Hearing restoration in posterior fossa tumors

Am J Otol. 1998 Sep;19(5):649-53.

Abstract

Objective: This study aimed to assess the results of hearing restoration with a cochlear or a brainstem implant in posterior fossa tumors.

Patients: Six patients were selected. Two patients with an acoustic neuroma in the only-hearing ear (cases 1 and 2), one patient with a posterior fossa meningioma (case 3), one patient with bilateral facial neuroma (case 4), and two patients with bilateral acoustic neuroma (cases 5 and 6) participated.

Intervention: In cases 1 and 2, the patients had a cochlear implant inserted on the only-hearing ear opposite the acoustic neuroma. In case 3, the patient presented with total deafness on the left side and a 10-mm meningioma on the right side. A cochlear implantation was performed after removal of the meningioma on the right side. In case 4, the patient was operated on on both sides with bilateral postoperative deafness. A cochlear implantation was performed on the better hearing ear. In cases 5 and 6, patients underwent an auditory brainstem implantation after the exeresis of the second tumor.

Results: Promontory test results were positive for patients 1, 2, 3, and 4. After implantation, patients 1, 2, 3, and 4 scored 98%, 13%, 70%, and 30%, respectively, in open-set sentence recognition tests, whereas patients 5 and 6 scored 0% and 20%, respectively.

Conclusions: In case of nonfunctional cochlear nerve, in acoustic neuroma, either bilateral and in the only-hearing ear, promontory test should be performed. If positive results, a cochlear implantation should be performed, because successful results could be expected. Overall results of cochlear implantation on speech discrimination are better than those obtained with a brainstem implant.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Stem / surgery
  • Cochlear Implantation / methods*
  • Cranial Fossa, Posterior / surgery*
  • Deafness / diagnosis
  • Deafness / etiology
  • Deafness / surgery*
  • Female
  • Humans
  • Male
  • Meningioma / complications
  • Meningioma / surgery*
  • Middle Aged
  • Severity of Illness Index
  • Skull Neoplasms / complications
  • Skull Neoplasms / surgery*
  • Treatment Outcome