Dallari Virginia, Apa Enrico, Monzani Daniele, Genovese Elisabetta, Marchioni Daniele, Soloperto Davide, Sacchetto Luca
Section of Ear, Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, Borgo Roma Hospital, University of Verona, 37134 Verona, Italy.
Department of Medical and Surgical Sciences for Children and Adults, Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria of Modena, University of Modena and Reggio Emilia, 41125 Modena, Italy.
Audiol Res. 2022 Dec 21;13(1):1-11. doi: 10.3390/audiolres13010001.
: Cochlear implantation (CI) following endoscopic transcanal infrapromontorial vestibular schwannoma (VS) dissection is a feasible intervention in intracanalicular VS, with minimal extension into the cerebellopontine angle, but no audiologic results have ever been reported in the literature. From 2015 to 2021 in the Otorhynolaryngology Departments of Modena and Verona, three patients underwent this intervention. All were suffering from sporadic left-sided intracanalicular Koos I VS. Intraoperative electrically evoked auditory brainstem responses and electrophysiological measurements were performed before and after the placement of the electrode array, respectively. Since device activation one month after the surgery, each patient was followed up with audiometric tests, data logging, electrode impedance measurements and neural response telemetry performed at each scheduled fitting session at 15 days and 3, 6, 12 and 24 months. Only in patient No. 3, an auditory benefit was observed and still evident even 36 months after activation. Impedances increased progressively in patient No. 1 and a benefit was never reported. Patient No. 2 left the follow-up for worsening comorbidities. CI following transcanal infrapromontorial VS resection is a beneficial intervention. The residual cochlear nerve after the tumour dissection and the course of electrophysiological measurements in the postoperative period were the main predictive factors for audiological outcomes.
在内镜经耳道前庭下神经鞘瘤（VS）切除术后进行人工耳蜗植入（CI），对于内耳道型VS是一种可行的干预措施，肿瘤向桥小脑角的延伸最小，但文献中从未报道过听力结果。2015年至2021年期间，在摩德纳和维罗纳的耳鼻喉科，有3例患者接受了这种干预。所有患者均患有散发性左侧内耳道型库斯I级VS。分别在植入电极阵列前后进行术中电诱发听觉脑干反应和电生理测量。自术后1个月设备激活以来，对每位患者进行了听力测试、数据记录、电极阻抗测量以及在术后15天、3个月、6个月、12个月和24个月的每次预定调试期间进行的神经反应遥测随访。仅在3号患者中观察到了听觉获益，甚至在激活后36个月仍很明显。1号患者的阻抗逐渐增加，未报告有获益情况。2号患者因合并症恶化而中断随访。经耳道前庭下神经鞘瘤切除术后的人工耳蜗植入是一种有益的干预措施。肿瘤切除术后残留的耳蜗神经以及术后电生理测量过程是听力结果的主要预测因素。
