Results achieved in the treatment of patients with vestibular schwannoma.
Personal experience gathered with the treatment of 264 vestibular schwannoma (VS) at the Magdeburg University ENT Hospital is analysed. ABR Audiometry is useful as a screening, even though it yielded false-negative values in 12.7% (n = 33) for intrameatal VS and 16.9% for all VS, despite accurate evaluation. Latency increases of Waves I, III and V and their intraaural comparison exhibited a statistically significant difference for the VS levels proposed by TOS. The mean of intrameatal VS too was found to have longer latencies compared with the normal-hearing ears of the patients. In the individual case, with threshold hearing normal, anamnestic findings as well as otoneurological evidence provide an early indication for enhanced MRI, CISS imaging, or individual 3D reconstruction of the pontocerebellar cisterna. Adopting intraoperative monitoring of the facial nerve and the cochlea as well as the Pars acustica by means of far-field and near-field electrodes, a good facial 'mobility' was achieved in 95.3%, and a useful audition (AAO-HNS Types A and B) in 60%. Monitoring is beneficial as it enhances the reliability and improves the subtle preparation during surgery. The power of hearing improved postoperatively within six months and remained at a good level over two years. From our perspective, otorhinolaryngologists are the right specialists to attend to VS.
Freigang
Bernd
B
ENT Hospital, Otto von Guericke University of Magdeburg, Germany. bernd.freigang@medizin.uni-magdeburg.de
Rudolf
Jan
J
D000368:Aged; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000473:pathology / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*