Cochlear Implantation Concurrent with Vestibular Schwannoma Resection

Cochlear implants provide successful auditory rehabilitation for patients with profound sensorineural hearing loss. This procedure is well described for patients with neurofibromatosis type 2 undergoing vestibular schwannoma surgery. Only recently, reports are emerging regarding ipsilateral cochlear implantation concurrent in patients undergoing surgery for sporadic vestibular schwannoma. We present a patient who underwent removal of an intravestibular schwannoma via labyrinthectomy with concurrent placement of a cochlear implant in the same ear. At 14 months postsurgery, auditory testing revealed soundfield thresholds between 20 and 35 dB and AzBio sentence testing score of 98% in the implant only condition. Disability testing revealed improvements in Hearing Handicap Inventory for Adults 82 to 48%, Tinnitus Handicap Inventory 78 to 28%, and Tinnitus Reaction Questionnaire score 73 to 21. This case contributes to our understanding of cochlear implant performance after vestibular schwannoma surgery, and makes a case for consideration of implantation in select patients when the cochlear nerve can be preserved.