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Erschienen in: Child's Nervous System 10/2020

21.06.2020 | Annual issue paper

Options and strategies for hearing restoration in pediatric neurofibromatosis type 2

verfasst von: Hossein Mahboubi, William H. Slattery III, Gautam U. Mehta, Gregory P. Lekovic

Erschienen in: Child's Nervous System | Ausgabe 10/2020

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Abstract

Purpose

In this article, we will review the mechanisms and natural history of hearing loss in neurofibromatosis type 2 (NF2) and discuss the hearing outcomes with different rehabilitation options.

Methods

Review of the published literature.

Results

NF2 is a rare autosomal dominant syndrome characterized by vestibular schwannomas and other intracranial and spinal tumors. Bilateral vestibular schwannomas are the hallmark of the disease which occur in 90 to 95% of the patients. As a result, hearing loss will eventually occur in almost all NF2 patients. Deafness can occur from tumor progression or from treatment of vestibular schwannomas and is among the most debilitating aspects of NF2. A number of surgical and non-surgical rehabilitation options are available for these patients including cochlear and auditory brainstem implants. The audiologic outcomes with surgical rehabilitation options have been variable but most patients are able to achieve sound awareness and benefit from auditory cues in lip reading.

Conclusion

Early identification and treatment of NF2 patients can help in achieving better hearing outcomes in the pediatric population. An increasing number of NF2 patients are receiving open set word understanding with refinement in surgical techniques.
Literatur
1.
Zurück zum Zitat Plotkin SR, Merker VL, Muzikansky A, Barker FG 2nd, Slattery W 3rd. (2014) Natural history of vestibular schwannoma growth and hearing decline in newly diagnosed neurofibromatosis type 2 patients. Otol Neurotol 35(1):e50–e56PubMed Plotkin SR, Merker VL, Muzikansky A, Barker FG 2nd, Slattery W 3rd. (2014) Natural history of vestibular schwannoma growth and hearing decline in newly diagnosed neurofibromatosis type 2 patients. Otol Neurotol 35(1):e50–e56PubMed
2.
Zurück zum Zitat Evans DG, Moran A, King A, Saeed S, Gurusinghe N, Ramsden R (2005) Incidence of vestibular schwannoma and neurofibromatosis 2 in the North West of England over a 10-year period: higher incidence than previously thought. Otol Neurotol 26(1):93–97PubMed Evans DG, Moran A, King A, Saeed S, Gurusinghe N, Ramsden R (2005) Incidence of vestibular schwannoma and neurofibromatosis 2 in the North West of England over a 10-year period: higher incidence than previously thought. Otol Neurotol 26(1):93–97PubMed
3.
Zurück zum Zitat Rouleau GA, Wertelecki W, Haines JL, Hobbs WJ, Trofatter JA, Seizinger BR, Martuza RL, Superneau DW, Conneally PM, Gusella JF (1987) Genetic linkage of bilateral acoustic neurofibromatosis to a DNA marker on chromosome 22. Nature. 329(6136):246–248PubMed Rouleau GA, Wertelecki W, Haines JL, Hobbs WJ, Trofatter JA, Seizinger BR, Martuza RL, Superneau DW, Conneally PM, Gusella JF (1987) Genetic linkage of bilateral acoustic neurofibromatosis to a DNA marker on chromosome 22. Nature. 329(6136):246–248PubMed
4.
Zurück zum Zitat Slattery WH (2015) Neurofibromatosis type 2. Otolaryngol Clin N Am 48(3):443–460 Slattery WH (2015) Neurofibromatosis type 2. Otolaryngol Clin N Am 48(3):443–460
5.
6.
Zurück zum Zitat Gutmann DH, Aylsworth A, Carey JC, Korf B, Marks J, Pyeritz RE, Rubenstein A, Viskochil D (1997) The diagnostic evaluation and multidisciplinary management of neurofibromatosis 1 and neurofibromatosis 2. Jama. 278(1):51–57PubMed Gutmann DH, Aylsworth A, Carey JC, Korf B, Marks J, Pyeritz RE, Rubenstein A, Viskochil D (1997) The diagnostic evaluation and multidisciplinary management of neurofibromatosis 1 and neurofibromatosis 2. Jama. 278(1):51–57PubMed
7.
Zurück zum Zitat Baser ME, Friedman JM, Joe H, Shenton A, Wallace AJ, Ramsden RT, Evans DGR (2011) Empirical development of improved diagnostic criteria for neurofibromatosis 2. Genet Med 13(6):576–581PubMed Baser ME, Friedman JM, Joe H, Shenton A, Wallace AJ, Ramsden RT, Evans DGR (2011) Empirical development of improved diagnostic criteria for neurofibromatosis 2. Genet Med 13(6):576–581PubMed
8.
Zurück zum Zitat Asthagiri AR, Parry DM, Butman JA, Kim HJ, Tsilou ET, Zhuang Z, Lonser RR (2009) Neurofibromatosis type 2. Lancet. 373(9679):1974–1986PubMedPubMedCentral Asthagiri AR, Parry DM, Butman JA, Kim HJ, Tsilou ET, Zhuang Z, Lonser RR (2009) Neurofibromatosis type 2. Lancet. 373(9679):1974–1986PubMedPubMedCentral
9.
Zurück zum Zitat Ruggieri M (1999) The different forms of neurofibromatosis. Childs Nerv Syst 15(6–7):295–308PubMed Ruggieri M (1999) The different forms of neurofibromatosis. Childs Nerv Syst 15(6–7):295–308PubMed
10.
Zurück zum Zitat Mautner VF, Tatagiba M, Guthoff R, Samii M, Pulst SM (1993) Neurofibromatosis 2 in the pediatric age group. Neurosurgery. 33(1):92–96PubMed Mautner VF, Tatagiba M, Guthoff R, Samii M, Pulst SM (1993) Neurofibromatosis 2 in the pediatric age group. Neurosurgery. 33(1):92–96PubMed
11.
Zurück zum Zitat Ruggieri M, Pratico AD, Serra A et al (2016) Childhood neurofibromatosis type 2 (NF2) and related disorders: from bench to bedside and biologically targeted therapies. Acta Otorhinolaryngol Ital 36(5):345–367PubMedPubMedCentral Ruggieri M, Pratico AD, Serra A et al (2016) Childhood neurofibromatosis type 2 (NF2) and related disorders: from bench to bedside and biologically targeted therapies. Acta Otorhinolaryngol Ital 36(5):345–367PubMedPubMedCentral
12.
Zurück zum Zitat Ruggieri M, Gabriele AL, Polizzi A, Salpietro V, Nicita F, Pavone P, Platania N, Milone P, Distefano A, Privitera G, Belfiore G, Granata F, Caltabiano R, Albanese V, Pavone L, Quattrone A (2013) Natural history of neurofibromatosis type 2 with onset before the age of 1 year. Neurogenetics. 14(2):89–98PubMed Ruggieri M, Gabriele AL, Polizzi A, Salpietro V, Nicita F, Pavone P, Platania N, Milone P, Distefano A, Privitera G, Belfiore G, Granata F, Caltabiano R, Albanese V, Pavone L, Quattrone A (2013) Natural history of neurofibromatosis type 2 with onset before the age of 1 year. Neurogenetics. 14(2):89–98PubMed
13.
Zurück zum Zitat Otsuka G, Saito K, Nagatani T, Yoshida J (2003) Age at symptom onset and long-term survival in patients with neurofibromatosis type 2. J Neurosurg 99(3):480–483PubMed Otsuka G, Saito K, Nagatani T, Yoshida J (2003) Age at symptom onset and long-term survival in patients with neurofibromatosis type 2. J Neurosurg 99(3):480–483PubMed
