title: Hearing preservation after middle fossa vestibular schwannoma removal: are the results durable?
abstract: OBJECTIVE
  To describe 5-year hearing preservation rates following microsurgical excision of vestibular schwannoma (VS) via the middle cranial fossa (MCF) approach.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  This study was performed at a tertiary care academic medical center.
  
  
  METHODS
  Fifty-seven subjects with VS underwent resection via an MCF approach between February 1998 and January 2009. Pure-tone average (PTA) and word recognition score (WRS) were obtained preoperatively, immediately postoperatively, and at 5-year follow-up.
  
  
  RESULTS
  Preoperative serviceable hearing (American Academy of Otolaryngology-Head and Neck Surgery class A/B) was present in 49 (86%) of the 57 patients, with an average PTA of 23 dB (range, 1-50 dB) and an average WRS of 97% (range, 76%-100%). Immediate postoperative serviceable hearing was maintained in 27 (55%) patients, with an average PTA and WRS of 31 dB (5-50 dB) and 96% (70%-100%), respectively. Five-year follow-up was available for 16 of the 27 patients. Twelve (75%) of the 16 patients maintained serviceable hearing with an average PTA and WRS of 35 dB (4-49 dB) and 95% (84%-100%), respectively. Of the 16 subjects who did maintain class A or B hearing, the mean change in PTA and WRS was 5 dB and 0.4%, respectively. Of the 4 patients who did not maintain class A/B hearing, average change in PTA and WRS was 16 dB (4.5-23 dB) and 16% (0%-40%), respectively.
  
  
  CONCLUSIONS
  For patients with VS in whom serviceable hearing is preserved following the MCF approach, the long-term hearing outcome remains durable in most patients.
authors: Division of Otolaryngology, University of Utah, Salt Lake City, Utah, USA.
authors: Tyler S
authors: TS
authors: Quist
authors: Division of Otolaryngology, University of Utah, Salt Lake City, Utah, USA.
authors: Daniel J
authors: DJ
authors: Givens
authors: Division of Otolaryngology, University of Utah, Salt Lake City, Utah, USA richard.gurgel@hsc.utah.edu.
authors: Richard K
authors: RK
authors: Gurgel
authors: Department of Neurosurgery, Kansas University Medical Center, Kansas City, Kansas, USA.
authors: Roukoz
authors: R
authors: Chamoun
authors: Division of Otolaryngology, University of Utah, Salt Lake City, Utah, USA.
authors: Clough
authors: C
authors: Shelton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D035301:Cranial Fossa, Middle / Q000601:surgery; D005260:Female; D006309:Hearing; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D013506:Otologic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome
keywords: hearing preservation; middle cranial fossa; vestibular schwannoma