Cochlear implantation in vestibular schwannoma: A game changer? A narrative review
Objectives: In recent years, indications for Cochlear Implants (CIs) have been on the rise, with Vestibular Schwannoma (VS) patients among these emerging indications. On the other hand, there is growing evidence in favor of the 'wait and see' approach as opposed to surgery or irradiation f...
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Elsevier
2025-05-01
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| Series: | Brazilian Journal of Otorhinolaryngology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1808869425000060 |
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| author | Luis Lassaletta Miryam Calvino Isabel Sánchez-Cuadrado José Manuel Morales-Puebla Javier Gavilán |
| author_facet | Luis Lassaletta Miryam Calvino Isabel Sánchez-Cuadrado José Manuel Morales-Puebla Javier Gavilán |
| author_sort | Luis Lassaletta |
| collection | DOAJ |
| description | Objectives: In recent years, indications for Cochlear Implants (CIs) have been on the rise, with Vestibular Schwannoma (VS) patients among these emerging indications. On the other hand, there is growing evidence in favor of the 'wait and see' approach as opposed to surgery or irradiation for most small VS. The aim of this paper is to discuss the current role of CIs in patients with VS, addressing the most controversial topics such as the variability of outcomes, the emerging clinical scenarios, the lack of consistent prognostic factors, and the need for an intraoperative tool to aid decision-making in challenging cases. Methods: A Pubmed search was performed, with a selection of relevant citations, and critical appraisal of selected studies. Articles written in English on VS and cochlear implantation were eligible for inclusion. Pictures of illustrative cases from a tertiary center were included. Results: The discussed topics were the following: (1) Variability in audiological outcomes; (2) Prognostic factors including tumor size, preoperative hearing, previous irradiation, extent of resection, and Neurofibromatosis type II (NF2) status; (3) Postoperative imaging; (4) The role of intraoperative testing; and (5) The current indication of CIs in different clinical scenarios. Conclusions: CIs have become a useful solution for certain patients with VS. Audiological outcomes are variable, but worse than those of conventional CI candidates. Small and medium-sized tumors and those with a better preoperative hearing are more likely to benefit from a CI. The effect of irradiation is uncertain. Outcomes in NF2 patients may decrease in the long term. The auditory nerve test system is a useful intraoperative tool in most scenarios. The variability of the outcomes still precludes routine CI in VS with normal contralateral hearing. In addition to VS undergoing surgical resection and CI placement, some observed and irradiated VS cases also benefit from a CI. Level of evidence: 5. |
| format | Article |
| id | doaj-art-f317b9e16ab9439297b14dddf8c8a2ee |
| institution | Kabale University |
| issn | 1808-8694 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Otorhinolaryngology |
| spelling | doaj-art-f317b9e16ab9439297b14dddf8c8a2ee2025-02-07T04:47:23ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942025-05-01913101563Cochlear implantation in vestibular schwannoma: A game changer? A narrative reviewLuis Lassaletta0Miryam Calvino1Isabel Sánchez-Cuadrado2José Manuel Morales-Puebla3Javier Gavilán4Hospital Universitario La Paz, IdiPAZ Research Institute, Department of Otorhinolaryngology, Madrid, Spain; Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain; Corresponding author.Hospital Universitario La Paz, IdiPAZ Research Institute, Department of Otorhinolaryngology, Madrid, Spain; Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, SpainHospital Universitario La Paz, IdiPAZ Research Institute, Department of Otorhinolaryngology, Madrid, SpainHospital Universitario La Paz, IdiPAZ Research Institute, Department of Otorhinolaryngology, Madrid, Spain; Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, SpainHospital Universitario La Paz, IdiPAZ Research Institute, Department of Otorhinolaryngology, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, SpainObjectives: In recent years, indications for Cochlear Implants (CIs) have been on the rise, with Vestibular Schwannoma (VS) patients among these emerging indications. On the other hand, there is growing evidence in favor of the 'wait and see' approach as opposed to surgery or irradiation for most small VS. The aim of this paper is to discuss the current role of CIs in patients with VS, addressing the most controversial topics such as the variability of outcomes, the emerging clinical scenarios, the lack of consistent prognostic factors, and the need for an intraoperative tool to aid decision-making in challenging cases. Methods: A Pubmed search was performed, with a selection of relevant citations, and critical appraisal of selected studies. Articles written in English on VS and cochlear implantation were eligible for inclusion. Pictures of illustrative cases from a tertiary center were included. Results: The discussed topics were the following: (1) Variability in audiological outcomes; (2) Prognostic factors including tumor size, preoperative hearing, previous irradiation, extent of resection, and Neurofibromatosis type II (NF2) status; (3) Postoperative imaging; (4) The role of intraoperative testing; and (5) The current indication of CIs in different clinical scenarios. Conclusions: CIs have become a useful solution for certain patients with VS. Audiological outcomes are variable, but worse than those of conventional CI candidates. Small and medium-sized tumors and those with a better preoperative hearing are more likely to benefit from a CI. The effect of irradiation is uncertain. Outcomes in NF2 patients may decrease in the long term. The auditory nerve test system is a useful intraoperative tool in most scenarios. The variability of the outcomes still precludes routine CI in VS with normal contralateral hearing. In addition to VS undergoing surgical resection and CI placement, some observed and irradiated VS cases also benefit from a CI. Level of evidence: 5.http://www.sciencedirect.com/science/article/pii/S1808869425000060Vestibular schwannomaHearing lossCochlear implantationNeurofibromatosis type-2Auditory Nerve Test System (ANTS) |
| spellingShingle | Luis Lassaletta Miryam Calvino Isabel Sánchez-Cuadrado José Manuel Morales-Puebla Javier Gavilán Cochlear implantation in vestibular schwannoma: A game changer? A narrative review Brazilian Journal of Otorhinolaryngology Vestibular schwannoma Hearing loss Cochlear implantation Neurofibromatosis type-2 Auditory Nerve Test System (ANTS) |
| title | Cochlear implantation in vestibular schwannoma: A game changer? A narrative review |
| title_full | Cochlear implantation in vestibular schwannoma: A game changer? A narrative review |
| title_fullStr | Cochlear implantation in vestibular schwannoma: A game changer? A narrative review |
| title_full_unstemmed | Cochlear implantation in vestibular schwannoma: A game changer? A narrative review |
| title_short | Cochlear implantation in vestibular schwannoma: A game changer? A narrative review |
| title_sort | cochlear implantation in vestibular schwannoma a game changer a narrative review |
| topic | Vestibular schwannoma Hearing loss Cochlear implantation Neurofibromatosis type-2 Auditory Nerve Test System (ANTS) |
| url | http://www.sciencedirect.com/science/article/pii/S1808869425000060 |
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