Cambridge Skull Base Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
University of Cambridge Medical Library, Cambridge, UK.
Cochlear Implants Int. 2020 Jan;21(1):9-17. doi: 10.1080/14670100.2019.1662161. Epub 2019 Sep 8.
Vestibular schwannomas (VS) are rare benign tumours of the vestibular nerve that cause hearing loss. Management strategies include watchful waiting, radiotherapy or surgical resection. Historically, the presence of retrocochlear disease has been considered to be a contra-indication to cochlear implantation (CI). The aim of this systematic review is to assess hearing rehabilitation outcomes for CI recipients with VS, either sporadic or associated with neurofibromatosis type 2, whose tumours have been managed with either observation or radiotherapy. PubMed, Embase, and Cochrane Library databases were searched from inception through to November 2018. 50 cases from 12 studies met the inclusion criteria. Patient demographics, VS characteristics, management strategy, pre-CI hearing status, electrical promontory stimulation testing, post-CI hearing status and speech perception scores, functional benefits and follow-up length are reported. Radiotherapy and observation groups had similar patient demographics in terms of age at CI, tumour size and duration of deafness. Following CI, 64% and 60% of patients in the radiotherapy and observation groups achieved open-set speech perception, respectively. Pure tone average thresholds (33 vs. 39 dB) and speech scores were also comparable between both groups. Ipsilateral CI in patients with VS that have not been surgically resected can provide beneficial hearing rehabilitation outcomes.
前庭神经鞘瘤（VS）是一种罕见的前庭神经良性肿瘤，可导致听力损失。治疗策略包括密切观察、放疗或手术切除。从历史上看，耳蜗后疾病的存在被认为是耳蜗植入（CI）的禁忌症。本系统评价的目的是评估接受 VS 治疗的 CI 患者（无论是散发性还是与 2 型神经纤维瘤病相关）的听力康复结果，这些肿瘤通过观察或放疗进行管理。从建立到 2018 年 11 月，对 PubMed、Embase 和 Cochrane Library 数据库进行了检索。12 项研究中的 50 例符合纳入标准。报告了患者人口统计学、VS 特征、管理策略、CI 前听力状况、电刺激测试、CI 后听力状况和言语感知评分、功能获益和随访时间。放疗组和观察组在 CI 年龄、肿瘤大小和耳聋持续时间方面的患者人口统计学特征相似。CI 后，放疗组和观察组分别有 64%和 60%的患者获得开放式言语感知。两组的纯音平均阈值（33 与 39dB）和言语评分也相似。未行手术切除的 VS 患者同侧 CI 可提供有益的听力康复效果。
