Early Outcomes of Simultaneous Translabyrinthine Resection and Cochlear Implantation

Laryngoscope. 2021 Jul;131(7):E2312-E2317. doi: 10.1002/lary.29436. Epub 2021 Apr 14.

Abstract

Objectives/hypothesis: Hearing rehabilitation after translabyrinthine resection of a vestibular schwannoma (VS) has largely been based on the transfer of acoustic stimulus to the contralateral ear, typically through a contralateral routing of signal hearing aid or bone-anchored hearing aid (BAHA). Cochlear implant, either as a subsequent surgery or simultaneously, has become a more common treatment option; however, there is still relatively limited data available on its success. The purpose of this study is to evaluate the early outcomes of simultaneous cochlear implantation in patients with sporadic VS undergoing translabyrinthine resection.

Study design: Prospective, nonrandomized study.

Methods: A prospective study of nonrandomized patients was completed at a tertiary care neurotology center. Audiologic outcomes, primarily based on AzBIO in quiet and background noise, as well as consonant-nucleus-consonant (CNC) testing of the affected ears were utilized. Tinnitus, dizziness, and spatial hearing questionnaries were also completed. Audiologic outcomes and questionnaires were compared between the pre- and postoperative groups.

Results: Ten patients were included in the study with 3 month follow-up data. There was statistically significant improvement in AzBO with +10 and +5 signal to noise ratio and in quiet, as well as in CNC testing (P < .05). There was a significant improvement in Tinnitus Handicap Inventory between the two groups.

Conclusions: Simultaneous cochlear implantation is a viable treatment for hearing loss after translabyrinthine approach to VS. These patients have improved hearing in background noise and tinnitus compared to their preoperative state. Further prognostic data are required to determine which patients are the best candidates.

Level of evidence: 4 Laryngoscope, 131:E2312-E2317, 2021.

Keywords: Cochlear implant; translabyrinthine approach; vestibular schwannoma.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Cochlear Implantation / instrumentation
  • Cochlear Implantation / methods*
  • Cochlear Implants*
  • Female
  • Follow-Up Studies
  • Hearing Loss / diagnosis
  • Hearing Loss / etiology
  • Hearing Loss / surgery*
  • Hearing Tests
  • Humans
  • Male
  • Middle Aged
  • Neuroma, Acoustic / complications
  • Neuroma, Acoustic / rehabilitation
  • Neuroma, Acoustic / surgery*
  • Prospective Studies
  • Treatment Outcome
  • Vestibule, Labyrinth / surgery