Vestibular schwannoma and CI - a challenging indication with the possibility of hearing rehabilitation

Background Vestibular schwannoma (VS) is a rare cause of sudden hearing loss, but due to improved MR imaging it is more often diagnosed. Therefore also intralabyrinthine (IL) and intracochlear (IC) VS are diagnosed, which are often accompanied by single-sided deafness, are more often diagnosed. The aim of the study is the evaluation of VS treatment and CI hearing rehabilitation in regard to feasibility, complications and hearing level.

Methods Thirteen patients (9 male, 4 female, mean age 58.0 10.2) with IM (n=4), IL (n=2) and IC (n=7) VS were enrolled in this prospective study between 09/2013 and 10/2019. Patients had CI-indication on the affected ear. VS was treated surgically or radiosurgically with Cyberknife. CI was done either sequentially after Cyberknife or during the VS surgery.

Results When initially diagnosed with VS, six of the patients were deaf on the affected ear, the others had residual hearing (preoperative Freiburg monosyllable test (FES)=1.55.5%). The patients with IC or IL schwannoma (n=9) were treated via partial cochleoektomie or translabyrinthine approach with simultaneous CI. The patients with IM VS were treated with either resection via retrosigmoidal approach (n=2) and/or Cyberknife radiosurgery and sequential CI after MRI control. Latest audiometry (1 or 2 years postoperatively) indicated a word recognition score (FES) of 46.427.6 % (n=7).

Conclusion CI in VS patients after succesful surgical or radiosurgical VS treatment is a promising possibility for hearing rehabilitation. But it remains a case by case decision after discussion in the interdisciplinary board.

Publication History

Article published online:
10 June 2020