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Cochlear Implantation following therapy of acoustic neuroma
Langer J. , Pethe W. , Braun A. , Begall K.
AMEOS Klinikum Halberstadt, ENT Department, Halberstadt, Germany, 2Cochlear Implant Rehab.-Center Saxony-Anhalt, Halberstadt,
Tumors of the inner ear canal are a rarity. Depending on the size of tumor hearing loss can occur. Sometimes an
acoustic neuroma is found during investigation regarding cochlear implantation. Radiotherapy of these tumors
represents an increasing alternative treatment instead of surgery. A successful Cochlear Implantation after
stereotactic or surgical treatment of an acoustic neuroma is bound to the presence of functional nerve fibers of
the N. cochlearis.
3 patients where investigated for Cochlear Implantation after irradiation (n=1) or surgery (n=2) of an acoustic
neuroma at the ENT-Hospital Halberstadt between 01/2012 and 08/2013.
A positive promontory testing was seen in 2 patients. One was treated surgically and one by radiotherapy.
Positive promontory test means to receive an acoustic signal during electrical stimulation by using a thin needle
placed on the promontory.
A second patient after neuroma-surgery showed a negative promontory test. The positive result of the
promontory test was the criteria for the Cochlear Implantation. The patient with negative promontory testing did
not get an advise for Cochlear Implant-surgery. Both patients implanted with a CI show an improvement of
speech perception after 6 and 10 days of rehabilitation.
The outcome in Freiburger number-test achieves 100% in both cases, the monosyllabics were detected correct
in 45% (patient after irradiation) and 15% (patient after surgery) at a level of 65dB in quite. Cochlear Implantation
is an appropriate method to restore hearing after acoustic neuroma-treatment. A positive promontory testing in
such cases is mandatory as well as an intensive information preoperatively regarding possible results below the
over-all average in comparison of patients implanted without acoustic neuroma anamnesis.