Promontory electrical stimulation in postoperative acoustic tumor patients.
Complete deafness can follow acoustic tumor surgery and results from labyrinthine injury, auditory nerve trauma, and/or vascular compromise. A central auditory prosthesis is one potential rehabilitative strategy in such patients. Anatomical studies suggest that some spiral ganglion cells may survive after vascular occlusion, and we have demonstrated responses to electrical stimulation in patients after labyrinthectomy. It was thus hypothesized that patients deafened after a hearing conservation attempt, but maintaining an intact auditory nerve, could utilize an intracochlear implant. To investigate this possibility, promontory electrical stimulation was performed on three patients who had tumors less than 2 cm and who had serviceable preoperative hearing, but no responses postoperatively. Behavioral responses and electrically evoked auditory brainstem and middle latency responses were obtained from two patients, one of whom was 6 years postsurgery. These data indicate that a cochlear implant may be possible after acoustic tumor surgery.
Lambert
P R
PR
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.
Ruth
R A
RA
Thomas
J F
JF
D000328:Adult; D001309:Auditory Threshold / Q000502:physiology; D003054:Cochlear Implants; D003390:Cranial Nerve Neoplasms / Q000503:physiopathology / Q000601:surgery*; D003638:Deafness / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation; D004558:Electric Stimulation; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006801:Humans; D008144:Loudness Perception / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology* / Q000534:rehabilitation; D000159:Vestibulocochlear Nerve / Q000503:physiopathology*; D000160:Vestibulocochlear Nerve Diseases / Q000503:physiopathology / Q000601:surgery*