J Neurol Surg B Skull Base 2016; 77 - LFP-09-08
DOI: 10.1055/s-0036-1592605

CI and ABI in One Patient: Benefit of an Unusual Combination

Konrad Schwager 1, Robert Behr 2, Wafaa Shehata Dieler 3
  • 1Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Philipps University of Marburg, Campus Fulda, Marburg, Germany
  • 2Department of Neurosurgery, Head and Skull Base Center, Philipps University of Marburg, Campus Fulda, Marburg, Germany
  • 3Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany

Objective: A 59 old woman presented with a sudden hearing loss left ear up to 60 dB pancochlear at the department of otorhinolaryngology. The right ear was deaf since early childhood without personal memories of hearing.

Methods: The patient was treated with high dose i.v. corticosteroids. An MR-scan revealed a vestibular schwannoma on the left side with an extrameatal extension of 2.5 cm. The decision was made to implant the right cochlea first. Three month after cochlear implantation the vestibula schwannoma was extirpated via a suboccipital approach interdisciplinary neurosurgical and otosurgical. Because of the low performance on the CI-site after a long period of deafness, during vestibular schwannoma surgery an auditory brainstem implant was inserted.

Results: The patient uses both devices. In the free field audiometry the threshold with CI only is between 30 and 55 dB, with ABI only between 55 and 65 dB. Using both devices it is between 35 and 55 dB. In speech audiometry (Freiburg numbers without lip reading) the patient achieves 10% with CI only and 10% with ABI only, combining both devices 40%.

Conclusion: Instead of different anatomical site of stimulation (i.e., cochlea versus brainstem) there is an obvious advantage of using CI and ABI together. In situation like the described a remarkable benefit and an increase in quality of life can be obtained.