Long-term hearing preservation after microsurgical excision of vestibular schwannoma.
OBJECTIVE
To examine long-term hearing outcomes after microsurgical excision of vestibular schwannoma (VS).


METHODS
Retrospective case review.


METHODS
Tertiary referral center.


METHODS
Forty-nine subjects at a single institution who had undergone microsurgical excision of a VS via middle cranial fossa (MCF) approach between 1994 and 2007 with immediate postoperative (PO) hearing preservation and for whom long-term audiograms were available.


METHODS
Diagnostic.


METHODS
Word Recognition Score (WRS) is defined by speech discrimination scores (SDS) greater than 70% (grade I), 50% to 70% (grade II), less than 50% (grade III), and 0% (grade IV).


RESULTS
For subjects with more than 2 years of follow-up, WRS I hearing was present PO in 42 of 49 patients and was preserved at the latest follow-up in 38 (90%) of 42 patients. No subjects fell beyond WRS II. WRS I hearing was maintained in 23 (88%) of 26 patients with more than 5 years of follow-up. Postoperative WRS I to II hearing was maintained in 28 (96%) of 29 patients with more than 5 years of follow-up. The patient who lost significant hearing in the ear operated on had sensorineural hearing loss that paralleled deterioration in her ear that was not operated on.


CONCLUSIONS
Most subjects maintain their initial PO SDS after microsurgical VS removal, and therefore, the initial PO WRS is predictive of long-term hearing. Postsurgical changes do not alter the natural rate or pattern of progressive bilateral sensorineural hearing loss in individual subjects.
Woodson
Erika Ann
EA
Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242-1078, U.S.A.
Dempewolf
Ryan Douglas
RD
Gubbels
Samuel Paul
SP
Porter
Aaron Thomas
AT
Oleson
Jacob Jay
JJ
Hansen
Marlan Rex
MR
Gantz
Bruce Jay
BJ
D000328:Adult; D000368:Aged; D000465:Algorithms; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D003390:Cranial Nerve Neoplasms / Q000503:physiopathology / Q000532:radiotherapy / Q000601:surgery*; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006309:Hearing; D006319:Hearing Loss, Sensorineural / Q000209:etiology / Q000523:psychology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000503:physiopathology / Q000532:radiotherapy / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013067:Speech Perception / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult