Concurrent Cochlear Implantation with Resection of Skull Base Hemangiopericytoma following Sudden Deafness in an Only Hearing Ear

Abstract

A 72-year-old man with a known left acoustic neuroma, left-sided deafness, and a recently diagnosed right infratemporal fossa (ITF) hemangiopericytoma, presented with sudden deafness in his right ear. Imaging revealed right-sided skull base extension and a large intracranial tumor component. The patient underwent a frontotemporal crainiotomy with concomitant ITF approach. Complete tumor resection was possible, though invasion of the otic capsule was present. Immediately postresection, a cochlear implant (CI) was performed via a transmastoid approach. Full electrode insertion was achieved and confirmed by visualization through the dehiscent middle fossa floor. Mastoid obliteration was then performed with a free fat graft. Postoperative imaging confirmed complete tumor resection (Simpson grade I) and adequate CI placement. Follow-up magnetic resonance imaging was performed at 6 and 12 months, and no tumor recurrence was seen. Prior to CI activation, the patient was completely deaf bilaterally. At 18-month follow-up, however, excellent hearing was achieved with the right CI (16 of 22 electrodes active), and the patient is now conversational with no obvious deficit. His cognitive function is excellent, corresponding to preoperative status, and he is independent in his activities of daily living. Following adjuvant radiation, our patient remains disease free at 18 months.

Treatment outcome and prognostic factors of head and neck hemangiopericytoma: Meta-analysis

“…The scope of the literature search was enlarged on the basis of the reference lists of all retrieved articles for additional relevant articles. Fifty‐four articles, including 2 case series (≥10 cases) and 52 cases reports, met the eligibility criteria for inclusion in the analysis . Data that were extracted for each patient included age, sex, tumor history, tumor presentation, tumor size, tumor extension, lymphadenopathy, surgery type, surgical margins, neck dissection, histologic grade, adjuvant therapy, follow‐up, and treatment outcome.…”