Clinical Innovation Outcomes research & clinical trials

Clinical trial hopes to restore hearing for patients with vestibular schwannomas

Anatomical illustration showing the location of a vestibular schwannoma adjacent to the auditory nerve (image courtesy of Blausen Medical).

Patients deafened from a vestibular schwannoma have very limited options to restore hearing in their affected ear. Researchers at Washington University hope to change that paradigm. In a new FDA-approved clinical trial, the lateral skull base team will evaluate  a new Auditory Nerve Testing System that may allow tumor removal with simultaneous cochlear implantation.

Currently, patients with single-sided deafness from a vestibular schwannoma suffer from poor hearing in background noise and an inability to localize sound. There are rare exceptions in which a tumor can be removed and the hearing preserved. For the vast majority of patients, hearing gradually declines regardless of whether their benign tumor is observed, radiated, or surgically removed. Current hearing rehabilitation options fail to restore hearing in the affected ear, thus once the hearing is gone it is typically gone forever.

Vestibular schwannomas, also referred to as acoustic neuromas, are benign tumors that grow on the nerves of balance, which are directly next to the nerve of hearing (auditory nerve). If a patient has already lost their hearing or if the surgical approach disrupts hearing, then the surgeons have limited ability to monitor the health of the auditory nerve. Without proper monitoring, the auditory nerve is often lost. If the auditory nerve could be kept intact, then the patient could potentially benefit from the use of a cochlear implant in the affected ear.

Cameron Wick, MD

The new Auditory Nerve Test System from MED-EL is designed to allow surgeons to monitor the auditory nerve and improve the chances of keeping it intact during vestibular schwannoma surgery. While the tumor is being removed, the device gets placed into the cochlea like a cochlear implant and stimulates the auditory nerve to provide surgeons with real-time feedback on the health of the nerve, according to Cameron Wick, MD, the primary investigator on the study.

Understanding the health of the nerve may change the way surgeons dissect and remove the tumor, according to Dr. Wick. This would then increase the chance that the patient could receive a cochlear implant at the same time and gain some of their hearing back. Dr. Wick emphasizes that this will not be possible for every patient, especially those with larger tumors. Still, the opportunity to improve the lives of patients with a vestibular schwannoma is exciting and this trial is unique to Washington University in St. Louis.

The study is supported by the diverse expertise within the Department of Otolaryngology and Washington University’s skull base team including Jill Firszt, PhD, Amanda Ortmann, PhD, Sarah Kukuljan, Jacques Herzog, MD, Craig Buchman, MD, and the Department of Neurosurgery.

Washington University is the only site for this clinical trial. For more information about the clinical trial, please contact Dr. Wick at 314-273-1589 or cameron.wick@wustl.edu.