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Hearing Preservation in Conservation Surgery for Vestibular Schwannoma

Holsinger, F. Christopher; Coker, Newton J.; Jenkins, Herman A.

American Journal of Otology:
Tumors of the Ear and Cranial Base

Objective: To evaluate preservation of hearing in the resection of vestibular schwannomas.

Study Design: A retrospective case review.

Setting: Tertiary-care medical center.

Patients: Forty-seven patients (25 men, 22 women) were studied; mean age was 46 years, mean tumor diameter 9.8 mm (range 3–30 mm.)

Interventions: All patients underwent resection of vestibular schwannomas by the middle cranial fossa (MCF) or the retrosigmoid (RS) approach.

Main Outcome Measures: Hearing preservation was classified by the criteria outlined by the American Academy of Otolaryngology-Head Neck Surgery. Hearing was assessed preoperatively and postoperatively at 1 month and 1 year. Facial function was graded according to the House-Brackmann scale. Minimum follow-up was 18 months.

Results: Hearing was preserved in 69% of patients who underwent the MCF approach but in only 33% of patients for whom the RS approach was used. The RS approach was used for larger tumors (mean diameter 15 mm) and the MCF procedure for smaller tumors (mean diameter 9 mm). One hundred percent of patients had facial function H/B grade II or better, regardless of approach.

Conclusion: Hearing function can be reliably preserved in a high percentage of selected patients undergoing resection of vestibular schwannoma.

Author Information

The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine Houston, Texas, U.S.A.

Address correspondence and reprint requests to Dr. Herman A. Jenkins, Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, U.S.A.

© 2000, The American Journal of Otology, Inc.