Treated large posterior fossa vestibular schwannoma and meningioma: Hearing outcome and willingness-to-accept brain implant for unilateral deafness.

Background/objective: To compare functional hearing and tinnitus outcomes in treated large (~ 3 cm) vestibular schwannoma (VS) and posterior fossa meningioma cohorts, and construct willingness-to-accept profiles for an experimental brain implant to treat unilateral hearing loss.

Methods: A two-way MANOVA model with two independent variables (tumor type; time from treatment) and three dependent variables (hearing effort of tumor ear; abbreviated Speech, Spatial, and Qualities of Hearing scale (SSQ12); Tinnitus Functional Index (TFI)) was used to analyze data from VS ( = 32) and meningioma ( = 50) patients who were treated at a tertiary care center between 2010 and 2020. A query to probe acceptance of experimental treatment for hearing loss relative to expected benefit was used to construct willingness-to-accept profiles.

Results: Tumor type was statistically significant on the combined dependent variables analysis ([3, 76] = 19.172,  < .0005, Wilks' Λ = 0.569). Meningioma showed better outcome for hearing effort ([1, 76] = 14.632,  < .0005) and SSQ12 ([1, 76] = 16.164,  < .0005), but not for TFI ([1, 76] = 1.247,  = .268) on univariate two-way ANOVA analyses. Superior hearing effort and SSQ12 indices in the short-term (< 2 years) persisted in the long-term (> 2 years) ( ≤ .017). At the 60% speech understanding level, 77% of respondents would accept an experimental brain implant.

Conclusion: Hearing outcome is better for posterior fossa meningioma compared to VS. Most patients with hearing loss in the tumor ear would consider a brain implant if the benefit level would be comparable to a cochlear implant.

Level Of Evidence: 2.