Resection of Intracochlear Schwannomas With Immediate Cochlear Implantation.

Area of Science:

• Neurosurgery
• Otolaryngology
• Audiology

Background:

• Intralabyrinthine schwannomas (ICS), including intracochlear types, are rare benign tumors.
• Tumor growth can affect inner ear structures and the skull base, potentially causing hearing loss.
• Surgical resection often results in permanent hearing dysfunction due to damage and fibrosis.

Purpose of the Study:

• To evaluate the safety and efficacy of simultaneous cochlear implantation after intracochlear schwannoma resection.
• To assess the potential for hearing restoration in patients with ICS undergoing this combined procedure.

Main Methods:

• Two cases of intracochlear schwannomas were treated with surgical resection.
• One patient underwent a translabyrinthine approach with endoscopic assistance; the other had a trans-otic approach.
• Cochlear implants were placed simultaneously via round window cochleostomy in both patients.

Main Results:

• Patient 1 achieved sound field thresholds near normal post-implantation (25-50 dB HL).
• Patient 2 demonstrated improved sound field thresholds (20-30 dB HL) and speech recognition (59% AZ Bio sentences).

Conclusions:

• Simultaneous cochlear implantation following ICS resection is a safe and effective method for hearing restoration.
• Adequate surgical exposure and techniques like endoscopic assistance minimize cochlear trauma.
• Immediate implantation facilitates hearing rehabilitation before cochlear fibrosis occurs.