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Intralabyrinthine schwannomas: Surgical management and hearing rehabilitation with cochlear implants

Intralabyrinthine schwannomas (ILS) are a rare differential diagnosis of sudden hearing loss and vertigo. In an own case series of 12 patients, 6 tumors showed an intracochlear, 3 an intravestibular, 1 a transmodiolar including the cerebellopontine angle (CPA), 1a transotic including the CPA, and 1 ...

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Autores principales: Plontke, S. K., Rahne, T., Pfister, M., Götze, G., Heider, C., Pazaitis, N., Strauss, C., Caye-Thomasen, P., Kösling, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Medizin 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5554299/
https://www.ncbi.nlm.nih.gov/pubmed/28664238
http://dx.doi.org/10.1007/s00106-017-0364-6
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author Plontke, S. K.
Rahne, T.
Pfister, M.
Götze, G.
Heider, C.
Pazaitis, N.
Strauss, C.
Caye-Thomasen, P.
Kösling, S.
author_facet Plontke, S. K.
Rahne, T.
Pfister, M.
Götze, G.
Heider, C.
Pazaitis, N.
Strauss, C.
Caye-Thomasen, P.
Kösling, S.
author_sort Plontke, S. K.
collection PubMed
description Intralabyrinthine schwannomas (ILS) are a rare differential diagnosis of sudden hearing loss and vertigo. In an own case series of 12 patients, 6 tumors showed an intracochlear, 3 an intravestibular, 1 a transmodiolar including the cerebellopontine angle (CPA), 1a transotic including the CPA, and 1 a multilocular location. The tumors were removed surgically in 9 patients, whereas 3 patients decided for a “wait-and-test-and-scan” strategy. Of the surgical patients, 3 underwent labyrinthectomy and cochlear implant (CI) surgery in a single-stage procedure; 1 patient had extended cochleostomy with CI surgery; 3 underwent partial or subtotal cochleoectomy, with partial cochlear reconstruction and CI surgery (n = 1) or implantation of electrode dummies for possible later CI after repeated MRI follow-up (n = 2); and in 2 patients, the tumors of the internal auditory canal and cerebellopontine angle exhibiting transmodiolar or transmacular growth were removed by combined translabyrinthine–transotic resection. For the intracochlear tumors, vestibular function could mostly be preserved after surgery. In all cases with CI surgery, hearing rehabilitation was successful, although speech discrimination was limited for the case with subtotal cochleoectomy. Surgical removal of intracochlear schwannomas via partial or subtotal cochleoectomy is, in principle, possible with preservation of vestibular function. In the authors’ opinion, radiotherapy of ILS is only indicated in isolated cases. Cochlear implantation during or after tumor resection (i. e., as synchronous or staged surgeries) is an option for hearing rehabilitation in cartain cases and represents a therapeutic approach in contrast to a “wait-and-test-and-scan” strategy.
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spelling pubmed-55542992017-08-25 Intralabyrinthine schwannomas: Surgical management and hearing rehabilitation with cochlear implants Plontke, S. K. Rahne, T. Pfister, M. Götze, G. Heider, C. Pazaitis, N. Strauss, C. Caye-Thomasen, P. Kösling, S. HNO Original Articles Intralabyrinthine schwannomas (ILS) are a rare differential diagnosis of sudden hearing loss and vertigo. In an own case series of 12 patients, 6 tumors showed an intracochlear, 3 an intravestibular, 1 a transmodiolar including the cerebellopontine angle (CPA), 1a transotic including the CPA, and 1 a multilocular location. The tumors were removed surgically in 9 patients, whereas 3 patients decided for a “wait-and-test-and-scan” strategy. Of the surgical patients, 3 underwent labyrinthectomy and cochlear implant (CI) surgery in a single-stage procedure; 1 patient had extended cochleostomy with CI surgery; 3 underwent partial or subtotal cochleoectomy, with partial cochlear reconstruction and CI surgery (n = 1) or implantation of electrode dummies for possible later CI after repeated MRI follow-up (n = 2); and in 2 patients, the tumors of the internal auditory canal and cerebellopontine angle exhibiting transmodiolar or transmacular growth were removed by combined translabyrinthine–transotic resection. For the intracochlear tumors, vestibular function could mostly be preserved after surgery. In all cases with CI surgery, hearing rehabilitation was successful, although speech discrimination was limited for the case with subtotal cochleoectomy. Surgical removal of intracochlear schwannomas via partial or subtotal cochleoectomy is, in principle, possible with preservation of vestibular function. In the authors’ opinion, radiotherapy of ILS is only indicated in isolated cases. Cochlear implantation during or after tumor resection (i. e., as synchronous or staged surgeries) is an option for hearing rehabilitation in cartain cases and represents a therapeutic approach in contrast to a “wait-and-test-and-scan” strategy. Springer Medizin 2017-06-29 2017 /pmc/articles/PMC5554299/ /pubmed/28664238 http://dx.doi.org/10.1007/s00106-017-0364-6 Text en © The Author(s) 2017 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Articles
Plontke, S. K.
Rahne, T.
Pfister, M.
Götze, G.
Heider, C.
Pazaitis, N.
Strauss, C.
Caye-Thomasen, P.
Kösling, S.
Intralabyrinthine schwannomas: Surgical management and hearing rehabilitation with cochlear implants
title Intralabyrinthine schwannomas: Surgical management and hearing rehabilitation with cochlear implants
title_full Intralabyrinthine schwannomas: Surgical management and hearing rehabilitation with cochlear implants
title_fullStr Intralabyrinthine schwannomas: Surgical management and hearing rehabilitation with cochlear implants
title_full_unstemmed Intralabyrinthine schwannomas: Surgical management and hearing rehabilitation with cochlear implants
title_short Intralabyrinthine schwannomas: Surgical management and hearing rehabilitation with cochlear implants
title_sort intralabyrinthine schwannomas: surgical management and hearing rehabilitation with cochlear implants
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5554299/
https://www.ncbi.nlm.nih.gov/pubmed/28664238
http://dx.doi.org/10.1007/s00106-017-0364-6
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