Hearing preservation in conservation surgery for vestibular schwannoma.
OBJECTIVE
To evaluate preservation of hearing in the resection of vestibular schwannomas.


METHODS
A retrospective case review.


METHODS
Tertiary-care medical center.


METHODS
Forty-seven patients (25 men, 22 women) were studied; mean age was 46 years, mean tumor diameter 9.8 mm (range 3-30 mm.)


METHODS
All patients underwent resection of vestibular schwannomas by the middle cranial fossa (MCF) or the retrosigmoid (RS) approach.


METHODS
Hearing preservation was classified by the criteria outlined by the American Academy of Otolaryngology-Head Neck Surgery. Hearing was assessed preoperatively and postoperatively at 1 month and 1 year. Facial function was graded according to the House-Brackmann scale. Minimum follow-up was 18 months.


RESULTS
Hearing was preserved in 69% of patients who underwent the MCF approach but in only 33% of patients for whom the RS approach was used. The RS approach was used for larger tumors (mean diameter 15 mm) and the MCF procedure for smaller tumors (mean diameter 9 mm). One hundred percent of patients had facial function H/B grade II or better, regardless of approach.


CONCLUSIONS
Hearing function can be reliably preserved in a high percentage of selected patients undergoing resection of vestibular schwannoma.
Holsinger
F C
FC
The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine Houston, Texas 77030, USA.
Coker
N J
NJ
Jenkins
H A
HA
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D003056:Cochlear Nerve / Q000502:physiology; D004584:Electronystagmography; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013067:Speech Perception / Q000502:physiology; D016896:Treatment Outcome