Neuromonitoring des N. cochlearis bei der Resektion des Vestibularisschwannoms mit simultaner Cochleaimplantation

Weiss, Nora M.; Großmann, Wilma; Schraven, Sebastian P.; Oberhoffner, Tobias; Mlynski, Robert

doi:10.1007/s00106-021-00996-4

Cited by 3 publications

(3 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Dazu ist eine sichere intraoperative Identifizierung desselben notwendig, auch wenn in der intraoperativen ABR methodenbedingt der Nc bereits elektrophysiologisch inaktiv imponiert. Alternativ wäre nur eine eABR denkbar [23], die dann aber einen 2-Höhlen-Eingriff erfordern würde und bereits präoperativ den Patientenwunsch nach einer Hörrehabilitation voraussetzt. Nc sinnvoll sein, Teile des bekanntermaßen als gutartig einzustufenden VS in diesem Bereich "rasenartig" stehen zu lassen.…”

Section: Diskussionunclassified

“…Der morphologisch-anatomische Kontinuitätserhalt des Nervus facialis (Nf) und des Nervus cochlearis (Nc) garantiert zwar noch keinen entsprechenden neurophysiologischen Funktionserhalt, ist aber die Grundvoraussetzung dafür. Der Kontinuitätserhalt des Nc ist auch Grundvoraussetzung für eine mögliche spätere Hörrehabilitation mit einem Cochleaimplantat (CI), auch wenn der Patient bereits tumorbedingt einseitig hochgradig schwerhörig oder ertaubt sein sollte [ 36 ]. Dies ist gerade in den fortgeschrittenen Tumorstadien des VS (Koos III und IV) zum Zeitpunkt der Operation häufig bereits eingetreten [ 12 ].…”

unclassified

See 1 more Smart Citation

Kontinuitätserhalt des Nervus cochlearis bei der retrosigmoidalen ablativen Osteotomie des inneren Gehörgangs bei fortgeschrittenen Vestibularisschwannomen

Schaumann

Albrecht

Turowski

et al. 2021

HNO

View full text Add to dashboard Cite

ZusammenfassungAusgewertet wurden 86 Patienten mit einem retrosigmoidal mikrochirurgisch resezierten Vestibularisschwannom im Tumorstadium Koos II–IV. Es zeigte sich, dass im Bereich des inneren Gehörgangs in über 2/3 der Fälle der Nervus cochlearis dem elektroneurographisch leicht zu identifizierenden Nervus facialis in immer wiederkehrenden ähnlichen Verlaufsmustern folgte. Ausgehend vom Fundus erleichterte dies die frühzeitige Identifizierung und damit den Kontinuitätserhalt des Nervus cochlearis im Verlauf des inneren Gehörgangs. Dies war vor allem dann von Bedeutung, wenn ein sicherer Funktionserhalt aufgrund der Tumorgröße oder -formation trotz intraoperativer Ableitung somatosensorischer Potenziale nicht sicher gewährleistet werden konnte, aber die Möglichkeit einer späteren Hörrehabilitation mit einem Cochleaimplantat bestehen bleiben sollte. Präoperative Magentresonanztomographie(MRT)-Sequenzen ergaben zwar in einigen Fällen einen Hinweis auf die möglichen Nervenverläufe, die intraoperative Darstellung im inneren Gehörgang war der MRT aber überlegen.

show abstract

Section: Diskussionunclassified

unclassified

Kontinuitätserhalt des Nervus cochlearis bei der retrosigmoidalen ablativen Osteotomie des inneren Gehörgangs bei fortgeschrittenen Vestibularisschwannomen

Schaumann

Albrecht

Turowski

et al. 2021

HNO

View full text Add to dashboard Cite

show abstract

“…are proposed to favor hearing preservation ( 7 , 74 – 77 ). While the intraoperative monitoring of facial nerve has become a standard technique in the surgery of SVS, some clinicians tried intraoperative brainstem auditory evoked response and cochlear compound action potentials to identify the location of cochlear nerves and monitor its functional status ( 76 , 78 ). Current literature supports its therapeutic value on hearing preservation in small-medium-sized tumors, but its role in the large SVS remains to be determined ( 76 , 77 , 79 ).…”

Section: Discussionmentioning

confidence: 99%

Current Understanding of Hearing Loss in Sporadic Vestibular Schwannomas: A Systematic Review

