Joseph Roche, M.D.
Assistant Professor, Department of Surgery, UW-Madison
Cochlear Implants for Tumors? From Fringe Treatment to a Next Generation Management Option for Patients with Vestibular Schwannoma
Neurofibromatosis type-2 (NF2) is an autosomal dominant genetic condition resulting in multiple benign central nervous system (CNS) tumors, including the hallmark finding of bilateral schwannomas of the vestibulocochlear nerves (AKA vestibular schwannomas). Hearing loss is a near universal symptom for these patients due to tumor induced derangement of auditory nerve fibers, the effect of CNS tumor treatment or both. Due to the nature of the induced hearing losses, aural preservation / rehabilitation has required non-traditional strategies including auditory brainstem implantation. Additionally, the retrocochlear mechanisms of NF-2 hearing losses precluded consideration of cochlear device implantation. Recent data, including work from the University of Wisconsin Cochlear Implant Program, has demonstrated that cochlear implantation is an effective aural rehabilitation option. Now, based on previous success in NF-2 subjects, cochlear implantation is being explored as a hearing restoration option for cerebellopontine angle tumors outside of NF-2. Recent data demonstrating cochlear implantation efficacy in sporadic vestibular schwannoma will be presented.