Cochlear Implantation in a Patient with Neurofibromatosis Type 2 and an Intracochlear Schwannoma: A Case Report and Literature Review

ORL J Otorhinolaryngol Relat Spec. 2022;84(5):425-428. doi: 10.1159/000522473. Epub 2022 May 10.

Abstract

A primary intracochlear schwannoma (ICS) is a unique type of vestibular schwannoma (VS); the tumor originates from the terminal branches of the cochlear nerve and is confined to the cochlea. An ICS is the most common subtype of schwannoma in the inner ear. As an ICS is clinically rare, diagnosis and treatment remain challenging. We report a rare case of cochlear implantation (CI) in a patient with neurofibromatosis type 2 and an ICS. The patient exhibited bilateral, profound, sensorineural hearing loss. The tumor on one side was a common VS treated via tumor and acoustic nerve resection and that on the other side an ICS. To ensure auditory rehabilitation via CI, we performed CI while removing part of the ICS via an enlarged round window. Auditory rehabilitation was satisfactory. Thus, ICS patients, especially those who urgently require auditory rehabilitation, can undergo simultaneous CI and (total or partial) tumor removal. However, the long-term results require close observation.

Keywords: Cochlear implantation; Intracochlear schwannoma; Intralabyrinthine schwannoma; Neurofibromatosis type 2; Vestibular schwannoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cochlear Implantation* / methods
  • Cochlear Nerve / surgery
  • Hearing Loss, Sensorineural* / etiology
  • Hearing Loss, Sensorineural* / surgery
  • Humans
  • Neurilemmoma* / complications
  • Neurilemmoma* / surgery
  • Neurofibromatosis 2* / complications
  • Neurofibromatosis 2* / diagnosis
  • Neurofibromatosis 2* / surgery
  • Neuroma, Acoustic* / complications
  • Neuroma, Acoustic* / surgery