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J Neurol Surg B Skull Base
DOI: 10.1055/a-2236-0113
Original Article

Audiometric Outcomes of Auditory Brainstem Implantation during Vestibular Schwannoma Resection in NF2 Patients

Víctor de Cos
1   University of California San Diego School of Medicine, La Jolla, California, United States
,
Madeline Gibson
1   University of California San Diego School of Medicine, La Jolla, California, United States
,
Vivienne Li
1   University of California San Diego School of Medicine, La Jolla, California, United States
,
Olivia La Monte
1   University of California San Diego School of Medicine, La Jolla, California, United States
,
Omid Moshtaghi
2   Department of Otolaryngology—Head and Neck Surgery, UC San Diego Medical Center, San Diego, California, United States
,
Peter Dixon
2   Department of Otolaryngology—Head and Neck Surgery, UC San Diego Medical Center, San Diego, California, United States
,
Usman Khan
2   Department of Otolaryngology—Head and Neck Surgery, UC San Diego Medical Center, San Diego, California, United States
,
Rick Friedman
2   Department of Otolaryngology—Head and Neck Surgery, UC San Diego Medical Center, San Diego, California, United States
,
Marc S. Schwartz
3   Department of Neurosurgery, UC San Diego Medical Center, San Diego, California, United States
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Abstract

Background Many patients with neurofibromatosis type 2 (NF2) suffer from sensorineural hearing loss, and associated cochlear nerve compromise in NF2 patients makes auditory brainstem implant (ABI) an attractive treatment option. The long-term outcomes and benefits of the device are still being explored.

Methods A retrospective review was conducted for 11 ABI recipients at a single-institution tertiary center between November 2017 and August 2022. Patients diagnosed with NF2 undergoing resection for concurrent vestibular schwannoma (VS) were included. Pre- and postaudiometric assessments were reviewed. Evaluation included pure-tone audiometry and speech testing.

Results Our cohort included 11 patients with a median age of 34 years. All patients underwent a translabyrinthine approach for implant placement with concurrent VS resection. Average tumor size of VS was 2.87 cm. Preoperatively, 8 patients had pure-tone averages with no response at 110 dB, 2 were within mild–moderate hearing loss (25–45 dB), and one patient had a PTA of profound loss (92 dB). Postoperatively, 9 (81%) patients had improvement in PTA. In total, seven patients reported mild side effects upon ABI activation which included dizziness (n = 2), tinnitus (n = 1), and abdominal and lower extremity tingling sensation (n = 3). Of the seven patients with early speech perception (ESP) scores, five had a score >75%, indicating the auditory ability to detect pattern perception upon auditory stimulation through the ABI alone.

Conclusion Nine of 11 patients derived benefits from ABI placement. These findings demonstrate that ABI placement during concurrent VS resection can provide a significant hearing benefit for NF2 patients.

Keywords

auditory brainstem implant - vestibular schwannoma - NF2 - neurofibramatosis 2 - audiometric outcomes


Publication History

Received: 06 October 2023

Accepted: 21 December 2023

Accepted Manuscript online:
28 December 2023

Article published online:
29 January 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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