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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Approach to Cochlear Implantation in Patients With Ventriculoperitoneal Shunts.

Robert J Macielak1, Anne Morgan Selleck2, Armine Kocharyan1

  • 1Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|March 20, 2023
PubMed
Summary

Cochlear implantation (CI) is safe in patients with ventriculoperitoneal (VP) shunts, with most not requiring shunt revision. Careful planning and device placement ensure optimal outcomes for hearing and shunt function.

Keywords:
VP shuntcerebrospinal fluid shuntcochlear implantationventriculoperitoneal shunt

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Audiology

Background:

  • Ventriculoperitoneal (VP) shunts are common in patients with hydrocephalus.
  • Cochlear implantation (CI) offers hearing restoration for severe hearing loss.
  • The safety of performing CI in patients with VP shunts requires evaluation.

Purpose of the Study:

  • To assess the safety and outcomes of cochlear implantation (CI) in patients who also have ventriculoperitoneal (VP) shunts.
  • To provide guidance for clinical practice regarding combined CI and VP shunt management.

Main Methods:

  • A multi-institutional historical cohort study analyzed patients with both VP shunts and CI.
  • Data on VP shunt status, CI timing, device placement, and surgical outcomes were collected.
  • Hearing outcomes, measured by word scores, were assessed in CI users.

Main Results:

  • 46 patients with VP shunts and CI were identified; 89% had shunts prior to CI.
  • CI was performed contralateral (59%) or ipsilateral (41%) to the VP shunt.
  • Low rates of shunt revision were observed (7% pediatric, 5% adult); 88% of patients were regular CI users with good hearing outcomes.

Conclusions:

  • Cochlear implantation (CI) can be safely performed in patients with ventriculoperitoneal (VP) shunts, regardless of placement side.
  • Most patients do not require shunt revision, but programmable shunts need special consideration for CI device interaction.
  • Preoperative planning and neurosurgery collaboration are crucial for successful outcomes.