| Hearing preservation following microsurgical resection of large vestibular schwannomas. | |
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MedLine Citation:
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PMID: 21164374 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Hearing, which is often still clinically useful at presentation even with larger tumors, is a major determinant of quality of life in vestibular schwannoma patients. OBJECTIVE:: To present the hearing preservation rate for our surgical series of large (≥3 cm) vestibular schwannomas (VSs), and identify possible clinical or radiologic predictors of hearing preservation. METHODS:: From April 2003 to March 2009, 192 patients underwent resection of a VS, including 46 large (≥3 cm) tumors, of which 28 had serviceable hearing pre-operatively. 6/28 patients (21.4%) had preserved hearing post-operatively. RESULTS:: Mean tumor diameter was 3.6 cm (range 3.0 - 5.0 cm) and tumor volume was 17.2 cc (range 6.9 - 45.2 cc). For patients with grade A Sanna-Fukushima hearing, the hearing preservation rate was 4/11 (36.4%). Complete resection was achieved in 6/6 cases with hearing preservation (41/47 for all patients). 6/6 patients with preserved hearing had a CSF cleft in the internal auditory canal (IAC), versus 9/16 patients without pre-operative hearing and 9/20 for patients with serviceable hearing but lost post-operatively (P = 0.045). 6/6 patients with preserved hearing had <35% of the tumor anterior to the longitudinal axis of the IAC, versus 13/20 in the serviceable hearing but lost group (P=0.036) CONCLUSION:: Our series demonstrates hearing preservation is possible for large VS and should be attempted in all cases with pre-operative hearing. The quality of pre-operative hearing, a CSF cleft at the apex of the IAC, and a smaller proportion of tumor anterior to the IAC were positively associated with hearing preservation. |
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Authors:
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Salvatore Di Maio; A Daniel Malebranche; Brian Westerberg; Ryojo Akagami |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2010-12-15 |
Journal Detail:
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Title: Neurosurgery Volume: - ISSN: 1524-4040 ISO Abbreviation: - Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Division of Neurosurgery, Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada; 2Division of Otolaryngology, Department of Surgery, St. