Intraoperative Cochlear Nerve Monitoring in Cochlear Implantation after Vestibular Schwannoma Resection

被引:9
作者
Fiasca, Valerio Maria Di Pasquale [1 ]
Tealdo, Giulia [1 ]
机构
[1] Univ Padua, Dept Neurosci, Otolaryngol Unit, Sect Otolaryngol, Via Giustiniani 2, I-35128 Padua, Italy
关键词
vestibular schwannoma; cochlear implant; intraoperative monitoring; BRAIN-STEM RESPONSES; HEARING; SURGERY; MANAGEMENT; OUTCOMES;
D O I
10.3390/audiolres13030035
中图分类号
R36 [病理学]; R76 [耳鼻咽喉科学];
学科分类号
100104 ; 100213 ;
摘要
Background: The use of a cochlear implant (CI) for hearing rehabilitation after vestibular schwannoma (VS) resection is widely spreading. The procedure is usually performed simultaneously to tumor resection with a translabyrinthine approach. To ensure the best device function, assessing the integrity of the cochlear nerve is of primary importance. Methods: A narrative review of the literature on the present topic was carried out up to June 2022. Finally, nine studies were considered. Results: Electrically evoked auditory brainstem responses (eABR) is the most widely used method of intraoperative monitoring of cochlear nerve (CN) during VS resection, although its limits are known. It can be assessed through the CI electrode array or through an intracochlear test electrode (ITE). Variations of the graph are evaluated during the surgical procedure, in particular the wave V amplitude and latency. As tumor dissection progresses, the parameters may change, informing of the CN status, and the surgical procedure may be modulated. Conclusion: An eABR positive result seems to be reliably correlated with a good CI outcome in those cases in which a clear wave V is recorded before and after tumor removal. On the contrary, in those cases in which the eABR is lost or altered during the surgical procedure, the positioning of a CI is still debatable.
引用
收藏
页码:398 / 407
页数:10
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