Download 13th International Conference on Cochlear Implants and Other

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Cochlear nerve preservation during acoustic neuroma removal - our experience and discussion of
relevance to a cochlear implantation program
Eisenberg R.
nn, Newcastle, Australia
Introduction: Increased numbers of acoustic neuromas (vestibular schwannoma,VS) are being discovered.
Some patients with VS desire a hearing solution with cochlear implantation.
Some patients with VS would like their tumor removed rather than monitored.
Insertion of a cochlear implant precludes MRI monitoring of an ipsilateral VS.
Provided the cochlear nerve is preserved cochlear implantation can be performed in the same surgery as
removal of the tumor.
Methods: 5 patients with VS requesting surgery were selected for attempted cochlear nerve preservation during
VS removal. Intraoperative monitoring of the cochlear nerve was performed by either round window electrically
evoked auditory brainstem response(EABR), direct stimulation EABR (from cochlear nerve in lateral internal
auditory canal) or cochlear implant EABR or a combination thereof. Postoperative audiological assessment of all
patients was performed using pure tone audiometry, implant evoked audiometry and speech discrimination
measures. A thorough elaboration of our techniques, results and potential pitfalls will be provided.
Conclusion: Cochlear nerve preservation is achievable in selected patients undergoing surgery for VS.
Intraoperative monitoring has been of assistance in confirming anatomical preservation of the nerve allowing
cochlear implantation.