To examine long-term hearing outcomes after microsurgical excision of vestibular schwannoma (VS).
Retrospective case review.
Tertiary referral center.
Forty-nine subjects at a single institution who had undergone microsurgical excision of a VS via middle cranial fossa (MCF) approach between 1994 and 2007 with immediate postoperative (PO) hearing preservation and for whom long-term audiograms were available.
Word Recognition Score (WRS) is defined by speech discrimination scores (SDS) greater than 70% (grade I), 50% to 70% (grade II), less than 50% (grade III), and 0% (grade IV).
For subjects with more than 2 years of follow-up, WRS I hearing was present PO in 42 of 49 patients and was preserved at the latest follow-up in 38 (90%) of 42 patients. No subjects fell beyond WRS II. WRS I hearing was maintained in 23 (88%) of 26 patients with more than 5 years of follow-up. Postoperative WRS I to II hearing was maintained in 28 (96%) of 29 patients with more than 5 years of follow-up. The patient who lost significant hearing in the ear operated on had sensorineural hearing loss that paralleled deterioration in her ear that was not operated on.
Most subjects maintain their initial PO SDS after microsurgical VS removal, and therefore, the initial PO WRS is predictive of long-term hearing. Postsurgical changes do not alter the natural rate or pattern of progressive bilateral sensorineural hearing loss in individual subjects.
*Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, Iowa; †Department of Surgery-Otolaryngology Division, University of Wisconsin-Madison, Madison, Wisconsin; and ‡Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, U.S.A.
Address correspondence and reprint requests to Bruce Jay Gantz, M.D., Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Dr (21201 PFP), Iowa City, IA 52242-1078; E-mail: firstname.lastname@example.org