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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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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2020
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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. |
collection | PubMed |
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). |
format | Online Article Text |
id | pubmed-7373454 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
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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