Vestibularisschwannom: Faktoren bei der Therapieentscheidung

Zusammenfassung

Die Behandlung von Vestibularisschwannomen (VS) stellt Ärzte von jeher vor eine Herausforderung. Zur Verfügung stehen 3 wesentliche Behandlungsprinzipien: wait and scan, Operation und stereotaktische Radiochirurgie. Neben der Art der Behandlung ist auch über den richtigen Therapiezeitpunkt, die Kombination verschiedener Behandlungsmodalitäten, den etwaigen chirurgischen Zugang oder die Art und Intensität der Bestrahlung zu entscheiden. Einfluss auf die Therapieentscheidung haben u.a. Tumorlokalisation und -größe bzw. -stadium, das Patientenalter, Komorbiditäten, die Symptomatik, die Möglichkeiten der postoperativen Hörrehabilitation, der Wunsch des Patienten und nicht zuletzt die Erfahrung der Operateure und die personellen und technischen Möglichkeiten des klinischen Standorts.

Dieser Artikel gibt zunächst eine kurze Übersicht über VS, stellt danach die grundsätzlichen interdisziplinären Behandlungsoptionen dar und diskutiert zum Schluss die HNO-relevanten Faktoren bei der Therapieentscheidung.

Abstract

The treatment of vestibular schwannomas (VS) has always posed a challenge for physicians. Three essential treatment principles are available: wait-and-scan, surgery, and stereotactic radiotherapy. In addition to the type of treatment, decisions must be made regarding the optimal timing of therapy, the combination of different treatment modalities, the potential surgical approach, and the type and intensity of radiation. Factors influencing the therapy decision include tumor location and size or stage, patient age, comorbidities, symptoms, postoperative hearing rehabilitation options, patient preferences, and, not least, the experience of the surgeons and the personnel and technical capabilities of the clinical site. This article begins with a brief overview of vestibular schwannomas, then outlines the fundamental interdisciplinary treatment options, and finally discusses the ENT (ear, nose, and throat)-relevant factors in the therapy decision.

Schlüsselwörter

Vestibularisschwannom - Akustikusneurinom - Radiochirurgie - GammaKnife - CyberKnife - Stereotaxie - Middle fossa approach - transtemporaler Zugang - subtemporaler Zugang - translabyrinthär - Vestibular schwannoma - Acoustic neuroma - Radio surgery - functional neurosurgery - middle fossa approach - subtemporal approach