14.
Zurück zum Zitat Baser ME, Friedman JM, Aeschliman D, Joe H, Wallace AJ, Ramsden RT, Evans DGR (2002) Predictors of the risk of mortality in neurofibromatosis 2. Am J Hum Genet 71(4):715–723PubMedPubMedCentral Baser ME, Friedman JM, Aeschliman D, Joe H, Wallace AJ, Ramsden RT, Evans DGR (2002) Predictors of the risk of mortality in neurofibromatosis 2. Am J Hum Genet 71(4):715–723PubMedPubMedCentral
15.
Zurück zum Zitat Mahboubi H, Maducdoc MM, Yau AY, Ziai K, Ghavami Y, Badran KW, al-Thobaiti M, Brandon B, Djalilian HR (2015) Vestibular Schwannoma excision in sporadic versus neurofibromatosis type 2 populations. Otolaryngol Head Neck Surg 153(5):822–831PubMed Mahboubi H, Maducdoc MM, Yau AY, Ziai K, Ghavami Y, Badran KW, al-Thobaiti M, Brandon B, Djalilian HR (2015) Vestibular Schwannoma excision in sporadic versus neurofibromatosis type 2 populations. Otolaryngol Head Neck Surg 153(5):822–831PubMed
16.
Zurück zum Zitat Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). American Academy of Otolaryngology-Head and Neck Surgery Foundation, INC. Otolaryngol Head Neck Surg. 1995;113(3):179–180 Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). American Academy of Otolaryngology-Head and Neck Surgery Foundation, INC. Otolaryngol Head Neck Surg. 1995;113(3):179–180
17.
Zurück zum Zitat Strasnick B, Glasscock ME 3rd, Haynes D, McMenomey SO, Minor LB (1994) The natural history of untreated acoustic neuromas. Laryngoscope. 104(9):1115–1119PubMed Strasnick B, Glasscock ME 3rd, Haynes D, McMenomey SO, Minor LB (1994) The natural history of untreated acoustic neuromas. Laryngoscope. 104(9):1115–1119PubMed
18.
Zurück zum Zitat Evans DG, Huson SM, Donnai D, Neary W, Blair V, Newton V, Harris R (1992) A clinical study of type 2 neurofibromatosis. Q J Med 84(304):603–618PubMed Evans DG, Huson SM, Donnai D, Neary W, Blair V, Newton V, Harris R (1992) A clinical study of type 2 neurofibromatosis. Q J Med 84(304):603–618PubMed
19.
Zurück zum Zitat Lee JM, Chang JW, Choi JY, Chang WS, Moon IS (2016) Hearing restoration in neurofibromatosis type II patients. Yonsei Med J 57(4):817–823PubMedPubMedCentral Lee JM, Chang JW, Choi JY, Chang WS, Moon IS (2016) Hearing restoration in neurofibromatosis type II patients. Yonsei Med J 57(4):817–823PubMedPubMedCentral
20.
Zurück zum Zitat Roosli C, Linthicum FH Jr, Cureoglu S, Merchant SN (2012) Dysfunction of the cochlea contributing to hearing loss in acoustic neuromas: an underappreciated entity. Otol Neurotol 33(3):473–480PubMedPubMedCentral Roosli C, Linthicum FH Jr, Cureoglu S, Merchant SN (2012) Dysfunction of the cochlea contributing to hearing loss in acoustic neuromas: an underappreciated entity. Otol Neurotol 33(3):473–480PubMedPubMedCentral
21.
Zurück zum Zitat Asthagiri AR, Vasquez RA, Butman JA, Wu T, Morgan K, Brewer CC, King K, Zalewski C, Kim HJ, Lonser RR (2012) Mechanisms of hearing loss in neurofibromatosis type 2. PLoS One 7(9):e46132PubMedPubMedCentral Asthagiri AR, Vasquez RA, Butman JA, Wu T, Morgan K, Brewer CC, King K, Zalewski C, Kim HJ, Lonser RR (2012) Mechanisms of hearing loss in neurofibromatosis type 2. PLoS One 7(9):e46132PubMedPubMedCentral
