Real-Time Intraoperative Cochlear Nerve Monitoring and Cochlear Implantation during Translabyrinthine Vestibular Schwannoma Resection in Cases of Neurofibromatosis Type 2

Objective: Review the use of electrically evoked cochlear nerve monitoring to enhance cochlear implantation simultaneous to translabyrinthine (TL) vestibular schwannoma (VS) resection associated with Neurofibromatosis type 2 (NF2).

Methods: Three patients with NF2 underwent a TL VS resection. An electrical auditory brainstem response (eABR) was measured periodically throughout resection to provide real-time feedback on the cochlear nerve integrity. A cochlear implant (CI) was placed simultaneous to tumor removal if eABR was maintained.

Results: Patients 1 and 3 had a reliable eABR throughout tumor removal. Patient 2 had eABR pretumor removal, but posttumor removal eABR presence could not be reliably determined due to electrical artifact interference. All patients achieved auditory percepts upon CI activation and have reported benefit from their device.

Conclusion: TL VS removal with simultaneous direct auditory nerve monitoring via electrical stimulation with a cochlear implant is feasible and may provide a reliable hearing rehabilitative option for NF2 patients.

Publication History

Article published online:
12 February 2021