Publication History

Received: 14 July 2023

Accepted after revision: 08 November 2023

Article published online:
21 December 2023

• Literatur

• 1 Ostrom QT, Gittleman H, Liao P. et al. CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010–2014. Neuro Oncol 2017; 19: v1-v88
• 2 Khrais T, Romano G, Sanna M. Nerve origin of vestibular schwannoma: a prospective study. J Laryngol Otol 2008; 122: 128-131
• 3 Roosli C, LinthicumCureoglu S. et al. What Is the Site of Origin of Cochleovestibular Schwannomas?. Audiol Neurootol 2012; 17: 121-125
• 4 Evans DGR, Moran A, King A. et al. Incidence of vestibular schwannoma and neurofibromatosis 2 in the North West of England over a 10-year period: higher incidence than previously thought. Otol Neurotol 2005; 26: 93-97
• 5 Singh K, Singh MP, Thukral C. et al. Role of magnetic resonance imaging in evaluation of cerebellopontine angle schwannomas. Indian J Otolaryngol Head Neck Surg 2015; 67: 21-27
• 6 Greenberg MS. Handbook of Neurosurgery. 9th Aufl.. 2019
• 7 Agnihotri S, Jalali S, Wilson MR. et al. The genomic landscape of schwannoma. Nat Genet 2016; 48: 1339-1348
• 8 Withrow DR, Devesa SS, Deapen D. et al. Nonmalignant meningioma and vestibular schwannoma incidence trends in the United States, 2004–2017. Cancer 2021; 127: 3579-3590
• 9 Stangerup S-E, Caye-Thomasen P. Epidemiology and natural history of vestibular schwannomas. Otolaryngol Clin North Am 2012; 45: 257-268
• 10 Marinelli JP, Beeler CJ, Carlson ML. et al. Global Incidence of Sporadic Vestibular Schwannoma: A Systematic Review. Otolaryngol Head Neck Surg 2022; 167: 209-214
• 11 Schoemaker MJ, Swerdlow AJ, Auvinen A. et al. Medical history, cigarette smoking and risk of acoustic neuroma: an international case-control study. Int J Cancer 2007; 120: 103-110
• 12 Shilo S, Hannaux O, Gilboa D. et al. Could the Audiometric Criteria for Sudden Sensorineural Hearing Loss Miss Vestibular Schwannomas?. Laryngoscope 2023; 133: 670-675
• 13 Andersen JF, Nilsen KS, Vassbotn FS. et al. Predictors of vertigo in patients with untreated vestibular schwannoma. Otol Neurotol 2015; 36: 647-652
• 14 Goldbrunner R, Weller M, Regis J. et al. EANO guideline on the diagnosis and treatment of vestibular schwannoma. Neuro-Oncology 2020; 22: 31-45
• 15 Strasilla C, Sychra V. Bildgebende Diagnostik des Vestibularisschwannoms. HNO 2017; 65: 373-380
• 16 Truong L-UF, Kleiber JC, Durot C. et al. The study of predictive factors for the evolution of vestibular schwannomas. Eur Arch Otorhinolaryngol 2023; 280: 1661-1670
• 17 Koos WT, Day JD, Matula C. et al. Neurotopographic considerations in the microsurgical treatment of small acoustic neurinomas. Journal of Neurosurgery 1998; 88: 506-512
• 18 Harati A, Oni P, Schultheiß R. et al. Management von Patienten mit Vestibularisschwannomen Typ IV. Laryngorhinootologie 2020; 99: 613-619
• 19 Rahne T, Plontke SK, Vordermark D. et al. Hörklassen bei Patienten mit Vestibularisschwannom bei Verwendung deutschsprachiger Testverfahren. HNO 2021; 69: 750-758
• 20 Iannacone FP, Visconti F, Zanoletti E. How Cochlear Implant Rehabilitation Impacts the Therapeutic Strategy for Vestibular Schwannoma. Audiology Research 2023; 13: 116-129
• 21 Schwartz MS, Otto SR, Shannon RV. et al. Auditory brainstem implants. Neurotherapeutics 2008; 5: 128-136
• 22 Plotkin SR, Stemmer-Rachamimov AO, Barker FG. et al. Hearing Improvement after Bevacizumab in Patients with Neurofibromatosis Type 2. New England Journal of Medicine 2009; 361: 358-367
