Hearing Preservation After Microsurgical Resection of Large Vestibular Schwannomas

Author:

Di Maio Salvatore1,Malebranche A Daniel2,Westerberg Brian1,Akagami Ryojo1

Affiliation:

1. Division of Neurosurgery, Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada

2. Division of Otolaryngology, Department of Surgery, St. Paul's Rotary Hearing Clinic, University of British Columbia, Vancouver, British Columbia, Canada

Abstract

AbstractBACKGROUND:Hearing, which is often still clinically useful at presentation even with larger tumors, is a major determinant of quality of life in vestibular schwannoma (VS) patients.OBJECTIVE:To present the hearing preservation rate after surgery in patients with large (≥3 cm) VSs and identify clinical or radiologic predictors of hearing preservation.METHODS:From April 2003 to March 2009, 192 patients underwent resection of a VS, including 46 large (≥3 cm) tumors, of whom 28 had serviceable hearing preoperatively. Six of 28 patients (21.4%) had preserved hearing postoperatively.RESULTS:Mean tumor diameter was 3.6 cm (range, 3.0-5.0 cm) and tumor volume was 17.2 mL (range, 6.9-45.2 mL). For patients with grade A Sanna-Fukushima hearing, the hearing preservation rate was 4 of 11 (36.4%). Complete resection was achieved in 6 of 6 cases with hearing preservation (41/47 for all patients). Six of 6 patients with preserved hearing had a cerebrospinal fluid cleft in the internal auditory canal (IAC) compared with 9 of 16 patients without preoperative hearing and 9 of 20 for patients with serviceable hearing that was lost postoperatively (P = .045). Six of 6 patients with preserved hearing had less than 35% of the tumor anterior to the longitudinal axis of the IAC compared with 13 of 20 in the serviceable hearing that was lost group (P = .036).CONCLUSION:Our series demonstrates hearing preservation is possible for patients with large VSs and should be attempted in all patients with preoperative hearing. The quality of preoperative hearing, a cerebrospinal fluid cleft at the apex of the IAC, and a smaller proportion of tumor anterior to the IAC were positively associated with hearing preservation.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Clinical Neurology,Surgery

Reference50 articles.

1. Management of acoustic neuromas (vestibular schwannomas) (honored guest presentation);Ojemann;Clin Neurosurg,1993

2. New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma;Kanzaki;Otol Neurotol,2003

3. Microsurgery of cerebellopontine angle tumors;Koos,1976

4. Prospective comparison of quality of life before and after observation, radiation, or surgery for vestibular schwannomas;Di Maio;J Neurosurg,2009

5. Hearing preservation in surgery for large vestibular schwannomas;Wanibuchi;J Neurosurg,2009

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