Translabyrinthine vestibular schwannoma resection with simultaneous cochlear implantation

Cochlear Implants Int. 2017 Sep;18(5):278-284. doi: 10.1080/14670100.2017.1337665. Epub 2017 Jun 12.

Abstract

Objectives: (1) Report a rare case of translabyrinthine resection of a sporadic vestibular schwannoma (VS) and concurrent cochlear implantation (CI). (2) Discuss pre-, intra-, and post-operative considerations in this unique patient population. (3) Describe surgical and audiologic outcomes reported in this population.

Methods: Case report and review of the literature. PubMed search 'Cochlear Implantation'[Mesh] AND ('Neuroma, Acoustic'[Mesh] OR 'VESTIBULAR SCHWANNOMA'[All Fields] OR 'SCHWANNOMA'[All Fields]) limited to humans and English language. Returned 64 search results, abstracts and references of relevant papers reviewed.

Results: A 75-year-old male with longstanding history of slowly progressive severe hearing loss and tinnitus presented for evaluation of worsening imbalance, vertigo, and nausea. Workup revealed a 7 mm right intracanalicular mass on MRI concerning for vestibular schwannoma. Audiogram showed bilateral, symmetric, severe-to-profound sensorineural hearing loss, with poor open-set speech comprehension while bilaterally aided. He underwent successful concurrent right translabyrinthine resection of his VS with complete preservation of the cochlear nerve and uncomplicated cochlear implantation.

Discussion: Literature review revealed few previous reports of simultaneous VS and CI. The vast majority of these were in patients with neurofibromatosis Type 2 in whom auditory outcomes were poor. This patient represents one of the few cases of concurrent translabyrinthine tumor removal and CI for a spontaneous VS.

Conclusion: Single-stage cochlear implantation and translabyrinthine tumor resection is a feasible and safe option to consider for auditory rehabilitation in rare situations.

Keywords: Cochlear implant; Hearing Restoration; Simultaneous implantation; Translabyrinthine; Vestibular schwannoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Cochlear Implantation / methods*
  • Combined Modality Therapy
  • Ear Neoplasms / complications
  • Ear Neoplasms / surgery*
  • Hearing Loss / complications
  • Hearing Loss / surgery*
  • Humans
  • Male
  • Nausea / etiology
  • Neuroma, Acoustic / complications
  • Neuroma, Acoustic / surgery*
  • Postural Balance
  • Tinnitus / etiology
  • Vertigo / etiology
  • Vestibule, Labyrinth / surgery*