• 23 Germano IM, Sheehan J, Parish J. et al. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Role of Radiosurgery and Radiation Therapy in the Management of Patients With Vestibular Schwannomas. Neurosurgery 2018; 82: E49-E51
• 24 Hillman TA, Chen DA, Quigley M. et al. Acoustic tumor observation and failure to follow-up. Otolaryngol Head Neck Surg 2010; 142: 400-404
• 25 Robinett ZN, Walz PC, Miles-Markley B. et al. Comparison of Long-term Quality-of-Life Outcomes in Vestibular Schwannoma Patients. Otolaryngol Head Neck Surg 2014; 150: 1024-1032
• 26 Carlson ML, Tveiten OV, Driscoll CL. et al. Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls. J Neurosurg 2015; 122: 833-842
• 27 Lin EP, Crane BT. The Management and Imaging of Vestibular Schwannomas. AJNR Am J Neuroradiol 2017; 38: 2034-2043
• 28 Dunn IF, Bi WL, Mukundan S. et al. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Role of Imaging in the Diagnosis and Management of Patients With Vestibular Schwannomas. Neurosurgery 2018; 82: E32-E34
• 29 Kirchmann M, Karnov K, Hansen S. et al. Ten-Year Follow-up on Tumor Growth and Hearing in Patients Observed With an Intracanalicular Vestibular Schwannoma. Neurosurgery 2017; 80: 49-56
• 30 Carlson ML, Link MJ, Driscoll CLW. et al. Working Toward Consensus on Sporadic Vestibular Schwannoma Care: A Modified Delphi Study. Otol Neurotol 2020; 41: e1360-e1371
• 31 Macielak RJ, Patel NS, Lees KA. et al. Delayed Tumor Growth in Vestibular Schwannoma: An Argument for Lifelong Surveillance. Otol Neurotol 2019; 40: 1224-1229
• 32 Nutik SL, Babb MJ. Determinants of tumor size and growth in vestibular schwannomas. J Neurosurg 2001; 94: 922-926
• 33 Link MJ, Driscoll CLW, Foote RL. et al. Radiation therapy and radiosurgery for vestibular schwannomas: indications, techniques, and results. Otolaryngol Clin North Am 2012; 45: 353-366
• 34 Charabi S, Mantoni M, Tos M. et al. Cystic vestibular schwannomas: neuroimaging and growth rate. J Laryngol Otol 1994; 108: 375-379
• 35 Seol HJ, Kim C, Park C-K. et al. Optimal extent of resection in vestibular schwannoma surgery: relationship to recurrence and facial nerve preservation. Neurol Med Chir (Tokyo) 2006; 46: 176-180
• 36 Samii M, Gerganov VM, Samii A. Functional outcome after complete surgical removal of giant vestibular schwannomas. J Neurosurg 2010; 112: 860-867
• 37 Bloch DC, Oghalai JS, Jackler RK. et al. The fate of the tumor remnant after less-than-complete acoustic neuroma resection. Otolaryngol Head Neck Surg 2004; 130: 104-112
• 38 Park C-K, Jung H-W, Kim JE. et al. Therapeutic strategy for large vestibular schwannomas. J Neurooncol 2006; 77: 167-171
• 39 van de Langenberg R, Hanssens PEJ, van Overbeeke JJ. et al. Management of large vestibular schwannoma. Part I. Planned subtotal resection followed by Gamma Knife surgery: radiological and clinical aspects. J Neurosurg 2011; 115: 875-884
• 40 Gurgel RK, Dogru S, Amdur RL. et al. Facial nerve outcomes after surgery for large vestibular schwannomas: do surgical approach and extent of resection matter?. Neurosurg Focus 2012; 33: E16
• 41 Rujimethapass S, Ananthanandorn A, Karnchanapandh K. et al. Surgical Outcomes After Total or Subtotal Resection of Large Vestibular Schwannoma: A Single-Institution Experience. Brain Tumor Res Treat 2022; 10: 108-112
• 42 Daniel RT, Tuleasca C, George M. et al. Preserving normal facial nerve function and improving hearing outcome in large vestibular schwannomas with a combined approach: planned subtotal resection followed by gamma knife radiosurgery. Acta Neurochir (Wien) 2017; 159: 1197-1211