22.
Zurück zum Zitat Silverstein H (1973) Labyrinthine tap as a diagnostic test for acoustic neurinoma. Otolaryngol Clin N Am 6(1):229–244 Silverstein H (1973) Labyrinthine tap as a diagnostic test for acoustic neurinoma. Otolaryngol Clin N Am 6(1):229–244
23.
Zurück zum Zitat Hoa M, Slattery WH 3rd. (2012) Neurofibromatosis 2. Otolaryngol Clin N Am 45(2):315–332 viii Hoa M, Slattery WH 3rd. (2012) Neurofibromatosis 2. Otolaryngol Clin N Am 45(2):315–332 viii
24.
Zurück zum Zitat Masuda A, Fisher LM, Oppenheimer ML, Iqbal Z, Slattery WH (2004) Hearing changes after diagnosis in neurofibromatosis type 2. Otol Neurotol 25(2):150–154PubMed Masuda A, Fisher LM, Oppenheimer ML, Iqbal Z, Slattery WH (2004) Hearing changes after diagnosis in neurofibromatosis type 2. Otol Neurotol 25(2):150–154PubMed
25.
Zurück zum Zitat Slattery WH 3rd, Fisher LM, Hitselberger W, Friedman RA, Brackmann DE (2007) Hearing preservation surgery for neurofibromatosis type 2-related vestibular schwannoma in pediatric patients. J Neurosurg 106(4 Suppl):255–260PubMed Slattery WH 3rd, Fisher LM, Hitselberger W, Friedman RA, Brackmann DE (2007) Hearing preservation surgery for neurofibromatosis type 2-related vestibular schwannoma in pediatric patients. J Neurosurg 106(4 Suppl):255–260PubMed
26.
Zurück zum Zitat Slattery WH 3rd, Brackmann DE, Hitselberger W (1998) Hearing preservation in neurofibromatosis type 2. Am J Otolaryngol 19(5):638–643 Slattery WH 3rd, Brackmann DE, Hitselberger W (1998) Hearing preservation in neurofibromatosis type 2. Am J Otolaryngol 19(5):638–643
27.
Zurück zum Zitat Doyle KJ, Shelton C (1993) Hearing preservation in bilateral acoustic neuroma surgery. Am J Otolaryngol 14(6):562–565 Doyle KJ, Shelton C (1993) Hearing preservation in bilateral acoustic neuroma surgery. Am J Otolaryngol 14(6):562–565
28.
Zurück zum Zitat Friedman RA, Goddard JC, Wilkinson EP, Schwartz MS, Slattery WH III, Fayad JN, Brackmann DE (2011) Hearing preservation with the middle cranial fossa approach for neurofibromatosis type 2. Otol Neurotol 32(9):1530–1537PubMed Friedman RA, Goddard JC, Wilkinson EP, Schwartz MS, Slattery WH III, Fayad JN, Brackmann DE (2011) Hearing preservation with the middle cranial fossa approach for neurofibromatosis type 2. Otol Neurotol 32(9):1530–1537PubMed
29.
Zurück zum Zitat Gugel I, Grimm F, Liebsch M, Zipfel J, Teuber C, Kluwe L, Mautner VF, Tatagiba M, Schuhmann MU (2019) Impact of surgery on long-term results of hearing in neurofibromatosis type-2 associated vestibular schwannomas. Cancers (Basel) 11(9):1376 Gugel I, Grimm F, Liebsch M, Zipfel J, Teuber C, Kluwe L, Mautner VF, Tatagiba M, Schuhmann MU (2019) Impact of surgery on long-term results of hearing in neurofibromatosis type-2 associated vestibular schwannomas. Cancers (Basel) 11(9):1376
30.
Zurück zum Zitat Slattery WH, Hoa M, Bonne N, Friedman RA, Schwartz MS, Fisher LM, Brackmann DE (2011) Middle fossa decompression for hearing preservation: a review of institutional results and indications. Otol Neurotol 32(6):1017–1024PubMed Slattery WH, Hoa M, Bonne N, Friedman RA, Schwartz MS, Fisher LM, Brackmann DE (2011) Middle fossa decompression for hearing preservation: a review of institutional results and indications. Otol Neurotol 32(6):1017–1024PubMed
31.
Zurück zum Zitat Mathieu D, Kondziolka D, Flickinger JC, Niranjan A, Williamson R, Martin JJ, Lunsford LD (2007) Stereotactic radiosurgery for vestibular schwannomas in patients with neurofibromatosis type 2: an analysis of tumor control, complications, and hearing preservation rates. Neurosurgery. 60(3):460–468 discussion 468-470PubMed Mathieu D, Kondziolka D, Flickinger JC, Niranjan A, Williamson R, Martin JJ, Lunsford LD (2007) Stereotactic radiosurgery for vestibular schwannomas in patients with neurofibromatosis type 2: an analysis of tumor control, complications, and hearing preservation rates. Neurosurgery. 60(3):460–468 discussion 468-470PubMed
32.
Zurück zum Zitat Jansson KJ, Hakansson B, Reinfeldt S, Rigato C, Eeg-Olofsson M (2015) Magnetic resonance imaging investigation of the bone conduction implant - a pilot study at 1.5 Tesla. Med Devices (Auckl) 8:413–423 Jansson KJ, Hakansson B, Reinfeldt S, Rigato C, Eeg-Olofsson M (2015) Magnetic resonance imaging investigation of the bone conduction implant - a pilot study at 1.5 Tesla. Med Devices (Auckl) 8:413–423
33.
Zurück zum Zitat Drusin MA, Lubor B, Losenegger T, Selesnick S (2019) Trends in hearing rehabilitation use among vestibular schwannoma patients. Laryngoscope Drusin MA, Lubor B, Losenegger T, Selesnick S (2019) Trends in hearing rehabilitation use among vestibular schwannoma patients. Laryngoscope
34.
Zurück zum Zitat Hitselberger WE, House WF, Edgerton BJ, Whitaker S (1984) Cochlear nucleus implants. Otolaryngol Head Neck Surg 92(1):52–54PubMed Hitselberger WE, House WF, Edgerton BJ, Whitaker S (1984) Cochlear nucleus implants. Otolaryngol Head Neck Surg 92(1):52–54PubMed
35.
Zurück zum Zitat Otto SR, Shannon RV, Wilkinson EP, Hitselberger WE, McCreery DB, Moore JK, Brackmann DE (2008) Audiologic outcomes with the penetrating electrode auditory brainstem implant. Otol Neurotol 29(8):1147–1154PubMed Otto SR, Shannon RV, Wilkinson EP, Hitselberger WE, McCreery DB, Moore JK, Brackmann DE (2008) Audiologic outcomes with the penetrating electrode auditory brainstem implant. Otol Neurotol 29(8):1147–1154PubMed
36.
Zurück zum Zitat Choi JY, Song MH, Jeon JH, Lee WS, Chang JW (2011) Early surgical results of auditory brainstem implantation in nontumor patients. Laryngoscope. 121(12):2610–2618PubMed Choi JY, Song MH, Jeon JH, Lee WS, Chang JW (2011) Early surgical results of auditory brainstem implantation in nontumor patients. Laryngoscope. 121(12):2610–2618PubMed
37.
Zurück zum Zitat Colletti V, Shannon RV (2005) Open set speech perception with auditory brainstem implant? Laryngoscope. 115(11):1974–1978PubMed Colletti V, Shannon RV (2005) Open set speech perception with auditory brainstem implant? Laryngoscope. 115(11):1974–1978PubMed
38.
Zurück zum Zitat Ebinger K, Otto S, Arcaroli J, Staller S, Arndt P (2000) Multichannel auditory brainstem implant: US clinical trial results. J Laryngol Otol Suppl 27:50–53 Ebinger K, Otto S, Arcaroli J, Staller S, Arndt P (2000) Multichannel auditory brainstem implant: US clinical trial results. J Laryngol Otol Suppl 27:50–53
39.
