Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Hearing Preservation Surgery for Small Endolymphatic Sac Tumors in Patients with von Hippel-Lindau Syndrome

Megerian, Cliff A.*; Haynes, David S.; Poe, Dennis S.; Choo, Daniel I.§; Keriakas, Thomas J.§; Glasscock, Michael E. III

Tumors Of The Ear And Cranial Base
Buy

Objective To determine the incidence of bilateral endolymphatic sac tumors in von Hippel-Lindau syndrome and to describe the technique and results of hearing preservation surgery for small endolymphatic sac tumors in a series of patients with von Hippel-Lindau syndrome.

Study Design Analysis of the literature to determine the incidence of bilateral endolymphatic sac tumors and a retrospective case review of hearing preservation surgery for removal of small endolymphatic sac tumors in four patients with von Hippel-Lindau syndrome.

Setting Tertiary care academic medical centers.

Patients Four patients with von Hippel-Lindau syndrome (three with bilateral endolymphatic sac tumors) and progressive sensorineural hearing loss in which preoperative imaging studies revealed in situ or small endolymphatic sac tumors without ipsilateral labyrinthine destruction.

Intervention All four patients had complete surgical excisions of the endolymphatic sac tumor via one of three surgical approaches with the goal of hearing preservation. One patient had bilateral surgery.

Main Outcome Measures Audiometric and radiographic.

Results Nearly one-third (30.2%) of patients with von Hippel-Lindau syndrome and endolymphatic sac tumors have bilateral disease. All four patients (five ears) maintained serviceable hearing postoperatively after surgical excision of the endolymphatic sac tumor via a variety of approach options.

Conclusion The discovery of a small or in situ endolymphatic sac tumor affords the patient the option of surgical removal with hearing preservation. This is critical in the patient with von Hippel-Lindau syndrome who is at risk for bilateral disease and complete bilateral anacusis if tumor growth progresses.

Departments of Otolaryngology at *University of Massachusetts Medical School, Worcester, Massachusetts, †Vanderbilt University School of Medicine, Nashville, Tennessee, ‡Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, and §University of Cincinnati School of Medicine, Cincinnati, Ohio, U.S.A.

Presented at the American Neurotologic Society Meeting, Palm Desert, CA, U.S.A., May 12–13, 2001.

Address correspondence and reprint requests to Dr. Cliff A. Megerian, Department of Otolaryngology–Head and Neck Surgery, University of Massachusetts Medical Center, 55 Lake Avenue, Room S2-861, Worcester, MA 01655, U.S.A. Email: megerianc@ummhc.org

© 2002 Otology & Neurotology, Inc.