Hearing preservation after translabyrinthine approach performed to remove a large vestibular schwannoma.

We report the case of a 27-year-old woman from whom a left vestibular schwannoma (grade IV) was removed by a translabyrinthine approach. The initial period was uneventful except for a few days of vertigo. This patient had no facial paresis (House-Brackman grade I). She was seen 1, 3, 6 and 12 months after operation and reported a sensation of hearing in the left ear. The audiological studies showed a left medium hearing loss. At the 1-year follow-up visit, her hearing status was unchanged. A hearing aid was fitted and functioned satisfactory. At the 5-year follow-up visit, audiometry studies were unchanged. Our case demonstrated that some hearing preservation could be obtained even if the vestibular schwannoma was large and excised by a translabyrinthine approach. Hearing with the help of a good hearing aid allowed a satisfactory function in this case. We believe that it is possible to preserve some hearing after translabyrinthine approach even if no care was taken to preserve the membraneous labyrinth and the loss of endolymph and even if the vestibular schwannoma was large. However, further experimental studies are needed to determine and understand the mechanisms of hearing preservation in this case.