• 43 Iwai Y, Ishibashi K, Watanabe Y. et al. Functional Preservation After Planned Partial Resection Followed by Gamma Knife Radiosurgery for Large Vestibular Schwannomas. World Neurosurg 2015; 84: 292-300
• 44 Anaizi AN, Gantwerker EA, Pensak ML. et al. Facial nerve preservation surgery for koos grade 3 and 4 vestibular schwannomas. Neurosurgery 2014; 75: 671-675
• 45 Brokinkel B, Sauerland C, Holling M. et al. Gamma Knife radiosurgery following subtotal resection of vestibular schwannoma. J Clin Neurosci 2014; 21: 2077-2082
• 46 Slattery WH. Microsurgery after radiosurgery or radiotherapy for vestibular schwannomas. Otolaryngol Clin North Am 2009; 42: 707-715
• 47 Roche PH, Ribeiro T, Khalil M. et al. Recurrence of vestibular schwannomas after surgery. Prog Neurol Surg 2008; 21: 89-92
• 48 Husseini ST, Piccirillo E, Taibah A. et al. Salvage surgery of vestibular schwannoma after failed radiotherapy: the Gruppo Otologico experience and review of the literature. Am J Otolaryngol 2013; 34: 107-114
• 49 Wise SC, Carlson ML, Tveiten ØV. et al. Surgical salvage of recurrent vestibular schwannoma following prior stereotactic radiosurgery. Laryngoscope 2016; 126: 2580-2586
• 50 Rosahl S, Eßer D. Chirurgische Techniken zur Behandlung des Vestibularisschwannoms. HNO 2017; 65: 395-403
• 51 Scheich M, Ginzkey C, Harnisch W. et al. Use of flexible CO₂ laser fiber in microsurgery for vestibular schwannoma via the middle cranial fossa approach. Eur Arch Otorhinolaryngol 2012; 269: 1417-1423
• 52 Schwartz MS, Lekovic GP. Use of a flexible hollow-core carbon dioxide laser for microsurgical resection of vestibular schwannomas. Neurosurg Focus 2018; 44: E6
• 53 Mastronardi L, Cacciotti G, Scipio ED. et al. Safety and usefulness of flexible hand-held laser fibers in microsurgical removal of acoustic neuromas (vestibular schwannomas). Clin Neurol Neurosurg 2016; 145: 35-40
• 54 Moffat DA, Quaranta N, Chang P. Management of the high jugular bulb in translabyrinthine surgery. Laryngoscope 2003; 113: 580-582
• 55 Ahmad RARL, Sivalingam S, Topsakal V. et al. Rate of recurrent vestibular schwannoma after total removal via different surgical approaches. Ann Otol Rhinol Laryngol 2012; 121: 156-161
• 56 Plontke SK, Rahne T, Pfister M. et al. Intralabyrinthäre Schwannome: Chirurgisches Management und Hörrehabilitation mit Cochleaimplantaten. HNO 2017; 65: 419-433
• 57 Rabelo de Freitas M, Russo A, Sequino G. et al. Analysis of hearing preservation and facial nerve function for patients undergoing vestibular schwannoma surgery: the middle cranial fossa approach versus the retrosigmoid approach--personal experience and literature review. Audiol Neurootol 2012; 17: 71-81
• 58 Gharabaghi A, Samii A, Koerbel A. et al. Preservation of function in vestibular schwannoma surgery. Neurosurgery 2007; 60: ONS124-127
• 59 Goddard JC, Schwartz MS, Friedman RA. Fundal fluid as a predictor of hearing preservation in the middle cranial fossa approach for vestibular schwannoma. Otol Neurotol 2010; 31: 1128-1134
• 60 Driscoll CL, Jackler RK, Pitts LH. et al. Is the entire fundus of the internal auditory canal visible during the middle fossa approach for acoustic neuroma?. Am J Otol 2000; 21: 382-388
• 61 DeMonte F, Gidley PW. Hearing preservation surgery for vestibular schwannoma: experience with the middle fossa approach. Neurosurg Focus 2012; 33: E10
• 62 Budohoski KP, Rennert RC, Gordon SA. et al. Factors associated with hearing outcomes after a middle fossa approach in 131 consecutive patients with vestibular schwannomas. J Neurosurg 2022; 1-10
