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Comparing Cochlear Implantation With Versus Without Resection in Intralabyrinthine Schwannoma: A Systematic Review
Brendon K Warner1, Lawrance Lee, Daniel H Coelho
1Department of Otolaryngology Head & Neck Surgery, Virginia Commonwealth University, Richmond, VA.
Summary
Cochlear implantation (CI) with or without intralabyrinthine schwannoma (ILS) resection improves hearing outcomes. There is no significant difference in results between the two groups, suggesting resection may not always be necessary for ILS patients undergoing CI.
Area of Science:
- Otorhinolaryngology
- Neurosurgery
- Audiology
Background:
- Intralabyrinthine schwannomas (ILS) are rare tumors that can affect hearing.
- Cochlear implantation (CI) is a treatment option for hearing loss.
- The necessity of ILS resection prior to CI is debated.
Purpose of the Study:
- To compare audiometric outcomes in patients undergoing cochlear implantation (CI) with and without primary resection of intralabyrinthine schwannomas (ILS).
Main Methods:
- A systematic review and meta-analysis of studies from PubMed, Embase, and CINAHL.
- Included 26 studies with 249 patients (213 with resection, 30 without).
- Analyzed preoperative and postoperative audiometric data using statistical tests.
Main Results:
- Both CI with and without ILS resection demonstrated favorable audiometric outcomes.
- No statistically significant difference was found in Pure Tone Average (PTA) or Word Recognition Score (WRS) between the groups.
- PTA mean difference (MD) with resection: -72.3; without resection: -81.1.
- WRS MD with resection: 50.0; without resection: 42.5.
Conclusions:
- Cochlear implantation improves audiometric outcomes, regardless of ILS resection.
- Surgical resection of ILS may not be a prerequisite for all patients undergoing CI.
- Further research could clarify optimal management strategies.
