Objective: Describe outcomes in patients undergoing simultaneous translabyrinthine resection of cerebellopontine angle (CPA) tumors and cochlear implantation (CI) 12 months following surgery.
Study Design: Prospective, nonrandomized study
Setting: Tertiary care neurotology center
Patients:Patients undergoing simultaneous translabyrinthine resection of CPA tumors and CI between 1/2019 and 1/2020.
Interventions: CI
Main Outcome Measures: AZ Bio Sentence Test; Consonant Nucleus Consonant (CNC) testing; Speech, Spatial and Qualities of Hearing Scale (SSQ) scores; Tinnitus Handicap Inventory (THI) scores.
Results: Thirteen patients underwent simultaneous CI with translabyrinthine tumor resection (vestibular schwannoma: 12; meningioma: 1). AZ Bio, CNC, SSQ, and THI scores were obtained at 1, 3, 6 and 12 months postoperatively. All modality measurements for AZ Bio testing showed statistically significant improvement at 3 months (In Quiet, p = 0.039; +10 SNR, p = 0.021; +5 SNR, p = 0.003), with the largest gains seen in +5 SNR scores (mean: +15%, range: +3-52%). There was no significant change in AZ Bio scores between 3 and 12 months, suggesting durable improvement. CNC test results showed statistically significant improvement at 3 months (mean: +27%, p = 0.016). Overall, comparing preoperative CNC results to those at 12 months revealed a statistically significant improvement (mean: +35%, p = 0.004). SSQ Speech subscore showed a statistically significant improvement at the 3 months (p = 0.023). This initial improvement was not maintained at 12 months (p = 0.171). THI scores showed statistically significant improvement at 3 months (mean: -23, p = 0.002). This initial improvement was maintained at the 12-month time point, as there was no significant change between 3 and 12 months (p = 0.958). Overall, comparing pre-operative THI scores to those at 12 months revealed a statistically significant improvement (mean: -22, p = 0.014).
Conclusions: Simultaneous CI with translabyrinthine tumor resection provides durable improvement in speech perception and tinnitus reduction one year following surgery.
*Professional Practice Gap & Educational Need: Simultaneous CI and translabyrinthine tumor resection is an evolving strategy for managing expected hearing loss. Long-term outcomes are not well described in the literature.
*Learning Objective: >Participants will understand the potential durable hearing benefits provided by simultaneous cochlear implantation and translabyrinthine tumor resection.
*Desired Result: For participants to incorporate consideration of simultaneous CI and translabyrinthine resection when managing patients with vestibular schwannoma or other CPA lesions.