However, the auditory nerve which travels from the cochlea to the brain usually remains intact. Therefore VHL patients who encounter deafness due to ELST are considered promising candidates for cochlear implantation. Even in those extremely rare situations where the tumors or the surgical procedure necessary to remove them did affect the auditory nerve, help might be possible. An even more intricate device has been developed which stimulates the nerve cells not at the site of the cochlea but directly in the brainstem, where the auditory nerve enters the brain. In cases of bilateral ELST causing deafness, the option of cochlear or brainstem implants should be considered and discussed before tumor surgery.
Thorough examination can differentiate between damage to the receptor cells or the auditory nerve.
The auditory nerve must be preserved during surgical removal of the tumor. In many cases it will then be possible to restore or retain hearing abilities.