Sporadic and NF2-associated vestibular schwannoma surgery and simultaneous cochlear implantation: a comparative systematic review

West, Niels; Sass, Hjalte; Cayé‐Thomasen, Per

doi:10.1007/s00405-019-05741-w

Cited by 25 publications

(54 citation statements)

References 43 publications

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“…The mean WRS65 for monosyllables after 6 months (52%) was still similar to results for other patients having CI [18,24,43], especially compared to patients with implants for single-sided deafness [1,13,16,40,55]. These results are also similar to or better than those reported in small case series with CI after translabyrinthine resection of classical VS (IAC ± CPA) [4,17,22,42,57]. The WRS65 values, however, were not as good and consistent as those reported for patients with CI after removal of solely intracochlear and intravestibulocochlear schwannomas [35,36,56].…”

Section: Discussionsupporting

confidence: 83%

“…Hearing loss because of vestibular schwannomas (VS) negatively influences the quality of life and patients with this condition are increasingly interested in hearing rehabilitation with cochlear implantation (CI) [25,28,57]. Several case reports, case series and first systematic reviews have illustrated that after surgical removal of sporadic VS or VS associated with NF2, CI can lead to good hearing results, even though not all patients will achieve good speech understanding.…”

Section: Introductionmentioning

confidence: 99%

“…Several case reports, case series and first systematic reviews have illustrated that after surgical removal of sporadic VS or VS associated with NF2, CI can lead to good hearing results, even though not all patients will achieve good speech understanding. The CI may be performed in one stage with tumor removal [3,45,50,57] or in a second surgery [3,4,17,22,42]. Similar initial results for hearing rehabilitation are available for CI after radiotherapy [9,28,31] and with a wait and test and scan strategy [5].…”

Section: Introductionmentioning

confidence: 99%

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Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation

Plontke

Cayé‐Thomasen

Strauß

et al. 2020

HNO

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Introduction Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). Methods This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. Results Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80–100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1–36 months (65–85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. Conclusions Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation

Plontke

Cayé‐Thomasen

Strauß

et al. 2020

HNO

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“…Die durch Vestibularisschwannome verursachte Schwerhörigkeit spielt eine relevante Rolle bezüglich der Einschränkung der Lebensqualität. Daher trifft die Möglichkeit der Hörrehabilitation mit Hilfe eines Cochleaimplantates (CI) bei gegebener audiologischer Indikation auch bei Patienten mit Vestibularisschwannom auf zunehmendes Interesse [25,28,57]. In mehreren Fallberichten, Fallserien und ersten systematischen Übersichtsarbeiten konnte gezeigt werden, dass nach operativer Entfernung sporadischer Vestibularisschwannome oder bei Patienten mit NF2 mittels CI prinzipiell gute Hörergebnisse erzielt werden können, auch wenn nicht alle Patienten ein gutes Sprachverstehen erreichten.…”

Section: Einführungunclassified

“…In mehreren Fallberichten, Fallserien und ersten systematischen Übersichtsarbeiten konnte gezeigt werden, dass nach operativer Entfernung sporadischer Vestibularisschwannome oder bei Patienten mit NF2 mittels CI prinzipiell gute Hörergebnisse erzielt werden können, auch wenn nicht alle Patienten ein gutes Sprachverstehen erreichten. Dabei kann die Cochleaimplantation einzeitig mit der Operation [3,45,50,57] oder zweizeitig [3,4,17,22,42] erfolgen.…”

Section: Einführungunclassified

Management transmodiolärer und transmakulärer Vestibularis- und Cochlearisschwannome mit und ohne Cochleaimplantation

