Hearing Restoration for Adults with Vestibular Schwannoma in the Only Hearing Ear: Ipsilateral or Contralateral Cochlear Implantation?

摘要

Objective: To explore auditory outcomes following cochlear implantation (CI) in patients with vestibular schwannoma (VS) in the only hearing ear. Methods: Three patients, all with a long history of hearing loss on one side and with newly diagnosed VS on the other side, underwent ipsilateral or contralateral CI. Their clinical data were collected retrospectively. Postoperative hearing outcomes were measured during follow-up and compared with the preoperative test results. Athorough search of the English-language literature was performed. Results: Patients 1 and 2 underwent CI in the ipsilateral and contralatera I ear, respectively, without tumor removal; patient 3 underwent CI after tumor resection. At the last follow-up, the result of pure tone audiometry was 25, 45, and 25 dB, respectively. An open-set speech discrimination score was achieved in all 3 patients, with monosyllabic word recognition of 60, 30, and 75%, respectively. Besides the patients included in our study, 28 CI cases with VS in the only hearing ear have been reported up to now. Conclusions: In patients with VS in the only hearing ear, significant hearing deterioration with no obvious tumor growth is a good indication for ipsilatera I CI. Long-term deafness in the tumor-free ear is not an absolute contraindication for CI. (C) 2016 S. Karger AG, Basel