Objective diagnostics by eBERA in the resection of vestibular schwannoma

The most common clinical symptoms of patients with vestibular schwannoma are hearing loss, tinnitus and vertigo. In case of functional deafness, intracochlear and intrameatal schwannomas can be treated by translabyrinthine approach and simultaneous cochlear implantation for hearing rehabilitation. Whether the patient will benefit from the cochlear implant postoperatively is difficult to predict preoperatively and intraoperatively based on current knowledge. An electrically evoked brainstem audiometry (eBERA) performed intraoperatively can give first indications. Since 2015, 12 vestibular schwannoma patients (7 intrameatal and 5 intracochlear/-labyrinthine vestibular schwannomas) at the Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner" Rostock have been treated with a cochlea implant (7 simultaneously and 5 sequentially). An eBERA was performed intraoperatively in 7 patients. 6 patients showed well reproducible stimulus responses; these patients had an auditory perception postoperatively with the cochlear implant (Freiburger Numbers at 65 dB SPL: 84 ± 20 %; Freiburger Monosyllables at 65 dB SPL: 32 ± 30 %). One patient had no intraoperative stimulus response, this patient had no postoperative hearing with the cochlear implant, so that the cochlear implant was explanated 1 year postoperatively. Objective diagnostics by eBERA in the resection of vestibular schwannoma is a possible intraoperative predictor for the postoperative success of the cochlear implant restoration.

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Publication History

Article published online:
10 June 2020