Ipsilateral cochlear implantation in cases with vestibular schwannoma

Background

Vestibular schwannomas (VS) are the most common tumors in the cerebellopontine angle, which can lead to hearing loss, particularly following tumor resection. For patients with bilateral VS associated with neurofibromatosis type 2 (NF2), hearing loss significantly undermines their quality of life.

Objective

This study aims to evaluate the outcomes of ipsilateral cochlear implantation (CI) in patients with VS.

Method

We assessed six patients with VS, three of whom were diagnosed with NF2. Four patients underwent VS resection combined with simultaneous ipsilateral CI. Two patients received CI without tumor removal. Electrically evoked auditory brainstem response (eABR) testing was employed to assess the functionality of the cochlear nerve during the resection procedure.

Results

Simultaneous ipsilateral CI following VS resection was performed in four patients who underwent tumor removal, and cochlear nerve function was identified using eABR testing. Two patients without tumor resection also had implantations. The average impedance of the test electrodes was within the normal range and neural telemetry responses were detected in all patients. One patient opted out of using the cochlear due to normal hearing in the contralateral ear and found the implant unbeneficial. The remaining five patients experienced improvements in hearing, albeit to varying degrees.

Conclusion

Simultaneous ipsilateral CI after VS resection is an effective approach for auditory rehabilitation. For NF2 patients with small, stable tumors, CI without tumor removal can also be considered a viable option. This study highlights the potential of CI in hearing rehabilitation for patients with VS, particularly those with NF2.