Search

Objective: To investigate consideration and performance of cochlear implantation (CI) for patients with sporadic vestibular schwannoma (VS) in the only-hearing ear. Methods: A retrospective analysis of four cases, who had a long history of hearing loss on the one side and a newly- presented symptom of a gradual hearing loss due to VS on the other side, and then received ipsilateral, contralateral or bilateral CI between January 2015 and December 2016 is carried out. Imaging examination and audiological tests were performed before operation. Hearing outcomes were measured by the pure tone audiogram (PTA) and the open set speech discrimination score (SDS). Mean follow-up time was 15 months. Results: There were four patients recruited in this study: one patient implanted on the ipsilateral side, two on the contralateral side, and the other one on bilateral sides. During follow-up period, three of all had a satisfactory improvement in their speech recognition. PTA showed positive results in all four cases, which conferred an awareness of environmental sounds and was an adjuvant to lip reading. The patient with bilateral CI showed significantly better performance on the open set speech perception compared to the other three patients with unilateral CI, especially in noise. Conclusions: Consideration of CI for patients with sporadic VS in the only-hearing ear is complicated. Side selection or bilateral CI needs to be well discussed. The performance of CI depends on several influential factors. Obviously, bilateral CI is more beneficial than unilateral CI on either side. [ABSTRACT FROM AUTHOR]

Objective: To predict round window niche (RWN) visibility using high-resolution computed tomography (HRCT) in children under 12 months old. Methods: RWN visibility was determined by a senior surgeon with surgical videos. We use St Thomas's classification for the visibility of RW during CI as follows: Type I RWM is entirely exposed. Type II RW is partial exposure and is subdivided into type IIa, more than 50% but less than 100% of the RWM is exposed and type IIb, the exposure is less than 50% but more than 0%. Type III, the RWM cannot be identified Next, we measured the following four radiologic parameters: 1) the angle of the line of posterior membrane of RWN to facial nerve outer margin relative to the cochlear basal turn(angle A), 2) the angle of the external auditory canal (EAC) relative to the cochlear basal turn(angle B), 3) the width of the facial recess, 4) the relative location of the facial nerve (FN) to the cochlear basal turn. These were compared with the RWN visibility. Subsequently, we draw a line parallel to the EAC line and along the anterior lateral FN. Results: 80 ears of 40 children were included in the study. Angle A and angle B had a significant correlation with the RWN visibility. The location of the prediction line to the round window membrane highly predicted the RWN view during the surgery. Conclusion: Preoperative temporal HRCT can predict RWN visibility in cochlear implant surgery. Drawing the prediction line is a simple and useful way for preoperatively predicting the RWN visibility. [ABSTRACT FROM AUTHOR]

Objective: To investigate cochlear implantation performance in patients with neurofibromatosis type 2 (NF2). Methods: Medical records of patients with NF2 treated with cochlear implantation (CI) by the same medical team at out center between 2012 and 2016 were retrospectively reviewed. Treatment strategies, pre-operative hearing status, electric promontory stimulation (EPS), and auditory performances after CI were evaluated. Results: Twelve patients were included. Seven patients had surgical tumor removal prior to CI. 4 of them were implanted simultaneously with tumor removal and 3 were implanted after the failure of hearing preservation surgery. Five patients were implanted with tumor in situ, 2 of them received gamma knife prior to CI, and 3 were implanted without any treatment. 10 of the 12 patients obtain pleasing speech recognition; the effective rate was 83%. One patient whose EPS was negative and another patient who had good contralateral hearing got limited benefits. The mean pure tone audiometry (PTA) with CI was 44dB (range 25- 80dB). The mean sentence speech discrimination score in quiet without lip-reading was 62% (range 0-97%). Conclusion: Cochlear implantation is an effective option and should be considered primarily in auditory rehabilitation for NF2 patients with intact cochlear nerve. EPS might be a predictor for CI performance. Simultaneous implantation could avoid cochlear ossification that decreases the effect. Good contralateral hearing may also decrease the performance. [ABSTRACT FROM AUTHOR]