Simultaneous Cochlear Implantation After Translabyrinthine Vestibular Schwannoma Resection: A Report of 41 Cases.

OBJECTIVE

To study the auditory outcome of simultaneous translabyrinthine vestibular schwannoma (VS) resection and cochlear implantation (CI) after successful cochlear nerve preservation.

STUDY

DESIGN

A retrospective case series and patient questionnaire.

SETTING

Quaternary referral center for skull base pathologies.

PATIENTS: Patients with small (<2 cm) sporadic or neurofibromatosis 2 related tumors were included in this study.

INTERVENTION: Vestibular schwannoma resection + simultaneous cochlear implantation.

MAIN OUTCOME MEASURE: Audiological performance postimplantation and perceived patients' benefits.

RESULTS

Forty-one patients were included. Thirty-three were sporadic VS and eight were neurofibromatosis 2. Auditory perception postimplantation was achieved in 33 patients (80.5%). At the last follow-up, 20 patients (48.8%) were users and 21 (51.2%) were nonusers. In the users' group, and after 1 year of implant activation, vowel identification was 75.3%, disyllabic word recognition 54%, sentence recognition 60.7%, and common phrase comprehension 61%, whereas in the nonusers' group and after 1 year of implant activation, vowel identification was 22.9%, disyllabic word recognition 14.8%, sentence recognition 15.3%, and common phrase comprehension 14%. Sixteen users were classified into 10 high performers, three intermediate performers, and three poor performers. In the user' group, the mean postimplantation pure tone average was 63.4 dB and the mean speech discrimination score was 63.7%.

CONCLUSIONS

Simultaneous CI and VS resection is a viable option with many patients achieving auditory perception and nearly half the patients are CI users at long follow-up.