Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Otology/Neurotology

Session: Scientific Oral Presentations 1 - Otology/Neurotology

Cochlear Implantation After Microsurgery for Vestibular Schwannoma: A Systematic Review on Hearing Improvement

Saturday, September 28, 2024
10:06 AM – 10:12 AM EDT
Location: MBCC, 231
Disclosure(s):
Alberto Nunez:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mia E. Miller, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kurtis C. Young, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: In patients with vestibular schwannoma (VS) that underwent microsurgery and cochlear implantation, were improvements in hearing function observed, and what was the cochlear implant (CI) failure rate of in these patients?

Methods: The study searched databases without publication year limits using terms like "acoustic neuroma," "schwannoma," or "microsurgery," with Boolean operators. Patients with VS who underwent microsurgery and CI were included. Three independent reviewers assessed bias, resolved by the primary author. The study was conducted in February 2023, including 10 articles from 2012-2023 after screening. The diseased studied was on VS, a mostly sporadic, single, and unilateral benign neoplasm originating from Schwann cells of cranial nerve VII. This study involved 35 patients (15 females, 20 males), 22 patients with neurofibromatosis type 2 (NF2), and 13 with spontaneous VS. Patients with VS who underwent microsurgery followed by CI were studied before and after CI to assess changes in hearing using various audiological and word sentence testing measures. The study observed positive changes in every test conducted after CI, with a majority of patients (88.6%) who underwent CI placement achieving either open-set speech (OSP) or environmental sound awareness (ESA).

Results: OSP was reported in 24 (68.57%) patients, and 7 patients (20%) achieved ESA after CI. There were 4 instances of CI failures (11.4%), attributed to 1) tumor recurrence in three cases (75%) and 2) failure occurring after initial success until the patient reported no longer receiving benefit in one case (25%).

Conclusions: Positive changes in hearing were observed in all samples undergoing audiometric testing at baseline and follow-up assessments, with (68.8%) achieving OSP or ESA (20%) post CI. However, 11.4% experienced CI failures, mostly due to progressive tumor growth (75%). This study suggests that proactive use of CIs after VS resection could lead to optimal hearing outcomes and assist physicians in developing a treatment plan for patients with hearing loss secondary to VS that may differ from conventional approaches.

    Presenting Author(s)

  • Alberto Nunez

    Presenter
    851 N Verde Ave
    Rialto, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Mia E. Miller, MD

    Director of Neurotology of the Acoustic Neuroma Center
    Cedars Sinai
    Encino, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • QB

    Quinton Blount, MD

    Resident
    Mercer University School of Medicine
    Albuquerque, NM, United States

    Disclosure information not submitted.

  • KY

    Kurtis C. Young, MD

    Resident
    University of Nevada, Las Vegas
    Foster City, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • TN

    Torbjoern Nielsen, BS

    Medical Student
    John A. Burns School of Medicine, United States

    Disclosure information not submitted.