在小听神经瘤中同时进行人工耳蜗植入和早期内窥镜手术。

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2024-08-21 DOI:10.1002/lio2.1319

Seong Hoon Bae MD, PhD, Ludovica Battilocchi MD, Nam Yunbin MD, Gerard Lapina MD, Ji Min Yun MD, In Seok Moon MD, PhD

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引用次数: 0

摘要

手术目的最近开发出了用于切除迷宫（迷宫内听神经瘤 [ILS]）或内耳道（IAC）内小尺寸听神经瘤的独家内窥镜经口转舌法（EETTA）。尽管符合 EETTA 适应症的小肿瘤也是人工耳蜗植入术（CI）的良好候选者，但关于使用 EETTA 切除分裂瘤后进行人工耳蜗植入术的报道却很少。在此，我们介绍了同时接受 EETTA 和 CI 的患者的治疗结果：我们回顾性地纳入了在 2020 年至 2022 年期间同时接受 EETTA 和 CI 手术的五名患者（两名患有 IAC 眼底肿瘤，三名患有 ILS）。结果：经过至少12个月的随访，没有出现脑膜炎、感染或皮肤坏死等严重手术并发症。五名患者中有四名对听觉刺激有反应。四名对听觉有反应的患者中有三人的句子识别率大于 80%：结论：同时使用 EETTA 和 CI 治疗 ILS 和 IAC 眼底肿瘤是可行的。保留耳蜗神经和耳模对获得良好的 CI 效果非常重要。因此，对于听力无法恢复的 ILS 和 IAC 眼底肿瘤患者，应尽早进行手术切除，以便通过 CI 进行适当的听力康复：证据等级：4 级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Simultaneous cochlear implantation with early endoscopic surgery in small acoustic neuroma

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Simultaneous cochlear implantation with early endoscopic surgery in small acoustic neuroma

Objectives

The exclusive endoscopic transcanal transpromontorial approach (EETTA) has recently been developed for the removal of small-sized acoustic neuromas in the labyrinth (intralabyrinthine schwannoma [ILS]) or internal auditory canal (IAC). Although small tumors that meet the indications for EETTA are also good candidates for cochlear implantation (CI), there are few reports on CI after schwannoma removal using EETTA. Here we present an outcome of patients who underwent simultaneous EETTA and CI.

Methods

Five patients (two with IAC fundus tumors and three with ILS) who underwent simultaneous EETTA and CI between 2020 and 2022 were retrospectively enrolled. Their medical charts and test results were reviewed.

Results

After at least 12 months of follow-up, there were no severe surgical complications such as meningitis, infection, or skin necrosis. Four of the five patients responded to auditory stimulation. Three out of four auditory-responsive patients scored >80% on sentence recognition.

Conclusion

Simultaneous EETTA and CI are feasible for the treatment of ILS and IAC fundus tumors. Preservation of the cochlear nerve and modiolus is important for favorable CI outcomes. Therefore, ILS and IAC fundus tumors in patients with nonserviceable hearing should be surgically removed as early as possible to enable proper hearing rehabilitation with CI.