A multidisciplinary team in the Department of Otolaryngology – Head and Neck Surgery is leading an innovative clinical trial aimed at improving hearing outcomes for patients with vestibular schwannomas. These benign tumors often cause progressive hearing loss, and surgical removal – while lifesaving – frequently results in complete deafness in the affected ear. Historically, treatment options focused on routing sound to the opposite ear rather than restoring natural hearing. A new approach seeks to change that trajectory.
“Over the years, we’ve learned that more patients with residual hearing are candidates for cochlear implants,” says Oliver Adunka, MD, MBA, professor in the Department of Otolaryngology – Head and Neck Surgery at The Ohio State University College of Medicine. “Rather than replacing hearing with an aid, we preserve what they have left. The cochlear implant becomes an addition that further improves their hearing.”
Vestibular schwannomas typically cause gradual sensorineural hearing loss as they grow, but surgery itself can also damage the delicate inner ear. As a result, restoration of hearing in the surgical ear has not traditionally been emphasized. “Usually, patients with these tumors lose their hearing over time, and it’s not always the focus to rehabilitate patients with hearing devices,” notes Yin Ren, MD, PhD, assistant professor. “There hasn’t previously been much research into ways to restore hearing in the ear affected by the tumor post-surgery.”
Recognizing and protecting residual hearing
Under the leadership of Dr. Adunka, a multicenter, NIH-funded clinical trial is evaluating whether cochlear implantation performed at the time of tumor removal can help preserve, and potentially restore, hearing. During surgery, a cochlear implant electrode is placed into the inner ear to monitor auditory responses through electrocochleography, allowing surgeons to better identify and protect residual hearing.
“The area where we perform surgery is the vulnerable part of the inner ear for residual hearing,” Dr. Adunka says. “We try to preserve it and use an electrocochleography system, which allows us to monitor auditory responses and enhance hearing preservation rates. Preserving hearing is important for patient outcomes and quality of life.”
Ohio State is collaborating with leading centers across the country, including the Mayo Clinic, the Medical College of Wisconsin, The University of Iowa, The University of North Carolina, Vanderbilt University and Washington University in St. Louis. The original U01 grant supporting this work was awarded in 2023, and the team is pursuing a two-year extension to continue data collection. Dr. Adunka’s long-standing expertise in this field includes developing an FDA-approved Electric-Acoustic Stimulation (EAS) system for adults with severe hearing loss, and leading clinical trials in Europe and at The University of North Carolina.
Leading from the front in hearing preservation
The trial targets adults with substantial hearing loss who are unable to benefit from hearing aids but retain some measurable inner-ear function. “These patients have substantial hearing loss but can’t benefit from any other treatments right now,” Dr. Adunka explains. “This trial offers the chance to expand cochlear implant indications to a broader audience and improve how people do with these implants. Preserving hearing should help with these goals.”
The study is one component of a broader departmental effort to advance hearing preservation and restoration. In parallel, Dr. Ren’s laboratory is investigating blood-based biomarkers in animal models to identify early indicators of hearing loss related to tumor growth. His team is also searching for markers that may identify which patients are more likely to respond to aggressive interventions. These noninvasive investigative pathways may ultimately support more personalized care.
“As a university, we are always trying to stay at the forefront of providing top-quality surgical care, but what’s unique here is the big research effort that allows us to pioneer newer innovations and care for patients looking into the future,” Dr. Ren says. “We’re always looking to improve with new projects, research and directions. It’s never an endpoint.”
This collaborative, forward-facing culture extends across disciplines. The vestibular schwannoma program maintains close ties with Neurosurgery through joint conferences, shared operative approaches and integrated trainee education. Partnerships with peer otolaryngology departments worldwide ensure that the team remains actively engaged with emerging advances in ear and skull base care.
“As otolaryngologists and neurotologists who specialize in diseases of the ear and brain, we strive to save and restore people’s hearing, and we’re doing it on a day-to-day basis from patient care, to research, to teaching the next generation of specialists,” Dr. Ren says. “I’m proud to be in this kind of atmosphere where we can provide excellent care and push the boundaries of what’s possible.”
“I view this clinical trial and its supporting research as exemplary of the innovation, collaboration and scientific rigor that define our program,” says James W. Rocco MD, PhD, chair of the department. “Restoring hearing after vestibular schwannoma surgery has historically been considered out of reach. By combining advanced surgical techniques, real-time physiologic monitoring, biomarker discovery and multi-institutional partnerships, our faculty are challenging that assumption and expanding what is possible for patients.”
These efforts reflect our department’s broader mission: to deliver outstanding care today while pioneering the breakthroughs that will shape the field tomorrow. The work led by Dr. Adunka, Dr. Ren and their collaborators positions Ohio State as a national leader in hearing preservation science, and embodies our commitment to improving both outcomes and quality of life for the patients we serve.