Hearing Rehabilitation in Patients With Neurofibromatosis Type 2: The Quebec's Experience With Auditory Implants

Otol Neurotol. 2023 Sep 1;44(8):e621-e627. doi: 10.1097/MAO.0000000000003967. Epub 2023 Aug 3.

Abstract

Objective: To review a single-center experience with hearing rehabilitation in patients with neurofibromatosis type 2 (NF2) and to describe the auditory outcomes of cochlear implants (CIs) and auditory brainstem implants (ABI) in this population.

Study design: Retrospective case series.

Setting: Tertiary referral center.

Patients: Twelve adult patients with NF2 who received a CI (n = 10) and/or an ABI (n = 5) between 2000 and 2021.

Interventions: Insertion of a CI and/or an ABI in NF2 patients with bilateral vestibular schwannomas (VSs).

Main outcome measures: Patients' demographic data, treatment history, hearing evolution, hearing rehabilitation methods, implant details, and auditory outcomes after implantation.

Results: Among those who received a CI, five patients had a stable untreated VS, one patient underwent a cochlear nerve preserving surgery, and four patients received radiotherapy treatments. Six patients became regular users of their device. The median open-set sentence recognition scores were as follows: 0.5% preoperatively, 60% at 1 year postoperatively, and 80% on the most recent audiological evaluation. All patients with an ABI were implanted concomitantly with VS surgical excision, and three of them also received radiotherapy treatments. The median open-set sentence recognition scores were as follows: 4% preoperatively, 26% at 1 year postoperatively, and 0% on the most recent evaluation. Three patients became regular ABI users.

Conclusion: Despite major technological advances, auditory outcomes with ABIs remain deceiving. Considering the overall improvement in postoperative auditory performances provided by CIs compared with ABIs, cochlear implantation standouts as a primary mean of hearing rehabilitation in NF2 patients.

MeSH terms

  • Adult
  • Auditory Brain Stem Implantation* / methods
  • Auditory Brain Stem Implants*
  • Hearing
  • Humans
  • Neurofibromatosis 2* / complications
  • Neurofibromatosis 2* / surgery
  • Neuroma, Acoustic* / complications
  • Neuroma, Acoustic* / surgery
  • Quebec
  • Retrospective Studies
  • Treatment Outcome