• 63 Rampp S, Rahne T, Plontke SK. et al. Intraoperatives Monitoring des N. cochlearis bei Eingriffen im Kleinhirnbrückenwinkel. HNO 2017; 65: 413-418
• 64 Samii M, Matthies C. Management of 1000 vestibular schwannomas (acoustic neuromas): hearing function in 1000 tumor resections. Neurosurgery 1997; 40: 248-260
• 65 Inoue Y, Ogawa K, Kanzaki J. Quality of life of vestibular schwannoma patients after surgery. Acta Otolaryngol 2001; 121: 59-61
• 66 Thomsen J, Tos M, Møller H. et al. The choice of approach in surgery for acoustic neuromas (vestibular schwannomas). Tokai J Exp Clin Med 1994; 19: 93-101
• 67 Wu CC, Guo WY, Chung WY. et al. Magnetic resonance imaging characteristics and the prediction of outcome of vestibular schwannomas following Gamma Knife radiosurgery. J Neurosurg 2017; 127: 1384-1391
• 68 Myrseth E, Møller P, Pedersen P-H. et al. Vestibular schwannoma: surgery or gamma knife radiosurgery? A prospective, nonrandomized study. Neurosurgery 2009; 64: 654-661
• 69 Friedman WA, Bradshaw P, Myers A. et al. Linear accelerator radiosurgery for vestibular schwannomas. J Neurosurg 2006; 105: 657-661
• 70 Régis J, Pellet W, Delsanti C. et al. Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas. J Neurosurg 2002; 97: 1091-1100
• 71 Hamm K, Herold H-U, Surber G. et al. Radiochirurgie und fraktionierte stereotaktische Radiotherapie des Vestibularisschwannoms. HNO 2017; 65: 434-442
• 72 Pollock BE, Driscoll CLW, Foote RL. et al. Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery. Neurosurgery 2006; 59: 77-85
• 73 Aman RA, Petonengan DAA, Hafif M. et al. Hearing Preservation, Facial Nerve Dysfunction, and Tumor Control in Small Vestibular Schwannoma: A Systematic Review of Gamma Knife Radiosurgery Versus Microsurgery. J Clin Neurol 2023;
• 74 Karpinos M, Teh BS, Zeck O. et al. Treatment of acoustic neuroma: stereotactic radiosurgery vs. microsurgery. Int J Radiat Oncol Biol Phys 2002; 54: 1410-1421
• 75 Pollock BE, Lunsford LD, Kondziolka D. et al. Outcome analysis of acoustic neuroma management: a comparison of microsurgery and stereotactic radiosurgery. Neurosurgery 1995; 36: 215-224
• 76 Yancey KL, Barnett SL, Kutz W. et al. Hearing Preservation After Intervention in Vestibular Schwannoma. Otol Neurotol 2022; 43: e846-e855
• 77 Huang B, Ren Y, Liu X. et al. Does preoperative gamma knife treatment affect the result of microresection of vestibular schwannoma?. J Neurooncol 2022; 160: 321-329
• 78 Ong V, Zhang AB, Wilson B. et al. The 100 Most Highly Cited Publications on Hearing Preservation for Vestibular Schwannomas. World Neurosurg 2022; 165: 115-130
• 79 Rueß D, Pöhlmann L, Grau S. et al. Outcome and toxicity analysis of single dose stereotactic radiosurgery in vestibular schwannoma based on the Koos grading system. Sci Rep 2020; 10: 9309
• 80 Bailo M, Boari N, Franzin A. et al. Gamma Knife Radiosurgery as Primary Treatment for Large Vestibular Schwannomas: Clinical Results at Long-Term Follow-Up in a Series of 59 Patients. World Neurosurg 2016; 95: 487-501
• 81 Wackym PA, Runge-Samuelson CL, Nash JJ. et al. Gamma knife surgery of vestibular schwannomas: volumetric dosimetry correlations to hearing loss suggest stria vascularis devascularization as the mechanism of early hearing loss. Otol Neurotol 2010; 31: 1480-1487
• 82 Tamura M, Carron R, Yomo S. et al. Hearing preservation after gamma knife radiosurgery for vestibular schwannomas presenting with high-level hearing. Neurosurgery 2009; 64: 289-296
