John Radcliffe Hospital, Oxford, UK.
Otol Neurotol. 2013 Sep;34(7):1291-8. doi: 10.1097/MAO.0b013e31829763a7.
Rehabilitation of hearing is complicated in patients with profound bilateral hearing loss in the presence of sporadic vestibular schwannoma (VS) or neurofibromatosis 2 (NF2), especially if the tumor does not need to be removed. We present the outcome of patients who have had a cochlear implant in the tumor affected ear without removal of the primary tumor.
This is a retrospective multicentre study investigating outcomes of cochlear implantation in profoundly deaf patients with vestibular schwannoma in the implanted ear.
Out of 11 implanted patients, 5 required no treatment for their tumor, whereas 6 had previously undergone radiotherapy. Nine patients experienced NF2, and 2 had unilateral VS in the only hearing ear. Postoperative hearing was assessed with open and closed set speech discrimination, including City University of New York (CUNY) in noise and Bamford, Kowal and Bench (BKB) sentence scores.
Patients with untreated lesions experienced marked improvement in their BKB and CUNY scores in the implanted ear and were daily cochlear implant users. The improvement was less consistent in the patients who had radiotherapy where only 1 patient attained open set speech discrimination.
Patients with unilateral VS (sporadic or those affected with NF2) whose tumor status was stable, benefited from cochlear implantation in their tumor-affected ear. Patients who had radiotherapy also benefited from CI, but their outcomes were variable.
在患有散发性前庭神经鞘瘤（VS）或神经纤维瘤病 2 型（NF2）的患者中，双侧深度听力丧失的听力康复较为复杂，尤其是当肿瘤不需要切除时。我们报告了在肿瘤受累耳中植入人工耳蜗而未切除原发性肿瘤的患者的结果。
这是一项回顾性多中心研究，旨在调查植入人工耳蜗的深度耳聋伴前庭神经鞘瘤患者的结果。
在 11 名植入患者中，5 名患者的肿瘤无需治疗，而 6 名患者之前接受过放射治疗。9 名患者患有 NF2，2 名患者在唯一有听力的耳朵中患有单侧 VS。术后听力采用开放式和封闭式言语辨别测试进行评估，包括纽约城市大学（CUNY）噪声测试和巴姆福德、科瓦尔和本奇（BKB）句子评分。
未接受治疗的病变患者在植入耳中的 BKB 和 CUNY 评分显著提高，且为日常人工耳蜗使用者。接受放射治疗的患者的改善则不那么一致，只有 1 名患者达到了开放式言语辨别。
单侧 VS（散发性或 NF2 受累）患者的肿瘤状况稳定，从肿瘤受累耳的人工耳蜗植入中受益。接受放射治疗的患者也从 CI 中受益，但他们的结果各不相同。
