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Cochlear patency following translabyrinthine vestibular schwannoma resection: implications for hearing rehabilitation

Published online by Cambridge University Press:  03 July 2019

V Carswell ,
J A Crowther ,
R Locke ,
W Taylor  and
G Kontorinis
V Carswell
Affiliation:
Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
J A Crowther
Affiliation:
Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
R Locke
Affiliation:
Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
W Taylor
Affiliation:
Department of Neurosurgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
G Kontorinis*
Affiliation:
Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
*
Author for correspondence: Mr Georgios Kontorinis, Department of Otolaryngology, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, Scotland, UK E-mail: gkontorinis@gmail.com
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Abstract

Objective

To examine when cochlear fibrosis occurs following a translabyrinthine approach for vestibular schwannoma resection, and to determine the safest time window for potential cochlear implantation in cases with a preserved cochlear nerve.

Methods

This study retrospectively reviewed the post-operative magnetic resonance imaging scans of patients undergoing a translabyrinthine approach for vestibular schwannoma resection, assessing the fluid signal within the cochlea. Cochleae were graded based on the Isaacson et al. system (from grade 0 – no obstruction, to grade 4 – complete obliteration).

Results

Thirty-nine patients fulfilled the inclusion criteria. The cochleae showed no evidence of obliteration in: 75 per cent of patients at six months, 38.5 per cent at one year and 27 per cent beyond one year. Most changes happened between 6 and 12 months after vestibular schwannoma resection, with cases of an unobstructed cochlear decreasing dramatically, from 75 per cent to 38.5 per cent, within this time.

Conclusion

The progress of cochlear obliteration that occurred between 6 and 12 months following vestibular schwannoma resection indicates that the first 6 months provides a safer time window for cochlear patency.

Keywords

Acoustic NeuromaCochleaCochlear ImplantationFibrosisMagnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 7 , July 2019 , pp. 560 - 565
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Mr G Kontorinis takes responsibility for the integrity of the content of the paper

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