Cochlear Implantation with Labyrinthectomy: Indications, Considerations, and Outcomes

The purpose of this review is to examine current evidence concerning cochlear implantation in the setting of previous or simultaneous labyrinthectomy.

Recent data support the use of cochlear implants (CIs) in certain settings where labyrinthectomy is indicated. Clinical situations where this was examined include refractory Meniere’s disease, inner ear schwannoma, and vestibular schwannoma. For Meniere’s disease and inner ear schwannoma, data support outcomes that are on par with general CI recipients. Implantation in the setting of labyrinthectomy for vestibular schwannoma is less consistent; however, simultaneous cochlear implantation with labyrinthectomy provides unique options for nerve monitoring in these patients.

CI is a viable strategy for hearing rehabilitation among patients with vestibular disease or vestibular schwannoma in cases where management incorporates labyrinthectomy. The use of CIs in these settings requires unique considerations given risk of cochlear ossification, potential partial cochlectomy for tumor access, manipulation of the cochlear modiolus or cochlear nerve, and the ability to use CIs for cochlear nerve monitoring during vestibular schwannoma resection.