Cochlear implant in vestibular schwannomas: long-term outcomes and critical analysis of indications.

Abstract

PURPOSE:

To describe our institutional experience in cochlear implantation after vestibular schwannoma (VS) resection, and compare the audiological outcomes between sporadic and neurofibromatosis type 2 (NF2) VS sub-cohorts of patients, and in relation to preoperative contralateral hearing.

METHODS:

Seventeen patients (8 sporadic and 9 NF2-associated VSs) who had undergone VS resection and cochlear implant (CI) were analyzed retrospectively. Audiological outcomes at 24 months were correlated with preoperative clinical variables. The results according to VS type (sporadic vs. NF2-associated) and contralateral hearing (impaired vs. normal) were compared.

RESULTS:

Fourteen CIs were actively used by the patients (77.8%). Twenty-four months after CI activation, the median postoperative PTA (pure tone average) was 45.6 dB nHL and a measurable WRS (Word Recognition Score) was achieved by 44.4% of patients (median WRS = 40%). The median postoperative PTA in the implanted ear resulted better in the group with an impaired contralateral hearing (36.3 dB nHL vs. 78.8 dB nHL, p = 0.019). Good preoperative contralateral hearing status (A-B classes of AAO-HNS) was a negative prognostic factor for CI performance on open-set discrimination (OR = 28.0, 95% CI 2.07-379.25, p = 0.012).

CONCLUSIONS:

CI is a viable rehabilitative option for patients with sporadic or NF2-associated VS. A good contralateral hearing adversely affects CI outcome and should be taken into consideration for patients' selection and rehabilitation programs.

• Authors: Flavia Sorrentino, Giulia Tealdo, Diego Cazzador, Niccolò Favaretto, Davide Brotto, Silvia Montino, Ezio Caserta, Roberto Bovo, Luca Denaro, Valentina Baro, Domenico D'Avella, Alessandro Martini, Antonio Mazzoni, Gino Marioni, Elisabetta Zanoletti
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 279 Issue 10 Pg. 4709-4718 (Oct 2022) ISSN: 1434-4726 [Electronic] Germany
• PMID: 35018505 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Topics

• Cochlear Implantation (methods)
• Cochlear Implants
• Hearing Loss (surgery)
• Humans
• Neurofibromatosis 2 (surgery)
• Neuroma, Acoustic (surgery)
• Retrospective Studies
• Treatment Outcome