Hearing preservation in patients with vestibular schwannomas with sudden sensorineural hearing loss.
OBJECTIVE
We evaluated hearing outcomes in patients with sudden hearing loss and vestibular schwannoma who underwent a hearing preservation operation for tumor resection in an effort to determine whether a history of sudden sensorineural hearing loss has an impact on subsequent hearing preservation surgery.


METHODS
Retrospective chart review of 45 patients operated between 1990 and 1998. Patients were divided into "Recovery" (n = 22) and "No Recovery" (n = 23) groups based on preoperative hearing recovery. Hearing preservation was assessed using the AAO-HNS hearing classification system.


RESULTS
Measurable hearing was preserved in 73% of patients, with 47% having good postoperative hearing (AAO-HNS Classes A-B). There was no significant difference in hearing outcome from patients presenting with progressive hearing loss (45% Classes A-B). There was also no difference in postoperative hearing between the "Recovery" and "No Recovery" groups.


CONCLUSIONS
Patients with sudden hearing loss and vestibular schwannoma have the same chance of hearing preservation after tumor removal as those with progressive loss. Preoperative recovery of hearing is not predictive of hearing preservation. Available data support the nerve compression theory as the mechanism of sudden hearing loss in patients with vestibular schwannoma.
Friedman
R A
RA
House Ear Clinic and House Ear Institute, the Piedmont Ear, Nose and Throat Associates, Los Angeles, CA 90057, USA. rfriedman@hei.org
Kesser
B W
BW
Slattery
W H
WH
Brackmann
D E
DE
Hitselberger
W E
WE
D000328:Adult; D000368:Aged; D004428:Ear Neoplasms / Q000150:complications / Q000601:surgery; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000209:etiology*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015837:Vestibular Diseases / Q000150:complications / Q000601:surgery*