[Hearing rehabilitation in vestibular and inner ear schwannomas - Hearing aids, bone conduction Implants and CI...

Patients with vestibular schwannoma (VS) in the internal auditory canal and/or cerebellopontine angle often experience hearing loss in the affected ear, which is attributable to the disease or its treatment. If conventional hearing aids do not provide sufficient speech comprehension, cochlear implantation (CI) can be an effective means of hearing rehabilitation after microsurgical tumour resection, radiotherapy or observation, if patients are carefully selected. However, the audiological results are more variable compared to the more common CI indications. A prerequisite for good hearing results with CI is sufficient function of the cochlear nerve. The auditory nerve testing system using electrically evoked auditory brainstem responses (eABR) is a useful tool for determining the functionality of the auditory nerve. In patients with inner ear schwannomas limited to the cochlea and/or the vestibular labyrinth and non-serviceable hearing, results after tumour removal and CI are good to above average, so that CI treatment has already become established in these cases. If the tumour extends into or through the modiolus, thus involving the region of the spiral ganglion cells, hearing rehabilitation using CI is more complex.