Simultaneous procedures advantageous over two-stage surgeries in vestibular schwannoma resection: Study
USA: Simultaneous schwannoma removal and cochlear implantation for long-term hearing restoration in vestibular schwannoma resection has a clear advantage over two-stage surgeries, says a recent study. The simultaneous procedures bypassed the risk of postoperative cochlear ossification and additionally avoided second surgery under general anesthesia.
The findings of the study will be presented at the the AAO-HNSF 2022 Annual Meeting & OTO Experience held from September 10-14 in Philadelphia, Pennsylvania.
For long-term hearing restoration in vestibular schwannoma resection, simultaneous cochlear implantation seems a viable option. Christoph Arnoldner, and colleagues conducted the study with the objective to assess the number of patients eligible for simultaneous schwannoma removal and cochlear implantation as well as to examine the long-term acceptance and usage of the cochlear implant (CI).
The researchers included 22 patients with sporadic vestibular schwannoma and functional deafness undergoing translabyrinthine schwannoma resection. Measurements of electric auditory brainstem response (eABR) were performed intraoperatively using an intracochlear test-electrode before, during and after tumor removal to investigate the functional integrity of the cochlear nerve and thus, to assess cochlear implantation visibility.
Cochlear implantation was subsequently performed, if viable, and obtained postoperative long-term follow-up (3-4 years) on hearing rehabilitation and usage status.
Key findings of the study were as follows:
- Complete tumor removal was achieved in all 22 patients included in this study.
- A total of twelve patients had positive eABR responses after tumor removal and consequently received a CI.
- In the long-term follow-up, eleven of these patients qualified as regular CI-users indicating a high rate of acceptance of the implant.
"Simultaneous procedures have a clear advantage over two-stage surgeries by the means of bypassing the postoperative cochlear ossification risk as well as avoiding a second surgery under general anesthesia," the researchers wrote.
"Eligible patients, however, must be carefully selected by thorough intraoperative assessment of the cochlear nerve function and must be tightly evaluated and cared for after cochlear implantation," they concluded.
Reference:
The study titled, "Simultaneous Translabyrinthine Vestibular Schwannoma Resection and Cochlear Implantation – Long-term Follow-up," will be presented at the AAO-HNSF 2022 Annual Meeting & OTO Experience, September 10-14.
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