Zurück zum Zitat Otto SR, Brackmann DE, Hitselberger WE, Shannon RV, Kuchta J (2002) Multichannel auditory brainstem implant: update on performance in 61 patients. J Neurosurg 96(6):1063–1071PubMed Otto SR, Brackmann DE, Hitselberger WE, Shannon RV, Kuchta J (2002) Multichannel auditory brainstem implant: update on performance in 61 patients. J Neurosurg 96(6):1063–1071PubMed
40.
Zurück zum Zitat Schwartz MS, Wilkinson EP (2017) Auditory brainstem implant program development. Laryngoscope. 127(8):1909–1915PubMed Schwartz MS, Wilkinson EP (2017) Auditory brainstem implant program development. Laryngoscope. 127(8):1909–1915PubMed
41.
Zurück zum Zitat Otto SR, Brackmann DE, Hitselberger W (2004) Auditory brainstem implantation in 12- to 18-year-olds. Arch Otolaryngol Head Neck Surg 130(5):656–659PubMed Otto SR, Brackmann DE, Hitselberger W (2004) Auditory brainstem implantation in 12- to 18-year-olds. Arch Otolaryngol Head Neck Surg 130(5):656–659PubMed
42.
Zurück zum Zitat Colletti L, Shannon R, Colletti V (2012) Auditory brainstem implants for neurofibromatosis type 2. Curr Opin Otolaryngol Head Neck Surg 20(5):353–357PubMed Colletti L, Shannon R, Colletti V (2012) Auditory brainstem implants for neurofibromatosis type 2. Curr Opin Otolaryngol Head Neck Surg 20(5):353–357PubMed
43.
Zurück zum Zitat Harris F, Tysome JR, Donnelly N, Durie-Gair J, Crundwell G, Tam YC, Knight RD, Vanat ZH, Folland N, Axon P (2017) Cochlear implants in the management of hearing loss in neurofibromatosis type 2. Cochlear Implants Int 18(3):171–179PubMed Harris F, Tysome JR, Donnelly N, Durie-Gair J, Crundwell G, Tam YC, Knight RD, Vanat ZH, Folland N, Axon P (2017) Cochlear implants in the management of hearing loss in neurofibromatosis type 2. Cochlear Implants Int 18(3):171–179PubMed
44.
Zurück zum Zitat Peng KA, Lorenz MB, Otto SR, Brackmann DE, Wilkinson EP (2018) Cochlear implantation and auditory brainstem implantation in neurofibromatosis type 2. Laryngoscope. 128(9):2163–2169PubMed Peng KA, Lorenz MB, Otto SR, Brackmann DE, Wilkinson EP (2018) Cochlear implantation and auditory brainstem implantation in neurofibromatosis type 2. Laryngoscope. 128(9):2163–2169PubMed
45.
Zurück zum Zitat Charlett SD, Biggs N (2015) The prevalence of cochlear obliteration after labyrinthectomy using magnetic resonance imaging and the implications for cochlear implantation. Otol Neurotol 36(8):1328–1330PubMed Charlett SD, Biggs N (2015) The prevalence of cochlear obliteration after labyrinthectomy using magnetic resonance imaging and the implications for cochlear implantation. Otol Neurotol 36(8):1328–1330PubMed
46.
Zurück zum Zitat Lim HH, Lenarz T (2015) Auditory midbrain implant: research and development towards a second clinical trial. Hear Res 322:212–223PubMedPubMedCentral Lim HH, Lenarz T (2015) Auditory midbrain implant: research and development towards a second clinical trial. Hear Res 322:212–223PubMedPubMedCentral
Metadaten
Titel
Options and strategies for hearing restoration in pediatric neurofibromatosis type 2
verfasst von
Hossein Mahboubi
William H. Slattery III
Gautam U. Mehta
Gregory P. Lekovic
Publikationsdatum
21.06.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 10/2020
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-020-04721-4

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