title: Middle fossa decompression for hearing preservation: a review of institutional results and indications.
abstract: OBJECTIVE
  To assess the duration of hearing preservation from time of vestibular schwannoma middle fossa decompression with short-term and 1-year hearing preservation rates.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Patients with and without neurofibromatosis type 2 who underwent middle fossa decompression. We excluded patients without tumor size or audiograms at initial diagnosis or follow-up less than 3 months.
  
  
  METHODS
  Middle cranial fossa decompression, audiometry, and magnetic resonance imaging.
  
  
  METHODS
  Period of hearing maintenance (from surgery to longest time point that preoperative American Academy of Otolaryngology-Head and Neck Surgery [AAO-HNS] hearing class maintained or improved), short-term hearing preservation (within 3 mo of surgery), and 1-year hearing preservation.
  
  
  RESULTS
  A total of 49 patients underwent middle fossa decompression of vestibular schwannoma. Approximately 90% of patients had documented hearing loss before surgery, and more than 50% of patients exhibited significant tumor growth before surgery. Of these surgeries, more than 90% were performed in patients with hearing loss in an only hearing ear, and more than 90% were patients with neurofibromatosis type 2. The mean period of hearing maintenance was 2.1 years. The short-term hearing preservation rate as measured by the change from preoperative AAO-HNS hearing class was approximately 90%. The 1-year hearing preservation rate as measured by change from preoperative AAO-HNS hearing class was 63%.
  
  
  CONCLUSIONS
  Middle fossa decompression for vestibular schwannoma can prolong hearing in patients with hearing changes in an only hearing ear. Understanding the duration of hearing preservation can enable more effective counseling of patients considering middle cranial fossa decompression for vestibular schwannoma.
authors: House Research Institute and House Clinic, Los Angeles, CA90057, USA. wslattery@hei.org
authors: William H
authors: WH
authors: Slattery
authors: Michael
authors: M
authors: Hoa
authors: Nicolas
authors: N
authors: Bonne
authors: Rick A
authors: RA
authors: Friedman
authors: Marc S
authors: MS
authors: Schwartz
authors: Laurel M
authors: LM
authors: Fisher
authors: Derald E
authors: DE
authors: Brackmann
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002648:Child; D035301:Cranial Fossa, Middle / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D034381:Hearing Loss / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016518:Neurofibromatosis 2 / Q000601:surgery*; D009464:Neuroma, Acoustic / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome