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Intraoperative Monitoring of the Cochlear Nerve during Neurofibromatosis Type-2 Vestibular Schwannoma Surgery and Description of a "Test Intracochlear Electrode".

Published version
Peer-reviewed

Type

Article

Change log

Authors

Kasbekar, Anand V 
Tam, Yu Chuen 
Carlyon, Robert P 
Deeks, John M 
Donnelly, Neil 

Abstract

Objectives  A decision on whether to insert a cochlear implant can be made in neurofibromatosis 2 (NF2) if there is objective evidence of cochlear nerve (CN) function post vestibular schwannoma (VS) excision. We aimed to develop intraoperative CN monitoring to help in this decision. Design  We describe the intraoperative monitoring of a patient with NF2 and our stimulating and recording set up. A novel test electrode is used to stimulate the CN electrically. Setting  This study was set at a tertiary referral center for skull base pathology. Main outcome measure  Preserved auditory brainstem responses leading to cochlear implantation. Results  Electrical auditory brainstem response (EABR) waveforms will be displayed from different stages of the operation. A cochlear implant was inserted at the same sitting based on the EABR. Conclusion  Electrically evoked CN monitoring can provide objective evidence of CN function after VS excision and aid in the decision-making process of hearing rehabilitation in patients who will be rendered deaf.

Description

Keywords

EABR, cochlear nerve monitoring, hearing preservation, neurofibromatosis type 2

Journal Title

J Neurol Surg Rep

Conference Name

Journal ISSN

2193-6358
2193-6366

Volume Title

80

Publisher

Georg Thieme Verlag KG
Sponsorship
MRC (unknown)
Medical Research Council (MC_UU_00005/3)