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An Improved Technique of Subtotal Cochleoectomy for Removal of Intracochlear Schwannoma and Single-stage Cochlear Implantation

Cochlear implantation in patients with intracochlear schwannomas has been reported anecdotally in case reports or small case series (1–5). The applied techniques have varied considerably ranging from extended cochleostomy (2–4), “push-through” and ”pull-through” techniques (3,4), partial and subtota...

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Autor principal: Plontke, Stefan K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373454/
https://www.ncbi.nlm.nih.gov/pubmed/32658406
http://dx.doi.org/10.1097/MAO.0000000000002718
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author Plontke, Stefan K.
author_facet Plontke, Stefan K.
author_sort Plontke, Stefan K.
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description Cochlear implantation in patients with intracochlear schwannomas has been reported anecdotally in case reports or small case series (1–5). The applied techniques have varied considerably ranging from extended cochleostomy (2–4), “push-through” and ”pull-through” techniques (3,4), partial and subtotal cochleoectomy (4) to cochlear implant insertion through the tumor (5). We here illustrate (see Video, Supplemental Digital Content 1) our improved surgical technique of subtotal cochleoectomy for tumor removal, cochlear implantation, and cochlear defect reconstruction with a “cartilage-in-perichondrium-bed” technique. The perimodiolar electrode array was closely placed around the preserved modiolus of the basal and second turn. It was stabilized and the electrodes were further approximated to the spiral ganglion cells in Rosenthal's canal with cartilage chips peripheral to the array. Despite substantial trauma to the cochlear capsule, surprisingly good results with respect to hearing rehabilitation were observed (word recognition score for monosyllables: 75% at 65 dB SPL, 18 mo after surgery). This good outcome is in accordance with recent case series on cochlear implantation after intracochlear tumor removal (6,7).
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spelling pubmed-73734542020-08-05 An Improved Technique of Subtotal Cochleoectomy for Removal of Intracochlear Schwannoma and Single-stage Cochlear Implantation Plontke, Stefan K. Otol Neurotol Video Reports Cochlear implantation in patients with intracochlear schwannomas has been reported anecdotally in case reports or small case series (1–5). The applied techniques have varied considerably ranging from extended cochleostomy (2–4), “push-through” and ”pull-through” techniques (3,4), partial and subtotal cochleoectomy (4) to cochlear implant insertion through the tumor (5). We here illustrate (see Video, Supplemental Digital Content 1) our improved surgical technique of subtotal cochleoectomy for tumor removal, cochlear implantation, and cochlear defect reconstruction with a “cartilage-in-perichondrium-bed” technique. The perimodiolar electrode array was closely placed around the preserved modiolus of the basal and second turn. It was stabilized and the electrodes were further approximated to the spiral ganglion cells in Rosenthal's canal with cartilage chips peripheral to the array. Despite substantial trauma to the cochlear capsule, surprisingly good results with respect to hearing rehabilitation were observed (word recognition score for monosyllables: 75% at 65 dB SPL, 18 mo after surgery). This good outcome is in accordance with recent case series on cochlear implantation after intracochlear tumor removal (6,7). Lippincott Williams & Wilkins 2020-08 2020-07-03 /pmc/articles/PMC7373454/ /pubmed/32658406 http://dx.doi.org/10.1097/MAO.0000000000002718 Text en Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Otology & Neurotology, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Video Reports
Plontke, Stefan K.
An Improved Technique of Subtotal Cochleoectomy for Removal of Intracochlear Schwannoma and Single-stage Cochlear Implantation
title An Improved Technique of Subtotal Cochleoectomy for Removal of Intracochlear Schwannoma and Single-stage Cochlear Implantation
title_full An Improved Technique of Subtotal Cochleoectomy for Removal of Intracochlear Schwannoma and Single-stage Cochlear Implantation
title_fullStr An Improved Technique of Subtotal Cochleoectomy for Removal of Intracochlear Schwannoma and Single-stage Cochlear Implantation
title_full_unstemmed An Improved Technique of Subtotal Cochleoectomy for Removal of Intracochlear Schwannoma and Single-stage Cochlear Implantation
title_short An Improved Technique of Subtotal Cochleoectomy for Removal of Intracochlear Schwannoma and Single-stage Cochlear Implantation
title_sort improved technique of subtotal cochleoectomy for removal of intracochlear schwannoma and single-stage cochlear implantation
topic Video Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373454/
https://www.ncbi.nlm.nih.gov/pubmed/32658406
http://dx.doi.org/10.1097/MAO.0000000000002718
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