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Twelve-Month Outcomes of Simultaneous Translabyrinthine Resection and Cochlear Implantation.

Karl W Doerfer1, Christian G Fritz2, Sandra L Porps2

  • 1Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
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Summary

Simultaneous translabyrinthine surgery and cochlear implantation for vestibular schwannoma improved speech perception and tinnitus. Hearing outcomes were durable at 12 months, though spatial hearing did not significantly improve.

Keywords:
cochlear implantssingle-sided deafnesstinnitusvestibular schwannoma

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Audiology

Background:

  • Vestibular schwannoma (VS) treatment often impacts hearing.
  • Cochlear implantation (CI) can restore hearing in cases of sensorineural hearing loss.
  • Simultaneous surgical resection of VS and CI is a complex procedure with evolving outcomes.

Purpose of the Study:

  • To evaluate audiometric and subjective outcomes 12 months after simultaneous translabyrinthine (TL) resection of vestibular schwannoma (VS) and cochlear implantation (CI).
  • To assess the durability of hearing improvements and tinnitus reduction.
  • To identify factors influencing outcomes in patients undergoing this combined procedure.

Main Methods:

  • A prospective cohort study enrolled adult patients with unilateral VS undergoing TL resection and simultaneous CI.
  • Audiometric tests (AZBio, CNC) and questionnaires (THI, SSQ) were administered preoperatively and at 1, 3, 6, and 12 months post-activation.
  • Statistical analyses compared outcomes at different time points and to baseline.

Main Results:

  • Significant improvements in speech perception (AZBio, CNC) and tinnitus severity (THI) were observed by 3 months and maintained at 12 months.
  • No significant overall improvement in the Speech, Spatial, and Qualities of Hearing (SSQ) questionnaire was noted, although some patients showed improvement in spatial subscores.
  • Poorer performance was associated with cerebellopontine angle tumors, but sample size limited definitive conclusions on tumor impact.

Conclusions:

  • Simultaneous TL resection of VS with CI provides durable improvements in speech perception and tinnitus severity at 12 months.
  • Subjective improvements in sound localization were not consistently observed.
  • Further research is needed to define optimal patient selection criteria for simultaneous VS resection and CI.