title: Does attempt at hearing preservation microsurgery of vestibular schwannoma affect postoperative tinnitus?
abstract: BACKGROUND
  The aim of this study was to analyze the effect of vestibular schwannoma microsurgery via the retrosigmoid-transmeatal approach with special reference to the postoperative tinnitus outcome.
  
  
  METHODS
  A prospective study was performed in 89 consecutive patients with unilateral vestibular schwannoma indicated for microsurgery. Patient and tumor related parameters, pre- and postoperative hearing level, intraoperative findings, and hearing and tinnitus handicap inventory scores were analyzed.
  
  
  RESULTS
  Cochlear nerve integrity was achieved in 44% corresponding to preservation of preoperatively serviceable hearing in 47% and useful hearing in 21%. Main prognostic factors of hearing preservation were grade/size of tumor, preoperative hearing level, intraoperative neuromonitoring, tumor consistency, and adhesion to neurovascular structures. Microsurgery led to elimination of tinnitus in 66% but also new-onset of the symptom in 14% of cases. Preservation of useful hearing and neurectomy of the eighth cranial nerve were main prognostic factors of tinnitus elimination. Preservation of cochlear nerve but loss of preoperative hearing emerged as the main factor for tinnitus persistence and new onset tinnitus. Decrease of THI scores was observed postoperatively.
  
  
  CONCLUSIONS
  Our results underscore the importance of proper pre- and intraoperative decision making about attempt at hearing preservation versus potential for tinnitus elimination/risk of new onset of tinnitus.
authors: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic.
authors: Martin
authors: M
authors: Chovanec
authors: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic.
authors: Eduard
authors: E
authors: Zvěřina
authors: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic ; Institute of Experimental Medicine vvi, Institute of Auditory Neuroscience, Czech Academy of Sciences, Vídeňská 1083, 142 20 Prague 4, Czech Republic.
authors: Oliver
authors: 0000-0002-7738-1791
authors: O
authors: Profant
authors: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic ; Institute of Experimental Medicine vvi, Institute of Auditory Neuroscience, Czech Academy of Sciences, Vídeňská 1083, 142 20 Prague 4, Czech Republic.
authors: Zuzana
authors: Z
authors: Balogová
authors: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic.
authors: Jan
authors: J
authors: Kluh
authors: Institute of Experimental Medicine vvi, Institute of Auditory Neuroscience, Czech Academy of Sciences, Vídeňská 1083, 142 20 Prague 4, Czech Republic.
authors: Josef
authors: J
authors: Syka
authors: Department of Radiodiagnostics, 2nd Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic.
authors: Jiří
authors: 0000-0001-7284-8586
authors: J
authors: Lisý
authors: Department of Electromagnetic Field, Faculty of Electrical Engineering, Czech Technical University, Technická 2, 166 27 Prague 6, Czech Republic.
authors: Ilja
authors: I
authors: Merunka
authors: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic.
authors: Jiří
authors: J
authors: Skřivan
authors: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic.
authors: Jan
authors: 0000-0001-8772-317X
authors: J
authors: Betka
mesh_terms: D003056:Cochlear Nerve / Q000601:surgery; D005260:Female; D006309:Hearing / Q000502:physiology*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects*; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D014012:Tinnitus / Q000209:etiology*
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