Simultaneous Nonmastoidectomy Infrapromontorial Tumor Removal and Cochlear Implantation in Vestibular Schwannoma Patient

Abstract

Introduction: Restoration of hearing in patients with vestibular schwannoma (VS) and poor hearing poses a great challenge. Simultaneous cochlear implantation during surgery for VS removal offers favorable hearing outcome if the cochlear nerve remains intact. Recent refinement of surgical techniques using the endoscope has made it possible to simultaneously restore the hearing and remove the tumor.

Case description: A 62-year-old male had left severe sensorineural hearing loss and a 4 mm intracanalicular VS. We performed simultaneous nonmastoidectomy infrapromontorial VS removal and cochlear implantation in this patient to achieve minimal invasiveness and to provide maximal hearing restoration. The tumor was removed via this corridor while maintaining the integrity of cochlear as well as facial nerves with full insertion of a medium length cochlear implant electrode. After surgery, the patient showed good hearing rehabilitation.

Conclusion: Simultaneous infrapromontorial VS removal and nonmastoidectomy cochlear implantation serves as an option for hearing restoration with minimal invasiveness in small VS removal.