Cochlear Implantation in Ears Affected with Untreated or Treated Vestibular Schwannomas

Objective: Patients with profound hearing loss in the presence of sporadic vestibular schwannomas (VSs) or neurofibromatosis 2 (NF2) have very limited options for hearing rehabilitation if the tumor doesn't need to be removed. This project aims primarily to quantify hearing results of patients who have had a cochlear implant in an untreated vestibular schwannoma (VS) while also studying hearing results of patients who have been implanted following radiotherapy.

Design: This is a retrospective multicenter study investigating outcomes of cochlear implantation in profoundly deaf patients with vestibular schwannoma in the implanted ear.

Materials and Methods: Out of 10 implanted patients, 4 required no treatment for their tumor while 6 had previously undergone radiotherapy. Eight patients suffered from NF2, and two had unilateral VS in the only hearing ear. Postoperative hearing was tested using City University of New York (CUNY) and Bamford-Kowal-Bench (BKB) sentence scores. Minimum follow-up was 6 months.

Results: Both groups of patients benefited from implantation, and most were daily cochlear implant users. In this cohort, this finding was more consistent in patients who had received no treatment before implantation.

Conclusion: Patients with VS (sporadic or those affected with NF2) whose tumor statuses are stable, benefit from cochlear implantation in their tumor-effected ear with or without prior treatment, thus gaining useful hearing for a longer period of time. Preliminary studies show promising results; however, a larger patient sample is required to be able to compare hearing results among the different groups.