Laryngorhinootologie 2024; 103(S 02): S294-S295
DOI: 10.1055/s-0044-1784987
Abstracts │ DGHNOKHC
Otology/Neurootology/Audiology: Lateral skull base

Update on the management of inner ear schwannomas including subtotal cochleoectomy and hearing rehabilitation using cochlear implants

Stefan Plontke
1   Martin-Luther-Universität Halle / Wittenberg, Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Halle a. d. S.
,
Luise Wagner
1   Martin-Luther-Universität Halle / Wittenberg, Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Halle a. d. S.
,
Anna Kopsch
1   Martin-Luther-Universität Halle / Wittenberg, Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Halle a. d. S.
,
Gerrit Götze
1   Martin-Luther-Universität Halle / Wittenberg, Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Halle a. d. S.
,
Dirk Vordermark
2   Martin-Luther-Universität Halle / Wittenberg, Klinik für Strahlentherapie, Halle a. d. S.
,
Christian Dietzel
2   Martin-Luther-Universität Halle / Wittenberg, Klinik für Strahlentherapie, Halle a. d. S.
,
Christian Strauss
3   Universitätsmedizin Halle, Klinik und Poliklinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle a. d. S.
,
Laura Fröhlich
1   Martin-Luther-Universität Halle / Wittenberg, Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Halle a. d. S.
4   Universitätsklinikum Bonn, Bonn
,
Per Caye-Thomasen
5   Copenhagen University Hospital Rigshospitalet, Department of Otorhinolaryngology, Head and Neck Surgery, Copenhagen
,
Jonas Scheffler
1   Martin-Luther-Universität Halle / Wittenberg, Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Halle a. d. S.
,
Sabrina Kösling
6   Martin-Luther-Universität Halle / Wittenberg, Klinik für Radiologie, Halle a. d. S.
,
Torsten Rahne
1   Martin-Luther-Universität Halle / Wittenberg, Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Halle a. d. S.
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Introduction Inner ear schwannomas (IES) are a rare differential diagnosis of sudden hearing loss and vertigo. We here report on the current management of IES including audiological and neurotological outcomes after surgical tumor removal by partial or subtotal cochleoectomy and hearing rehabilitation by cochlear implantation (CI).

Method In a monocentric case series of 106 patients, the tumors were found 58 times intracochlear, 15 times intravestibular, 8 times intravestibulocochlear, 23 times with growth through the fundus of the internal auditory canal and here in the majority with involvement of the modiolus and 2 times multifocal. Surgical tumor removal was performed in 80 cases, 76 patients received a CI.

Results In the case of an exclusively intracochlear tumor localization, surgical tumor removal by partial or subtotal cochleoectomy [1] is also feasible with preservation of the function of all five vestibular receptors [2]. In almost all cases with CI implantation, hearing rehabilitation was successful during the observation period (mean monosyllable word recognition score>70% at 65 dB SPL after 12 months) and is therefore above the mean result for all CI patients, independent of the cause of deafness.

Discussion Based on our experience with this patient population, early surgical removal, especially of intracochlear IES, seems to be reasonable before they completely fill the cochlea, cause further loss of function and/or grow into the internal auditory canal. The management of inner ear schwanomas involving the modiolus is particularly complex. In case of nonserviceable hearing, CI after surgical IES removal is recommended over observation.



Publication History

Article published online:
19 April 2024

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