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J Neurol Surg B Skull Base 2015; 76(06): 440-450
DOI: 10.1055/s-0034-1544121
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Retrosigmoid Craniotomy for Auditory Brainstem Implantation in Adult Patients with Neurofibromatosis Type 2

Sidharth V. Puram
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2   Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Barbara Herrmann
2   Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
3   Department of Audiology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
,
Fred G. Barker II
4   Neurosurgical Service, Massachusetts General Hospital, Boston, Massachusetts, United States
5   Department of Surgery (Neurosurgery), Harvard Medical School, Boston, Massachusetts, United States
,
Daniel J. Lee
1   Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2   Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations
Further Information

Publication History

02 August 2014

07 December 2014

Publication Date:
12 June 2015 (online)

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Abstract

Objective To report our technique and experience using a retrosigmoid craniotomy approach for auditory brainstem implantation (ABI) placement in adult neurofibromatosis type 2 (NF2) patients.

Design Retrospective case series.

Setting Single-center study, Boston, Massachusetts, United States.

Participants All NF2 patients who underwent evaluation at Massachusetts Eye and Ear Infirmary and surgery at Massachusetts General Hospital from 2009 to 2013 were reviewed. Six cases of retrosigmoid craniotomy for ABI surgery in five adult NF2 patients were identified. The clinical history, operative course, and outcomes in these patients were reviewed.

Main Outcome Measures Postoperative complications and audiological outcomes.

Results Indications for ABI surgery were profound hearing loss associated with growth or treatment of bilateral vestibular schwannomas. In all cases, a retrosigmoid craniotomy was performed for tumor resection and ABI placement without complication. Electrode placement was confirmed intraoperatively using electrical-evoked auditory brainstem responses. The ABI was activated in the awake patient 4 to 6 weeks postoperatively. Audiological testing was used to evaluate sound detection and speech perception with the ABI. There were no cases of cerebrospinal fluid leak.

Conclusion Retrosigmoid craniotomy is a safe and effective means to provide access to the cochlear nucleus for ABI placement following tumor resection in the adult NF2 patient. Preliminary data indicate that this approach has few complications while offering benefits for hearing. The retrosigmoid craniotomy should be considered a reasonable alternative to the traditional translabyrinthine approach for placement of the ABI in deaf patients who are not candidates for the cochlear implant.

Keywords

auditory brainstem implant (ABI) - neurofibromatosis type 2 (NF2) - retrosigmoid craniotomy
 

