Quality control after cochlear intralabyrinthine schwannoma resection and cochlear implantation

Objective MRI observation is part of the regular follow-up after vestibular schwannoma (VS) or intralabyrinthine schwannoma (ILS) resection. Because cochlear implantation (CI) after resection is part of the audiological rehabilitation process, the MRI behaviour of CI systems needs to be considered. In light of recent developments in MRI artifact positioning and pain prevention, this study evaluates reproducible MRI observations after tumor resection and CI surgery as part of follow-up and quality control of the surgical procedure. Especially in cases of cochlear ILS complete resection is challenging. The aim of this study was to perform a long term follow up after cochlear ILS resection.

Methods In a retrospective study, we evaluated 7 patients with a T1 KM Gad/T2 sequence MRI observation with a min. of two years after cochlear ILS resection and CI. Different surgical techniques (cochleostomy pull out, first turn push out, drill out) were chosen dependent from the extent of tumor size.

Results We observed in all of the seven cases no MRI pattern of reoccurrence/residual cochlear ILS. In the case of drill out no T2 fluid signal was persisting.

Conclusion MRI follow-up after cochlear ILS resection and CI is reproducibly possible and necessary. It acts as a regular follow up but even as a quality control of the surgical procedure. In contrast to vestibular ILS, cochlear ILS can potentially incompletely removed. The area behind the modiolus is possible area of residual ILS.

Poster-PDF A-1693.pdf

Publication History

Article published online:
13 May 2021