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New outcomes with auditory brainstem implants in NF2 patients.

Robert Behr1, Vittorio Colletti, Cordula Matthies

  • 1*Klinikum Fulda gAG, Academic Hospital of the University of Marburg, Fulda, Germany; †University of Verona, Verona, Italy; ‡University of Wuerzburg, Wuerzburg, Germany; §NTT Medical Center Tokyo, Tokyo, Japan; ∥University of Tokyo, Tokyo, Japan; ¶University of Bordeaux, Bordeaux, France; and #Institute of Physiology and Pathology of Hearing, Warsaw, Poland.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|October 18, 2014
PubMed
Summary

Auditory brainstem implants (ABI) can provide high speech recognition for neurofibromatosis type 2 (NF2) patients. Minimizing brainstem trauma during ABI surgery is crucial for successful outcomes.

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Area of Science:

  • Neurosurgery
  • Audiology
  • Otolaryngology

Background:

  • Neurofibromatosis type 2 (NF2) patients often develop bilateral vestibular schwannomas, necessitating surgical intervention.
  • Auditory brainstem implants (ABI) are utilized to restore hearing in NF2 patients after tumor removal.
  • Variability in speech recognition outcomes following ABI surgery requires investigation.

Purpose of the Study:

  • To identify factors associated with high speech recognition in patients with auditory brainstem implants (ABI).
  • To analyze the relationship between surgical techniques and speech recognition outcomes in NF2 patients with ABI.

Main Methods:

  • Retrospective case review of international multicenter data.
  • Analysis of demographic and surgical data from 26 NF2 patients with ABI achieving >30% speech recognition in quiet.
  • Correlation of speech recognition scores with surgical factors, patient characteristics, and implant parameters.

Main Results:

  • 31% (26/84) of NF2 patients achieved >30% speech recognition with ABI in quiet conditions.
  • Speech recognition correlated with surgical position, duration of deafness, electrode pitch distinctness, perceptual levels, and stimulation rate.
  • No correlation found between speech recognition and tumor size, stage, electrode count, or electrophysiological recordings.

Conclusions:

  • Brainstem trauma is a primary factor influencing speech recognition variability in NF2 patients undergoing ABI surgery.
  • Careful surgical technique to minimize physical and venous trauma to the brainstem is essential for optimal ABI outcomes.
  • High levels of open-set speech recognition are achievable with ABI in NF2 patients, even with large tumors.