Cochlear Implantation in NF2 Patients Without Intracochlear Schwannoma Removal

Objective: To determine if cochlear implantation without removal of inner ear schwannomas (IES) is an effective treatment option for Neurofibromatosis 2 (NF2) patients. To determine how the presence of an intracochlear schwannoma might impact cochlear implant (CI) outcomes and programming parameters. Study Design: Retrospective chart review. Setting: Tertiary center for cochlear and auditory brainstem implantation. Patients: Of 10 NF2 patients with IES, 8 are reported with no previous tumor removal on the implanted ear. Interventions: Cochlear implant without tumor removal. Main Outcome Measures: Performance outcomes with CI at least 1-year post intervention. Programming parameters, including impedances, for patients with IES. Results: All patients had full insertion of the electrode arrays with round window approaches. Performance outcomes ranged from 0 to 100% for Bamford-Kowal-Bench sentences. Impedance measurements for active electrodes for patients with IES were comparable to those measured in patients without vestibular schwannoma (VS). Only patients who had radiation treatment before receiving their implant had elevated threshold requirements for CI programming compared with CI recipients without VS. Conclusion: Cochlear implantation without tumor removal is an effective option for treating NF2 patients with IES. The presence of an intracochlear tumor did not have an impact on CI performance or programming requirements compared with patients without VS; however, previous treatment with radiation may be related to elevated current requirements in the CI settings.