Clin Exp Otorhinolaryngol.  2015 Dec;8(4):329-334. 10.3342/ceo.2015.8.4.329.

Cochlear Implantation for Profound Hearing Loss After Multimodal Treatment for Neuroblastoma in Children

• Ryu NG
• Moon IJ
• Chang YS
• Kim BK
• Chung WH
• Cho YS
• Hong SH

• KMID: 2128905
• DOI: http://doi.org/10.3342/ceo.2015.8.4.329

Abstract

OBJECTIVES
Neuroblastoma (NBL) predominantly affects children under 5 years of age. Through multimodal therapy, including chemotherapy, radiotherapy, surgery, and peripheral blood stem cell transplantation, the survival rate in patients with NBL have improved while treatment-related complications have also increased. Treatment-related ototoxicity, mainly from cisplatin, can result in profound hearing loss requiring cochlear implantation (CI). We analyzed the effectiveness and hearing preservation of CI recipients who had treated with multimodal therapy due to NBL.
METHODS
Patients who received multimodal therapy for NBL and subsequent CIs were enrolled. A detailed review of the perioperative hearing test, speech evaluation, and posttreatment complications was conducted. Speech performance was analyzed using the category of auditory performance (CAP) score and the postoperative hearing preservation of low frequencies was also compared. Patients who were candidates for electro-acoustic stimulation (EAS) used an EAS electrode for low frequency hearing preservation.
RESULTS
Three patients were identified and all patients showed improvement of speech performance after CI. The average of CAP score improved from 4.3 preoperatively to 5.8 at 1 year postoperatively. Two patients who were fitted with the Flex electrode showed complete hearing preservation and the preserved hearing was maintained over 1 year. The one remaining patient was given the standard CI-512 electrode and showed partial hearing preservation.
CONCLUSION
Patients with profound hearing loss resulting from NBL multimodal therapy can be good candidates for CI, especially for EAS. A soft surgical technique as well as a specifically designed electrode should be applied to this specific population during the CI operation in order to preserve residual hearing and achieve better outcomes.

Keyword

Neuroblastoma; Chemotherapy; Cochlear Implantation; Hearing Loss

MeSH Terms

Child*
Cisplatin
Cochlear Implantation*
Cochlear Implants*
Combined Modality Therapy*
Drug Therapy
Electrodes
Hearing Loss*
Hearing Tests
Hearing*
Humans
Neuroblastoma*
Peripheral Blood Stem Cell Transplantation
Radiotherapy
Survival Rate
Cisplatin

Figure

• 

  Fig. 1 Pre- and postoperative hearing threshold of patients. Patient 1 (A), patient 2 (B), and patient 3 (C) are shown.

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