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Long-Term Follow-Up After Translabyrinthine IAC Tumor Removal With Simultaneous Cochlear Implantation.

Anselm Joseph Gadenstaetter1, Alice Barbara Auinger1, Matthias Gerlitz

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|September 16, 2024
PubMed
Summary

Cochlear implantation (CI) effectively restores hearing after translabyrinthine tumor resection, with significant long-term improvements in hearing thresholds and speech recognition observed up to 3 years post-surgery. Electrically evoked auditory brainstem response audiometry (eABR) is a valuable tool for patient selection.

Keywords:
Cochlear implantationCochlear nerveElectrically evoked auditory brainstem responseIAC tumorsOutcomeVestibular schwannomaeABR

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Audiology

Background:

  • Tumors of the internal auditory canal (IAC) often necessitate surgical intervention, potentially leading to hearing loss.
  • Translabyrinthine resection is a common surgical approach for IAC tumors.
  • Restoring hearing after such interventions remains a significant clinical challenge.

Purpose of the Study:

  • To assess the long-term hearing outcomes in patients undergoing translabyrinthine resection of IAC tumors followed by simultaneous cochlear implantation (CI).
  • To evaluate the efficacy of CI in restoring both pure-tone hearing and speech recognition.
  • To determine the utility of intraoperative electrically evoked auditory brainstem response audiometry (eABR) in identifying suitable candidates for CI.

Main Methods:

  • A prospective study was conducted at a tertiary referral center.
  • Thirty-seven patients with IAC tumors underwent translabyrinthine tumor surgery.
  • Intraoperative eABR was used to assess cochlear nerve (CN) integrity; CI was performed if CN function was preserved.

Main Results:

  • Of 37 patients, 22 (59.46%) showed positive eABR responses, and 21 underwent simultaneous CI.
  • Follow-up averaged 24.24 months; significant hearing improvement was noted from 73.87 dB preoperatively to 41.56 dB at 1 year and 34.58 dB at 3 years (p < 0.016).
  • Speech recognition improved significantly from 13.33% to 58.93% at 1 year and 51.67% at 3 years (p < 0.016).

Conclusions:

  • Simultaneous cochlear implantation is an effective strategy for hearing restoration after translabyrinthine tumor surgery, irrespective of tumor pathology.
  • Hearing function can be successfully restored and maintained long-term (minimum 3 years) post-CI.
  • eABR is a practical intraoperative tool for evaluating CN function and selecting patients for CI.