title: Stability of hearing preservation and regeneration capacity of the cochlear nerve following vestibular schwannoma surgery via a retrosigmoid approach.
abstract: OBJECTIVE The purpose of this research was to examine the stability of long-term hearing preservation and the regeneration capacity of the cochlear nerve following vestibular schwannoma (VS) surgery in a prospective study. METHODS A total of 112 patients were recruited for a randomized multicenter trial between January 2010 and April 2012 to investigate the efficacy of prophylactic nimodipine treatment versus no prophylactic nimodipine treatment in VS surgery. For the present investigation, both groups were pooled to compare hearing abilities in the early postoperative course and 1 year after the surgery. Hearing was examined using pure-tone audiometry with speech discrimination, which was performed preoperatively, in the early postoperative course, and 12 months after surgery and was subsequently classified by an independent otorhinolaryngologist using the Gardner-Robertson classification system. RESULTS Hearing abilities at 2 time points were compared by evaluation in the early postoperative course and 1 year after surgery in 102 patients. The chi-square test showed a very strong association between the 2 measurements in all 102 patients (p < 0.001) and in the subgroup of 66 patients with a preserved cochlear nerve (p < 0.001). CONCLUSIONS There is no significant change in cochlear nerve function between the early postoperative course and 1 year after VS surgery. The result of hearing performance, as evaluated by early postoperative audiometry after VS surgery, seems to be a reliable prognosticator for future hearing ability. Clinical trial registration nos.: 2009-012088-32 ( clinicaltrialsregister.eu ) and DRKS 00000328 ("AkNiPro," drks-neu.uniklinik-freiburg.de/drks_web/ ).
authors.affiliation: Department of Neurosurgery, University of Halle-Wittenberg.|Translational Centre for Regenerative Medicine (TRM), University of Leipzig.
authors.forename: Christian
authors.initials: C
authors.lastname: Scheller
authors.affiliation: Institute of Medical Epidemiology, Biostatistics, and Informatics, University of Halle-Wittenberg.
authors.forename: Andreas
authors.initials: A
authors.lastname: Wienke
authors.affiliation: Department of Neurosurgery, University of Tübingen.
authors.forename: Marcos
authors.initials: M
authors.lastname: Tatagiba
authors.affiliation: Department of Neurosurgery, University of Tübingen.
authors.forename: Alireza
authors.initials: A
authors.lastname: Gharabaghi
authors.affiliation: Department of Neurosurgery, University of Tübingen.
authors.forename: Kristofer F
authors.initials: KF
authors.lastname: Ramina
authors.affiliation: Department of Neurosurgery, University of Erlangen-Nuremberg.
authors.forename: Oliver
authors.initials: O
authors.lastname: Ganslandt
authors.affiliation: Department of Neurosurgery, University of Erlangen-Nuremberg.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bischoff
authors.affiliation: Department of Neurosurgery, Würzburg University Hospital.
authors.forename: Cordula
authors.initials: C
authors.lastname: Matthies
authors.affiliation: Department of Neurosurgery, Würzburg University Hospital.
authors.forename: Thomas
authors.initials: T
authors.lastname: Westermaier
authors.affiliation: Department of Neurosurgery, Bezirkskrankenhaus Günzburg, University of Ulm.
authors.forename: Gregor
authors.initials: G
authors.lastname: Antoniadis
authors.affiliation: Department of Neurosurgery, Bezirkskrankenhaus Günzburg, University of Ulm.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Pedro
authors.affiliation: Department of Neurosurgery, University of Göttingen; and.
authors.forename: Veit
authors.initials: V
authors.lastname: Rohde
authors.affiliation: Department of Neurosurgery, University of Göttingen; and.
authors.forename: Kajetan
authors.initials: K
authors.lastname: von Eckardstein
authors.affiliation: Department of Neurosurgery, Evangelisches Krankenhaus, University of Oldenburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kretschmer
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg.
authors.forename: Johannes
authors.initials: J
authors.lastname: Zenk
authors.affiliation: Department of Neurosurgery, University of Halle-Wittenberg.
authors.forename: Christian
authors.initials: C
authors.lastname: Strauss
mesh_terms: D003056:Cochlear Nerve / Q000502:physiology*; D005260:Female; D034381:Hearing Loss / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies
keywords: SRS = stereotactic radiosurgery; VS = vestibular schwannoma; cochlear nerve; hearing; regeneration; vestibular schwannoma