Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2010
Long-term hearing preservation after microsurgical excision of vestibular schwannoma.
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Woodson Erika Ann, Dempewolf Ryan Douglas, Gubbels Samuel Paul, Porter Aaron Thomas, Oleson Jacob Jay, Hansen Marlan Rex, Gantz Bruce Jay
Аннотация
OBJECTIVE: To examine long-term hearing outcomes after microsurgical excision of vestibular schwannoma (VS).
STUDY DESIGN: Retrospective case review.
SETTING: Tertiary referral center.
PATIENTS: 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.
INTERVENTION: Diagnostic.
MAIN OUTCOME MEASURES: 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).
RESULTS: 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.
CONCLUSION: 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.
STUDY DESIGN: Retrospective case review.
SETTING: Tertiary referral center.
PATIENTS: 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.
INTERVENTION: Diagnostic.
MAIN OUTCOME MEASURES: 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).
RESULTS: 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.
CONCLUSION: 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.
Предметные рубрики MeSH
AdultAgedAlgorithmsAudiometry, Pure-ToneAuditory ThresholdCranial Nerve NeoplasmsData Interpretation, StatisticalFemaleFollow-Up StudiesFunctional LateralityHearingHearing Loss, SensorineuralHumansKaplan-Meier EstimateMaleMicrosurgeryMiddle AgedNeuroma, AcousticOtologic Surgical ProceduresRetrospective StudiesSpeech PerceptionTreatment OutcomeYoung Adult