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Tumor Size Impacts Auditory Brainstem Implant Outcomes

Publication Title: Implications of Tumor Size on Auditory Brainstem Implant Performance

Summary

Question
This study examined the impact of tumor size on the performance of auditory brainstem implants (ABIs) in patients with neurofibromatosis type 2 (NF2). The researchers aimed to determine whether larger tumor volumes are associated with poorer auditory outcomes, measured by the Categories of Auditory Performance (CAP) score, a 7-point scale that evaluates auditory abilities, ranging from sound awareness to using a telephone with a known listener.
Why it Matters
Understanding how tumor size affects ABI performance is important for guiding treatment decisions and setting realistic expectations for patients with NF2. ABIs are a crucial option for individuals who cannot receive cochlear implants, offering benefits such as environmental sound awareness and speech discrimination. By identifying factors that influence ABI outcomes, healthcare providers can improve patient counseling and surgical planning, ultimately enhancing the quality of life for individuals with NF2 and hearing loss.
Methods
The researchers conducted a retrospective review of 14 patients with NF2 who underwent ABI placement between 2009 and 2023 at a tertiary referral center. Patients were excluded if they had prior surgical resection that might have caused cochlear nucleus trauma. Tumor volumes were measured using preoperative MRIs, and CAP scores were collected up to one year post-surgery. Statistical analysis included linear regression to assess the relationship between tumor size and CAP scores.
Key Findings
The study found a negative correlation between tumor size and ABI performance. Larger tumors were associated with lower CAP scores, indicating reduced auditory function. For every additional cubic centimeter of tumor volume, the CAP score decreased by 0.058 points on average. Despite this trend, some patients with larger tumors still experienced benefits from ABI placement, highlighting variability in outcomes.
Implications
These findings suggest that tumor size is an important factor in predicting ABI performance, but it should not be used as a sole contraindication for ABI placement. The study emphasizes the need for tailored patient counseling, taking tumor size into account while also considering other factors such as surgical techniques and individual variability. This knowledge can improve surgical planning and help patients make informed decisions about their treatment options.
Next Steps
The authors recommend further research through multi-center studies with larger sample sizes to better understand the impact of tumor size on ABI outcomes. They also suggest exploring how different surgical techniques might affect cochlear nucleus trauma and ABI performance, aiming to refine procedural strategies for patients with NF2.
Funding Information

NYU Langone Hospital and Yale University also provided funding and support for this research.

Full Citation

Cottrell J, Breen M, Leeuwen M, Shapiro W, Azadpour M, Friedmann D, Jethanamest D, McMenomey S, Pacione D, Hagiwara M, Moonis G, Golfinos J, Roland J. Implications of Tumor Size on Auditory Brainstem Implant Performance. Journal Of Neurological Surgery Part B Skull Base 2025 DOI: 10.1055/a-2706-1437.
This AI-assisted summary has been reviewed and approved by at least one of the study's authors to ensure it accurately reflects the research.

Authors

  • Justin Cottrell, MD

    First Author
    Yale School of Medicine

    Assistant Professor

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  • J. Thomas Roland

    Last Author
    School Building Streamline Icon: https://streamlinehq.comOther Institution

Other Authors

  • Matthew Breen;
  • Matthew V. Leeuwen;
  • William Shapiro;
  • Mahan Azadpour;
  • David Friedmann;
  • Daniel Jethanamest;
  • Sean McMenomey;
  • Donato Pacione;
  • Mari Hagiwara;
  • Gul Moonis;
  • John Golfinos

Research Themes

Concepts