Hearing preservation with the retrosigmoid approach for vestibular schwannoma: myth or reality?
OBJECTIVE
The purpose of this study is to present our experience with the retrosigmoid approach for vestibular schwannoma resection, emphasizing our hearing results, discussing selection and reporting results criteria.Study design and setting The notes of 65 consecutive cases of vestibular schwannoma undergoing the retrosigmoid approach were reviewed. Hearing data were reported according to the recommendations of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). In addition, the terms normal, serviceable, useful, and measurable hearing were considered.


RESULTS
Tumor size ranged from 8 to 50 mm (mean, 24.1 mm). Of the 29 patients with preoperative serviceable hearing (AAO-HNS classes A and B), 5 patients (17%) had postoperative serviceable hearing, and 6 patients (20%) had postoperative useful hearing (AAO-HNS classes A, B, and C).


CONCLUSIONS
The retrosigmoid approach is a reliable surgical procedure for most vestibular schwannoma tumors. However, hearing preservation results show wide differences depending on selection and reporting results criteria. Hearing preservation, although possible, may not be the main reason to choose this approach.
Department of Otolaryngology, La Paz University Hospital, Madrid, Spain. luislassaletta@wanadoo.es
Luis
L
Lassaletta
Leonardo
L
Fontes
Enrique
E
Melcon
Maria Jose
MJ
Sarria
Javier
J
Gavilan
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone / Q000379:methods; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009464:Neuroma, Acoustic / Q000150:complications / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*; D011182:Postoperative Care; D011184:Postoperative Period; D011300:Preoperative Care; D012189:Retrospective Studies