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Acta Neurochirurgica
Published in: Acta Neurochirurgica 11/2020

01-11-2020 | Vestibular Schwannoma | Original Article - Tumor - Schwannoma

Long-term prognosis of preserved useful hearing after surgery in patients with vestibular schwannoma: a study of 91 cases

Authors: Norio Ichimasu, Michihiro Kohno, Nobuyuki Nakajima, Ken Matsushima, Yujiro Tanaka, Kiyoaki Tsukahara, Taro Inagaki, Masanori Yoshino, Osamu Nagata

Published in: Acta Neurochirurgica | Issue 11/2020

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Abstract

Background

In patients with a vestibular schwannoma, some studies have reported that useful hearing preserved initially after surgery deteriorates gradually in the long term. Studies with more patients are needed to clarify the maintenance rate of postoperative hearing function and to identify prognostic of hearing function.

Method

Ninety-one patients (mean age, 39.5 years; mean tumor size, 18.9 mm) with preserved useful hearing immediately after surgery were retrospectively analyzed. The useful hearing was defined as the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) classes A and B. Hearing tests, including auditory brainstem responses (ABR) and distortion product otoacoustic emissions (DPOAE), were evaluated preoperatively, immediately after surgery, and at outpatient follow-up.

Results

At the final follow-up (mean, 63.0 months), the useful hearing was maintained in 79 patients (87%), and the hearing class remained unchanged during the follow-up period in 40 patients (44%). Significant predictors of useful hearing maintenance were AAO-HNS class A immediately after surgery, improvement of ABR, and the absence of postoperative DPOAE deterioration. Postoperative DPOAE deterioration correlated with hearing class deterioration.

Conclusions

Despite hearing being preserved in vestibular schwannoma patients immediately after surgery, Thirteen percent lost their useful hearing during the long follow-up period, and hearing class worsened in 55% of the patients. This study, which analyzed one of the largest series of vestibular schwannoma patients, demonstrated that retrocochlear condition is a key factor for useful hearing maintenance. In patients with vestibular schwannoma who have preserved hearing function, regular postoperative monitoring of hearing function is as important as regular MRI.
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Metadata
Title
Long-term prognosis of preserved useful hearing after surgery in patients with vestibular schwannoma: a study of 91 cases
Authors
Norio Ichimasu
Michihiro Kohno
Nobuyuki Nakajima
Ken Matsushima
Yujiro Tanaka
Kiyoaki Tsukahara
Taro Inagaki
Masanori Yoshino
Osamu Nagata
Publication date
01-11-2020
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 11/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-020-04523-2

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