Skull Base 2010; 20(4): 279-284
DOI: 10.1055/s-0030-1247633
CASE REPORT

© Thieme Medical Publishers

Concurrent Cochlear Implantation with Resection of Skull Base Hemangiopericytoma following Sudden Deafness in an Only Hearing Ear

Evan R. Ransom1 , Kevin D. Judy2 , Douglas C. Bigelow1
  • 1Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
  • 2Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
Further Information

Publication History

Publication Date:
27 January 2010 (online)

ABSTRACT

A 72-year-old man with a known left acoustic neuroma, left-sided deafness, and a recently diagnosed right infratemporal fossa (ITF) hemangiopericytoma, presented with sudden deafness in his right ear. Imaging revealed right-sided skull base extension and a large intracranial tumor component. The patient underwent a frontotemporal crainiotomy with concomitant ITF approach. Complete tumor resection was possible, though invasion of the otic capsule was present. Immediately postresection, a cochlear implant (CI) was performed via a transmastoid approach. Full electrode insertion was achieved and confirmed by visualization through the dehiscent middle fossa floor. Mastoid obliteration was then performed with a free fat graft. Postoperative imaging confirmed complete tumor resection (Simpson grade I) and adequate CI placement. Follow-up magnetic resonance imaging was performed at 6 and 12 months, and no tumor recurrence was seen. Prior to CI activation, the patient was completely deaf bilaterally. At 18-month follow-up, however, excellent hearing was achieved with the right CI (16 of 22 electrodes active), and the patient is now conversational with no obvious deficit. His cognitive function is excellent, corresponding to preoperative status, and he is independent in his activities of daily living. Following adjuvant radiation, our patient remains disease free at 18 months.

REFERENCES

Douglas C Bigelow, M.D. 

Associate Professor, Dept. Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania

3400 Spruce Street, 5th Floor Silverstein Building, Philadelphia, PA 19103

Email: douglas.bigelow@uphs.upenn.edu