Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-25T19:02:20.641Z Has data issue: false hasContentIssue false
  • English
  • Français

Cochlear patency following translabyrinthine vestibular schwannoma resection: implications for hearing rehabilitation

Published online by Cambridge University Press:  03 July 2019

V Carswell ,
J A Crowther ,
R Locke ,
W Taylor  and
G Kontorinis
V Carswell
Affiliation:
Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
J A Crowther
Affiliation:
Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
R Locke
Affiliation:
Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
W Taylor
Affiliation:
Department of Neurosurgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
G Kontorinis*
Affiliation:
Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
*
Author for correspondence: Mr Georgios Kontorinis, Department of Otolaryngology, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, Scotland, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To examine when cochlear fibrosis occurs following a translabyrinthine approach for vestibular schwannoma resection, and to determine the safest time window for potential cochlear implantation in cases with a preserved cochlear nerve.

Methods

This study retrospectively reviewed the post-operative magnetic resonance imaging scans of patients undergoing a translabyrinthine approach for vestibular schwannoma resection, assessing the fluid signal within the cochlea. Cochleae were graded based on the Isaacson et al. system (from grade 0 – no obstruction, to grade 4 – complete obliteration).

Results

Thirty-nine patients fulfilled the inclusion criteria. The cochleae showed no evidence of obliteration in: 75 per cent of patients at six months, 38.5 per cent at one year and 27 per cent beyond one year. Most changes happened between 6 and 12 months after vestibular schwannoma resection, with cases of an unobstructed cochlear decreasing dramatically, from 75 per cent to 38.5 per cent, within this time.

Conclusion

The progress of cochlear obliteration that occurred between 6 and 12 months following vestibular schwannoma resection indicates that the first 6 months provides a safer time window for cochlear patency.

Keywords

Acoustic NeuromaCochleaCochlear ImplantationFibrosisMagnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 7 , July 2019 , pp. 560 - 565
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr G Kontorinis takes responsibility for the integrity of the content of the paper

References

1Hougaard, D, Norgaard, A, Pedersen, T, Bibby, BM, Ovesen, T. Is a redefinition of the growth criteria of vestibular schwannomas needed? Am J Otolaryngol 2014;35:192–7Google Scholar
2Springborg, JB, Fugleholm, K, Poulsgaard, L, Cayé-Thomasen, P, Thomsen, J, Stangerup, SE. Outcome after translabyrinthine surgery for vestibular schwannomas: report on 1244 patients. J Neurol Surg B Skull Base 2012;73:168–74Google Scholar
3Gal, TJ, Shinn, J, Huang, B. Current epidemiology and management trends in acoustic neuroma. Otolaryngol Head Neck Surg 2010;142:677–81Google Scholar
4Wu, H, Sterker, J. Translabyrinthine removal of large acoustic neuromas in young adults. Auris Nasus Larynx 2000;27:201–5Google Scholar
5Lustig, LR, Yeagle, J, Driscoll, CL, Blevins, N, Francis, H, Niparko, JK. Cochlear implantation in patients with neurofibromatosis type 2 and bilateral vestibular schwannoma. Otol Neurotol 2006;27:512–18Google Scholar
6Roehm, PC, Mallen-St Clair, J, Jethanamest, D, Golfinos, J, Shapiro, W, Waltzman, S et al. Auditory rehabilitation of patients with neurofibromatosis type 2 by using cochlear implants. J Neurosurg 2011;115:827–34Google Scholar
7Belal, A. Is cochlear implantation possible after acoustic tumour removal? Otol Neurotol 2001;22:497–500Google Scholar
8Hassepass, F, Arndt, S, Aschendorff, A, Laszig, R, Wesarg, T. Cochlear implantation for hearing rehabilitation in single-sided deafness after translabyrinthine vestibular schwannoma surgery. Eur Arch Otorhinolaryngol 2016;273:2373–83Google Scholar
9Kim, JW, Han, JH, Kim, JW, Moon, IS. Simultaneous translabyrinthine tumour removal and cochlear implantation in vestibular schwannoma patients. Yonsei Med J 2016;57:1535–9Google Scholar
10Kameswaran, M, Kumar, RS, Murali, S, Natarajan, K, Krishnan, V. Cochlear implantation in ossified cochlea - Merf experience. Indian J Otolaryngol Head Neck Surg 2005;57:327–9Google Scholar
11Isaacson, B, Booth, T, Kutz, JW, Lee, KH, Roland, PS. Labyrinthitis ossificans: how accurate is MRI in predicting cochlear obstruction? Otolaryngol Head Neck Surg 2009;140:692–6Google Scholar
12Wanna, GB, Carlson, ML, Blachon, GS, Noble, JH, Dawant, BM, Labadie, RF et al. Implantation of the completely ossified cochlea: an image-guided approach. Otol Neurotol 2013;34:522–5Google Scholar
13Nichani, J, Green, K, Hans, P, Bruce, I, Henderson, L, Ramsden, R. Cochlear implantation after bacterial meningitis in children: outcomes in ossified and non-ossified cochleae. Otol Neurotol 2011;32:784–9Google Scholar
14Sargent, EW, Liao, E, Gonda, RL. Cochlear patency after transmastoid labyrinthectomy for Meniere's syndrome. Otol Neurotol 2016;37:937–9Google Scholar
15Booth, T, Roland, P, Kutz, J, Lee, K, Isaacson, B. High-resolution 3-D T2-weighted imaging in the diagnosis of labyrinthitis ossificans: emphasis on subtle cochlear involvement. Pediatr Radiol 2013;43:1584–90Google Scholar
16Beutner, C, Mathys, C, Turowski, B, Schipper, J, Klenzner, T. Cochlear obliteration after translabyrinthine vestibular schwannoma surgery. Eur Arch Otorhinolaryngol 2015;272:829–33Google Scholar
17Arriaga, MA, Marks, S. Simultaneous cochlear implantation and acoustic neuroma resection: imaging considerations, technique, and functional outcome. Otolaryngol Head Neck Surg 1995;112:325–8Google Scholar