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Cochlear implantation for hearing rehabilitation in single-sided deafness after translabyrinthine vestibular schwannoma surgery

  • Otology
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Abstract

The aim of the study was to investigate the option of cochlear implantation (CI) in resultant single-sided deafness associated with unilateral translabyrinthine resection of sporadic vestibular schwannoma (VS). This is a retrospective study performed at Tertiary Care Academic Centre. Following extensive counselling regarding the potential for delayed CI, translabyrinthine VS resection was performed and an intracochlear placeholder was inserted to allow later CI in 11 patients who showed intraoperative microscopic confirmation of preserved cochlear nerve anatomy. Follow-up magnetic resonance imaging (MRI) and promontory testing were performed 1 year after surgery to confirm the absence of VS recurrence and viable cochlea. Confirmed CI candidates underwent a second procedure where the placeholder was removed and the CI inserted (4/11). Preimplant unaided and CI-aided evaluations at 12 and 24 months were performed for subjective and objective hearing outcomes. Tinnitus suppression was also measured for implant on and off effects. Available audiological data for three patients demonstrated significant hearing benefits for ‘speech from deaf/implanted side, noise from the normal-hearing side’ in all three patients and localisation ability improved for 2/3 patients. Subjective findings presented similar results. For the two patients with preimplant tinnitus, complete suppression occurred during active CI. CI is beneficial for hearing rehabilitation and tinnitus reduction in SSD patients with remaining viable cochlear nerve after translabyrinthine VS surgery. Counselling on the risks of intracochlear placeholder insertion and the inherent limitations for ongoing MRI investigations of VS recurrence is essential.

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Acknowledgments

The authors are grateful to the association ‘Taube Kinder lernen Hören e.V.’, which considerably supports the CI rehabilitation centre and the hearing research on cochlear implant listeners in Freiburg. We also thank Josie Wyss (Cochlear Europe Ltd) and Dianne Mecklenburg (consultant with Cochlear Europe Ltd) for constructive comments on an early draft of this paper.

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Freiburg, Killianstrasse 5, 79106, Freiburg, Germany

    Frederike Hassepass, Susan Arndt, Antje Aschendorff, Roland Laszig & Thomas Wesarg

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  1. Frederike Hassepass
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  2. Susan Arndt
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  3. Antje Aschendorff
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  4. Roland Laszig
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Correspondence to Frederike Hassepass.

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Hassepass, F., Arndt, S., Aschendorff, A. et al. Cochlear implantation for hearing rehabilitation in single-sided deafness after translabyrinthine vestibular schwannoma surgery. Eur Arch Otorhinolaryngol 273, 2373–2383 (2016). https://doi.org/10.1007/s00405-015-3801-8

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  • DOI: https://doi.org/10.1007/s00405-015-3801-8

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