TY - JOUR

T1 - Sporadic and NF2-associated vestibular schwannoma surgery and simultaneous cochlear implantation

T2 - a comparative systematic review

AU - West, Niels

AU - Sass, Hjalte

AU - Cayé-Thomasen, Per

PY - 2020

Y1 - 2020

N2 - Purpose: Cochlear implantation (CI) in patients with sensorineural hearing loss caused by a vestibular schwannoma (VS) represents a unique subtype of hearing rehabilitation, as the outcome may be compromised by vestibulocochlear nerve injury as part of the natural VS history or due to iatrogenic trauma induced by surgical tumor removal. This paper aims to review and report contemporary knowledge and practice regarding feasibility and outcomes of simultaneous vestibular schwannoma resection and cochlear implantation to serve as a reference and guide for future surgery and studies. Methods: The current literature was searched systematically according to the PRISMA guidelines and after criteria-based selection, 29 studies were identified, including a total of 86 patients who had undergone surgical resection of a vestibular schwannoma and subsequent cochlear implantation in a single procedure. Results: The postoperative outcomes were reported with a high degree of heterogeneity, hindering a proper meta-analysis. However, pooling those cases with reported speech discrimination outcomes demonstrated mean scores equivalent to moderate-to-high performance. A few cases had no audibility. A positive cochlear nerve test result was not a secure positive predictor of success. Complications were rare. Conclusion: NF2-associated and sporadic VS had good and comparable postoperative outcomes despite significant differences in tumor size, location and surgical approach.

AB - Purpose: Cochlear implantation (CI) in patients with sensorineural hearing loss caused by a vestibular schwannoma (VS) represents a unique subtype of hearing rehabilitation, as the outcome may be compromised by vestibulocochlear nerve injury as part of the natural VS history or due to iatrogenic trauma induced by surgical tumor removal. This paper aims to review and report contemporary knowledge and practice regarding feasibility and outcomes of simultaneous vestibular schwannoma resection and cochlear implantation to serve as a reference and guide for future surgery and studies. Methods: The current literature was searched systematically according to the PRISMA guidelines and after criteria-based selection, 29 studies were identified, including a total of 86 patients who had undergone surgical resection of a vestibular schwannoma and subsequent cochlear implantation in a single procedure. Results: The postoperative outcomes were reported with a high degree of heterogeneity, hindering a proper meta-analysis. However, pooling those cases with reported speech discrimination outcomes demonstrated mean scores equivalent to moderate-to-high performance. A few cases had no audibility. A positive cochlear nerve test result was not a secure positive predictor of success. Complications were rare. Conclusion: NF2-associated and sporadic VS had good and comparable postoperative outcomes despite significant differences in tumor size, location and surgical approach.

KW - Acoustic neuroma

KW - Cochlear implant

KW - Hearing loss

KW - Hearing rehabilitation

KW - Neurofibromatosis type 2

KW - Treatment

U2 - 10.1007/s00405-019-05741-w

DO - 10.1007/s00405-019-05741-w

M3 - Review

C2 - 31802225

AN - SCOPUS:85076098809

VL - 277

SP - 333

EP - 342

JO - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde

JF - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde

SN - 0942-8992

IS - 2

ER -