Intraoperative Cochlear Nerve Monitoring in Vestibular Schwannoma Microsurgery

Kevin Y Zhan; Cameron C Wick

doi:10.1016/j.otc.2023.02.007

Intraoperative Cochlear Nerve Monitoring in Vestibular Schwannoma Microsurgery

Otolaryngol Clin North Am. 2023 Jun;56(3):471-482. doi: 10.1016/j.otc.2023.02.007. Epub 2023 Mar 22.

Authors

Kevin Y Zhan¹, Cameron C Wick²

Affiliations

¹ Department of Otolaryngology-Head & Neck Surgery, Washington University, St Louis, MO, USA.
² Department of Otolaryngology-Head & Neck Surgery, Washington University, St Louis, MO, USA. Electronic address: cameron.wick@wustl.edu.

PMID: 36964094
DOI: 10.1016/j.otc.2023.02.007

Abstract

Monitoring the cochlear nerve during vestibular schwannoma (VS) microsurgery depends on the hearing status and surgical approach. Traditional hearing preservation VS microsurgery relies on acoustically driven auditory brainstem response (ABR) and cochlear nerve action potential. Both modalities have advantages and disadvantages that need to be understood for proper implementation. When hearing is lost or the approach violates the otic capsule, electrically evoked monitoring methods may be used. Evoked ABR (eABR) is feasible and safe but may be limited by artifact. Combining eABR with near-field measures such as electrocochleography or neural telemetry shows promise.

Keywords: Auditory brainstem response; Cochlear nerve action potential; Electrocochleography.

Publication types

Review

MeSH terms

Cochlea / surgery
Cochlear Nerve
Evoked Potentials, Auditory, Brain Stem / physiology
Hearing
Humans
Microsurgery / methods
Neuroma, Acoustic* / surgery