  • References

  • 1 Lustig 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 (4) 512-518
    CrossrefPubMedGoogle Scholar
  • 2 Neff BA, Wiet RM, Lasak JM , et al. Cochlear implantation in the neurofibromatosis type 2 patient: long-term follow-up. Laryngoscope 2007; 117 (6) 1069-1072
    CrossrefPubMedGoogle Scholar
  • 3 Trotter MI, Briggs RJ. Cochlear implantation in neurofibromatosis type 2 after radiation therapy. Otol Neurotol 2010; 31 (2) 216-219
    CrossrefPubMedGoogle Scholar
  • 4 Lin HW, Herrmann BS, Lee DJ. Cochlear implants and other implantable hearing devices. In: Ruckenstein MJ, , ed. Cochlear Implants and Other Implantable Hearing Devices. San Diego, CA: Plural Publishing; 2013: 317-348
    Google Scholar
  • 5 Kuchta J. Twenty-five years of auditory brainstem implants: perspectives. Acta Neurochir Suppl (Wien) 2007; 97 (Pt 2) 443-449
    PubMedGoogle Scholar
  • 6 Colletti V. Auditory outcomes in tumor vs. nontumor patients fitted with auditory brainstem implants. Adv Otorhinolaryngol 2006; 64: 167-185
    PubMedGoogle Scholar
  • 7 Colletti V, Carner M, Miorelli V, Guida M, Colletti L, Fiorino F. Auditory brainstem implant (ABI): new frontiers in adults and children. Otolaryngol Head Neck Surg 2005; 133 (1) 126-138
    CrossrefPubMedGoogle Scholar
  • 8 Colletti V, Fiorino FG, Carner M, Miorelli V, Guida M, Colletti L. Auditory brainstem implant as a salvage treatment after unsuccessful cochlear implantation. Otol Neurotol 2004; 25 (4) 485-496 ; discussion 496
    CrossrefPubMedGoogle Scholar
  • 9 Colletti V, Shannon R, Carner M, Veronese S, Colletti L. Outcomes in nontumor adults fitted with the auditory brainstem implant: 10 years' experience. Otol Neurotol 2009; 30 (5) 614-618
    CrossrefPubMedGoogle Scholar
  • 10 Moffat DA, Lloyd SK, Macfarlane R , et al. Outcome of translabyrinthine surgery for vestibular schwannoma in neurofibromatosis type 2. Br J Neurosurg 2013; 27 (4) 446-453
    CrossrefPubMedGoogle Scholar
  • 11 Otto SR, Brackmann DE, Hitselberger WE, Shannon RV, Kuchta J. Multichannel auditory brainstem implant: update on performance in 61 patients. J Neurosurg 2002; 96 (6) 1063-1071
    CrossrefPubMedGoogle Scholar
  • 12 Colletti V, Fiorino FG, Carner M, Giarbini N, Sacchetto L, Cumer G. Advantages of the retrosigmoid approach in auditory brain stem implantation. Skull Base Surg 2000; 10 (4) 165-170
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Colletti V, Fiorino FG, Carner M, Giarbini N, Sacchetto L, Cumer G. The retrosigmoid approach for auditory brainstem implantation. Am J Otol 2000; 21 (6) 826-836
    PubMedGoogle Scholar
  • 14 Colletti V, Sacchetto L, Giarbini N, Fiorino F, Carner M. Retrosigmoid approach for auditory brainstem implant. J Laryngol Otol Suppl 2000; (27) 37-40
    PubMedGoogle Scholar
  • 15 Plotkin SR, Stemmer-Rachamimov AO, Barker II FG , et al. Hearing improvement after bevacizumab in patients with neurofibromatosis type 2. N Engl J Med 2009; 361 (4) 358-367
    CrossrefPubMedGoogle Scholar
  • 16 American National Standards Institute. Methods for Manual Pure-Tone Threshold Audiometry (ANSI S3.21-2004). New York, NY: ANSI; 2004
    Google Scholar
  • 17 American National Standards Institute. Method for Calculation of the Speech Intelligibility Index (ANSI S3.5-1997). New York, NY: ANSI; 1998
    Google Scholar
  • 18 American National Standards Institute. Specification for Audiometers (ANSI S3.6-2004). New York, NY: ANSI; 2004
    Google Scholar
  • 19 Moog JS, Geers AE. Early Speech Perception Test for Profoundly Deaf Hearing-Impaired Children. St. Louis, MO: Central Institute for the Deaf; 1990
    Google Scholar
  • 20 Briggs RJ, Brackmann DE, Baser ME, Hitselberger WE. Comprehensive management of bilateral acoustic neuromas. Current perspectives. Arch Otolaryngol Head Neck Surg 1994; 120 (12) 1307-1314
    CrossrefPubMedGoogle Scholar
  • 21 Casselman JW. Diagnostic imaging in clinical neuro-otology. Curr Opin Neurol 2002; 15 (1) 23-30
    CrossrefPubMedGoogle Scholar
  • 22 Cerini R, Faccioli N, Cicconi D , et al. Role of CT and MRI in the preoperative evaluation of auditory brainstem implantation in patients with congenital inner ear pathology. Radiol Med (Torino) 2006; 111 (7) 978-988
    CrossrefPubMedGoogle Scholar
  • 23 Lee DJ, Driver M. Cochlear implant fixation using titanium screws. Laryngoscope 2005; 115 (5) 910-911
    CrossrefPubMedGoogle Scholar
  • 24 Friedland DR, Wackym PA. Evaluation of surgical approaches to endoscopic auditory brainstem implantation. Laryngoscope 1999; 109 (2 Pt 1): 175-180
    CrossrefPubMedGoogle Scholar
  • 25 Kuroki A, Møller AR. Microsurgical anatomy around the foramen of Luschka in relation to intraoperative recording of auditory evoked potentials from the cochlear nuclei. J Neurosurg 1995; 82 (6) 933-939
    CrossrefPubMedGoogle Scholar
  • 26 Colletti V, Fiorino F, Carner M, Sacchetto L, Miorelli V, Orsi A. Auditory brainstem implantation: the University of Verona experience. Otolaryngol Head Neck Surg 2002; 127 (1) 84-96
    CrossrefPubMedGoogle Scholar