[Hearing preservation in vestibular schwannoma surgery: indications, techniques and results in the literature since 1990].
Many authors have recently reported hearing preservation for approximately two-thirds of acoustic neuroma patients. The results have driven them to recommend early surgery for all patients whose hearing might be saved. Inversely, other authors advocate that MRI-screening may be beneficial in some patients and suggest surgery only in case of tumor growth or progressive hearing loss. In order to facilitate therapeutic decision making, we reviewed the techniques and results in the main papers dealing with hearing preservation in the course of acoustic neuroma surgery published since 1990. This analysis showed that the average percentage of useful hearing preservation is about 31%. It is however difficult to compare the different series due to the different methodologies used. This emphasizes the need for standardization of hearing selection and reporting criteria to a) identify factors predictive of success (tumor characteristics, preoperative hearing, monitoring, surgical pathways), and b) elaborate well accepted decisional guidelines (early surgery or MRI screening), notably for small and non-symptomatic tumors which show increasing prevalence.
Portier
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F
Clinique d'ORL et de Chirurgie Cervico-Faciale, Hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris.
Lot
G
G
Herman
P
P
Salvan
D
D
George
B
B
Tran Ba Huy
P
P
D001299:Audiometry; D006309:Hearing; D006320:Hearing Tests; D006801:Humans; D008991:Monitoring, Physiologic; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009464:Neuroma, Acoustic / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection