Cochlear Implantation Outcomes in Patients With Retrocochlear Pathology: A Systematic Review and Pooled Analysis
Otology & Neurology
Schlacter, J. A., Kay-Rivest, E., et al. (2022).
Otology & Neurology, 43(9), 980-986.
This systematic review investigates the effects of unilateral or bilateral cochlear implantation (CI) on speech perception scores and device outcomes (e.g., daily use time, failure rates, duration of benefit) between 6-12 months after CI in adults, 18 years and older, with retrocochlear pathologies (i.e., vestibular schwannoma [VS], meningiomas, central nervous system [CNS] or head and neck cancers, neurosarcoidosis, sideroses, NF2).
SR MA Compendium
Not stated
From database inception to March 7, 2022
All study designs, excluding non-English studies containing aggregated data and conference abstracts.
53
Adults with retrocochlear pathologies who receive a CI demonstrated improved consonant-nucleus-consonant (CNC) word scores from a preoperative average of 7.3% (SD=12.7) to a postoperative average score of 46.2% (SD=25.3). Individual pathologies showed the following mean change in average CNC scores: irradiated vestibular schwannoma (VS; 29.7%; SD= 22.6), observed VS (40.0%; SD= 26.6), superficial siderosis (25.6%; SD=35.3), neurosarcoidosis (78.0%; SD=2.8), and previous CNS/skull base irradiation (34.4%; SD=29.8). <br /><br />The included studies reported limited adverse events, demonstrated heterogeneity in the tests used for assessing speech discrimination, and showed a high risk of bias due to their retrospective study designs. With 80% of patients demonstrating improved speech perception post-CI, the authors conclude that "a retrocochlear pathology should not preclude CI consideration" (p. 983).