Plontke

Cayé‐Thomasen

Strauß

et al. 2020

HNO

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Zusammenfassung Einführung Die Hörrehabilitation mittels Cochleaimplantat (CI) ist auch für Patienten mit cochleovestibulären Schwannomen von zunehmendem Interesse. Berichtet wird über Erfahrungen bezüglich des chirurgischen Managements von Tumoren mit einer seltenen transmodiolären oder transmakulären Ausdehnung und über die Ergebnisse bei Hörrehabilitation mit CI. Methode In die retrospektive Fallserie wurden 9 Patienten mit primären intralabyrinthären Schwannomen oder mit sekundärer Invasion des Tumors vom inneren Gehörgang in das Innenohr eingeschlossen. Primärer Zielparameter bei CI-Patienten war das Sprachverstehen bei 65 dB SPL („sound pressure level“), sekundäre Zielparameter waren intra- und postoperative elektrophysiologische Parameter: elektrisch ausgelöste Summenaktionspotenziale eCAP, Impedanzmessungen, das Vorhandensein einer Welle V in den elektrisch (über das CI) evozierten Hirnstammpotenzialen (eBERA), Besonderheiten bei der postoperativen CI-Programmierung und unerwünschte Ereignisse. Ergebnisse Alle 6 implantierten Patienten erreichten ein gutes Sprachverstehen für Zahlwörter in Ruhe (80–100 % bei 65 dB SPL, spätestens 12 Monate nach Erstanpassung). Im Zeitraum von einem bis 36 Monaten erreichten 4 der 6 Patienten mit CI gute bis sehr gute Ergebnisse im Freiburger Einsilbertest in Ruhe (65–85 % bei 65 dB SPL), 2 erreichten 6 Monate nach Erstanpassung nur geringe Werte (25 und 15 % bei 65 dB SPL) mit im weiteren Verlauf abnehmendem Zahlen- und Einsilberverstehen. Schlussfolgerungen Cochleovestibuläre Schwannome mit transmodiolärer und transmakulärer Ausdehnung stellen eine sehr seltene und bezüglich des Managements besondere Entität dar. Das therapeutische Vorgehen erfordert eine differenzierte Abwägung. Auch bei diesen Tumoren stellt die Cochleaimplantation prinzipiell eine Option zur Hörrehabilitation dar.

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Functional Outcome After Simultaneous Vestibular Schwannoma Resection and Cochlear Implantation With Intraoperative Cochlear Nerve Monitoring

Gadenstaetter

Auinger

Gerlitz

et al. 2023

Otolaryngol.--head neck surg.

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Objective. Electrically evoked auditory brainstem response audiometry has emerged as a suitable option to intraoperatively assess cochlear nerve function during vestibular schwannoma resection. This study aimed to analyze the functional outcome and implant usage of patients with preserved auditory nerve responses after simultaneous translabyrinthine schwannoma resection and cochlear implantation.Study Design. Prospective study. Setting. Tertiary referral center.Methods. Patients with unilateral sporadic vestibular schwannoma underwent translabyrinthine tumor resection. Intraoperatively, electrically evoked auditory brainstem response audiometry was performed before and after tumor removal. Cochlear implantation was carried out if positive responses were detected after tumor removal indicating cochlear nerve function. Postoperatively, patients were biannually followed-up to assess aided sound field audiometry and word recognition as well as implant usage.Results. Overall, 26 patients with vestibular schwannoma underwent translabyrinthine schwannoma resection. Out of these patients, 15 had positive cochlear nerve responses after tumor removal and concurrently received a cochlear implant. In 13 patients with histologically confirmed vestibular schwannoma, hearing improved by 23.7 ± 33.2 decibels and word recognition by 25.0 ± 42.4% over a mean follow-up period of 18 months. Overall, 12 included patients were regular cochlear implant users. Conclusion.Patients with vestibular schwannoma can benefit substantially from cochlear implantation. Intraoperative assessment of cochlear nerve function using electrically evoked auditory brainstem response audiometry can help to better identify individuals eligible for simultaneous vestibular schwannoma resection and cochlear implantation.

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Sporadic and NF2-associated vestibular schwannoma surgery and simultaneous cochlear implantation: a comparative systematic review

Cited by 25 publications

References 43 publications

Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation

Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation

Management transmodiolärer und transmakulärer Vestibularis- und Cochlearisschwannome mit und ohne Cochleaimplantation

Functional Outcome After Simultaneous Vestibular Schwannoma Resection and Cochlear Implantation With Intraoperative Cochlear Nerve Monitoring

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