• 83 Jacob JT, Carlson ML, Schiefer TK. et al. Significance of cochlear dose in the radiosurgical treatment of vestibular schwannoma: controversies and unanswered questions. Neurosurgery 2014; 74: 466-474
• 84 Linskey ME. Hearing preservation in vestibular schwannoma stereotactic radiosurgery: what really matters?. J Neurosurg 2008; 109: 129-136
• 85 Carlson ML, Vivas EX, McCracken DJ. et al. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on Hearing Preservation Outcomes in Patients With Sporadic Vestibular Schwannomas. Neurosurgery 2018; 82: E35-E39
• 86 Rueß D, Schütz B, Celik E. et al. Pseudoprogression of Vestibular Schwannoma after Stereotactic Radiosurgery with Cyberknife: Proposal for New Response Criteria. Cancers (Basel) 2023; 15: 1496
• 87 Hayhurst C, Zadeh G. Tumor pseudoprogression following radiosurgery for vestibular schwannoma. Neuro Oncol 2012; 14: 87-92
• 88 Delsanti C, Roche P-H, Thomassin J-M. et al. Morphological changes of vestibular schwannomas after radiosurgical treatment: pitfalls and diagnosis of failure. Prog Neurol Surg 2008; 21: 93-97
• 89 Nagano O, Higuchi Y, Serizawa T. et al. Transient expansion of vestibular schwannoma following stereotactic radiosurgery. J Neurosurg 2008; 109: 811-816
• 90 Meijer OWM, Weijmans EJ, Knol DL. et al. Tumor-volume changes after radiosurgery for vestibular schwannoma: implications for follow-up MR imaging protocol. AJNR Am J Neuroradiol 2008; 29: 906-910
• 91 Carlson ML, Link MJ. Vestibular Schwannomas. N Engl J Med 2021; 384: 1335-1348
• 92 Seferis C, Torrens M, Paraskevopoulou C. et al. Malignant transformation in vestibular schwannoma: report of a single case, literature search, and debate. J Neurosurg 2014; 121: 160-166
• 93 Breshears JD, Chang J, Molinaro AM. et al. Temporal Dynamics of Pseudoprogression After Gamma Knife Radiosurgery for Vestibular Schwannomas-A Retrospective Volumetric Study. Neurosurgery 2019; 84: 123-131
• 94 Kemper M, Paliege K, Zahnert T. Vestibularisschwannome – Basis- und Verlaufsdiagnostik. Laryngorhinootologie 2022; 101: 518-538
• 95 Laszig R, Lehnhardt E. Praxis der Audiometrie. 9. Aufl.. Stuttgart New York: Thieme Verlag; 2009
• 96 Hoth S, Lenarz T. Elektrische Reaktions-Audiometrie. Heidelberg: Springer; 1994
• 97 Hoth S, Müller-Deile J. Audiologische Rehabilitation von Kochleaimplantat-Trägern. HNO 2009; 57: 635-648
• 98 Walger M, Hoth S, Mühler R. Akustisch evozierte Potentiale. In: Hoth S, Mühler R, Neumann K, Walger M. Objektive Audiometrie im Kindesalter. Heidelberg: Springer Verlag; 99-181
• 99 Hoth S, Lenarz T. Experience with electrostimulation of the acoustic nerve before cochlea implantation. Laryngorhinootologie 1991; 70: 199-207
• 100 Spies TH, Snik AFM, Mens LHM. et al. Preoperative Electrical Stimulation for Cochlear Implant Selection the Use of Ear Canal Electrodes versus Transtympanic Electrodes. Acta Oto-Laryngologica 1993;
• 101 Kileny PR. Use of electrophysiologic measures in the management of children with cochlear implants: brainstem, middle latency, and cognitive (P300) responses. Am J Otol 1991; 12: 37-42
• 102 Polterauer D, Mandruzzato G, Neuling M. et al. Evaluation of auditory pathway excitability using a pre-operative trans-tympanic electrically evoked auditory brainstem response under local anesthesia in cochlear implant candidates. Int J Audiol 2022; 1-11
• 103 Cinar BC, Yarali M, Atay G. et al. The role of eABR with intracochlear test electrode in decision making between cochlear and brainstem implants: preliminary results. Eur Arch Otorhinolaryngol 2017; 274: 3315-3326