Gan

Zhang

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

ObjectiveHearing loss is the most common initial symptom in patients with sporadic vestibular schwannomas (SVS). Hearing preservation is an important goal of both conservative and surgical therapy. However, the mechanism of SVS-associated hearing loss remains unclear. Thus, we performed this systematic review to summarize the current understanding of hearing loss in the SVS and distill a testable hypothesis to further illuminate its underlying mechanism.MethodsA systematic review querying four databases (PubMed, Medline, Embase, and Web of Science) was performed to identify studies evaluating hearing loss in patients with SVS and exploring the potential mechanisms of hearing impairment.ResultsA total of 50 articles were eligible and included in this review. After analysis, the retrieved studies could be categorized into four types: (1) 29 studies explore the relationship between hearing loss and the growth pattern of the tumor (e.g., tumor size/volume, growth rate, tumor location, etc.); (2) ten studies investigate the potential role of cochlear dysfunction in hearing deterioration, including structural abnormality, protein elevation in perilymph, and cochlear malfunctioning; (3) two studies looked into SVS-induced impairment of auditory pathway and cortex; (4) in the rest nine studies, researchers explored the molecular mechanism underlying hearing loss in SVS, which involves molecular and genetic alterations, inflammatory response, growth factors, and other tumor-associated secretions.ConclusionsMultiple factors may contribute to the hearing impairment in SVS, including the growth pattern of tumor, cochlear dysfunction, impairment of auditory pathway and cortex, genetic and molecular changes. However, our current understanding is still limited, and future studies are needed to explore this multifactorial hypothesis and dig deeper into its underlying mechanism.

show abstract

Subjective perception of activity level: A prognostic factor for developing chronic dizziness after vestibular schwannoma resection?

et al. 2022

View full text Add to dashboard Cite

IntroductionA vestibular schwannoma (VS) resection causes an acute unilateral vestibular deafferentation resulting in acute postoperative symptoms. Despite the expected resolution of most of the symptoms, due to central vestibular compensation, more than one out of four patients develop chronic dizziness. Several predictive factors, such as age and tumor size, have been suggested. Despite its potential effect on the process of central vestibular compensation, the level of physical activity after VS resection was not yet considered. Therefore, the association between the level of physical activity and chronic dizziness after VS resection will be investigated.MethodsThis retrospective cohort study included 66 patients who underwent a retro-sigmoid VS resection between October 2001 and February 2007. Patients were assessed before surgery and at 9 weeks and 6 months postoperatively. At 9 weeks, patients were asked to report their level of physical activity (PA) during the past week by using a visual analogue scale and their balance performance was assessed by four standing balance conditions with eyes closed and the Timed Up and Go test (TUG). Based on the Dizziness Handicap Inventory (DHI) score at 6 months, patients were divided in a chronic dizziness group (DHI > 30) and non-chronic dizziness group (DHI-score ≤ 30). Age, sex, Koos classification, preoperative vestibular function, treatment group, balance performance, and level of PA were compared between both groups and used as independent variables in linear regression analyses with the DHI score at 6 months as dependent variable.ResultsThe chronic dizzy patients revealed to have significantly lower levels of PA (p < 0.001) and worse static and dynamic balance performance (p = 0.023 and p = 0.041, respectively) 9 weeks after surgery. After elimination, the multiple regression analysis resulted in a model with two variables (PA level, TUG) which significantly predicted the DHI score (F2,42 = 6.581; R2 = 0.239; p = 0.003).ConclusionThis study revealed associations between (1) the level of PA and balance performance in the subacute phase and (2) chronic dizziness after VS resection. Assessment of the level of PA and balance performance during the subacute phase, which can be performed in a non-invasive and non-time-consuming way, might therefore provide prognostic information after VS resection.

show abstract

Neuromonitoring des N. cochlearis bei der Resektion des Vestibularisschwannoms mit simultaner Cochleaimplantation

Cited by 3 publications

References 37 publications

Kontinuitätserhalt des Nervus cochlearis bei der retrosigmoidalen ablativen Osteotomie des inneren Gehörgangs bei fortgeschrittenen Vestibularisschwannomen

Kontinuitätserhalt des Nervus cochlearis bei der retrosigmoidalen ablativen Osteotomie des inneren Gehörgangs bei fortgeschrittenen Vestibularisschwannomen

Current Understanding of Hearing Loss in Sporadic Vestibular Schwannomas: A Systematic Review

Subjective perception of activity level: A prognostic factor for developing chronic dizziness after vestibular schwannoma resection?

Contact Info

Product

Resources

About