nerve, treatment depends on tumor characteristics such as size, location, and growth behavior, on clinical symptoms, and on the desired outcome, e.g., in terms of tumor control, vestibular symptoms, and hearing rehabilitation with CIs [ 9 ]. Surgical resection is preferred to observation for patients with vestibular symptoms such as dizziness and vertigo [ 10 ] and for patients with intended hearing rehabilitation with cochlear implants [ 11 , 12 ]. In cases of a solely intracochlear location of the inner ear schwannoma, observation likely complicates management in the future due to possible growth into the vestibular labyrinth and/or through the modiolus into the internal auditory canal (IAC).…”