• 104 Colletti V, Fiorino FG, Carner M. et al. Intraoperative monitoring for hearing preservation and restoration in acoustic neuroma surgery. Skull Base Surg 2000; 10: 187-195
• 105 Acioly MA, Liebsch M, de Aguiar PHP. et al. Facial nerve monitoring during cerebellopontine angle and skull base tumor surgery: a systematic review from description to current success on function prediction. World Neurosurg 2013; 80: e271-e300
• 106 Vivas EX, Carlson ML, Neff BA. et al. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on Intraoperative Cranial Nerve Monitoring in Vestibular Schwannoma Surgery. Neurosurgery 2018; 82: E44-E46
• 107 Scheich M, Ginzkey C, Reuter E. et al. Quality of life after microsurgery for vestibular schwannoma via the middle cranial fossa approach. Eur Arch Otorhinolaryngol 2014; 271: 1909-1916
• 108 Marx M, Mosnier I, Venail F. et al. Cochlear Implantation and Other Treatments in Single-Sided Deafness and Asymmetric Hearing Loss: Results of a National Multicenter Study Including a Randomized Controlled Trial. Audiol Neurootol 2021; 26: 414-424
• 109 017–071l_S2k_Cochlea-Implantat-Versorgung-zentral-auditorische-Implantate_2020–12.pdf.
• 110 Longino ES, Manzoor NF, Cass ND. et al. Cochlear Implantation Outcomes in Observed Vestibular Schwannoma: A Preliminary Report. Otolaryngol Head Neck Surg 2022; 167: 149-154
• 111 Patel NS, Carlson ML, Link MJ. et al. Cochlear implantation after radiosurgery for vestibular schwannoma. J Neurosurg 2021; 135: 126-135
• 112 Lustig LR, Yeagle J, Driscoll CLW. et al. Cochlear implantation in patients with neurofibromatosis type 2 and bilateral vestibular schwannoma. Otol Neurotol 2006; 27: 512-518
• 113 Urban MJ, Moore DM, Kwarta K. et al. Ipsilateral Cochlear Implantation in the Presence of Observed and Irradiated Vestibular Schwannomas. Ann Otol Rhinol Laryngol 2020; 129: 1229-1238
• 114 Todt I, Tittel A, Ernst A. et al. Pain Free 3 T MRI Scans in Cochlear Implantees. Otol Neurotol 2017; 38: e401-e404
• 115 Todt I, Rademacher G, Mittmann P. et al. MRI Artifacts and Cochlear Implant Positioning at 3 T In Vivo. Otol Neurotol 2015; 36: 972-976
• 116 Sudhoff H, Gehl HB, Scholtz LU. et al. MRI Observation After Intralabyrinthine and Vestibular Schwannoma Resection and Cochlear Implantation. Front Neurol 2020; 11: 759
• 117 Huang Y-C, Hsu SPC, Chiang K-W. et al. Cochlear Obliteration after Translabyrinthine Resection for Large Cerebellopontine Angle Tumor. Audiol Neurootol 2023; 28: 63-74
• 118 Delgado-Vargas B, Medina M, Polo R. et al. Cochlear obliteration following a translabyrinthine approach and its implications in cochlear implantation. Acta Otorhinolaryngol Ital 2018; 38: 56-60
• 119 Schipper J, Kristin J, Volpert S. et al. Hörrehabilitation durch Cochlea-Implantation nach Vestibularisschwannom-Entfernung?. Laryngorhinootologie 2017; 95: 836-843
• 120 Rooth MA, Dillon MT, Brown KD. Prospective Evaluation of Patients Undergoing Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation. Otology & Neurotology 2017; 38: 1512
• 121 Borsetto D, Hammond-Kenny A, Tysome JR. et al. Hearing rehabilitation outcomes in cochlear implant recipients with vestibular schwannoma in observation or radiotherapy groups: A systematic review. Cochlear Implants International 2020; 21: 9-17
• 122 Iannacone FP, Visconti F, Zanoletti E. How Cochlear Implant Rehabilitation Impacts the Therapeutic Strategy for Vestibular Schwannoma. Audiology Research 2023; 13: 116-129