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Cochlear implantation for hearing loss associated with bilateral endolymphatic sac tumors in von Hippel-Lindau disease.

Jagannathan J, Lonser RR, Stanger RA, Butman JA, Vortmeyer AO, Zalewski CK, Brewer C, Surowicz C, Kim HJ

Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414, USA.

OBJECTIVE: Bilateral endolymphatic sac tumors (ELSTs) are associated with von Hippel-Lindau disease and often underlie significant audiovestibular morbidity, including hearing loss. PATIENT: This 44-year-old female von Hippel-Lindau disease patient presented with tinnitus, vertigo, and binaural hearing loss. Magnetic resonance and computed tomography imaging demonstrated bilateral ELSTs, and audiometry confirmed bilateral hearing loss. INTERVENTION: The patient underwent staged resection of the ELSTs (left then right). After resection of the left ELST and during the same operation, a cochlear implant was placed. MAIN OUTCOME MEASURES: Clinical, audiometric, and imaging data. RESULTS: Postoperatively, the patient had resolution of tinnitus and vertigo with a significant implant-aided improvement in hearing. CONCLUSION: Because of their unique anatomic and biologic features, resection of bilateral tumors and cochlear implantation in deaf ELST patients is a potential option to improve hearing and quality of life.

Published 16 October 2007 in Otol Neurotol, 28(7): 927-30.
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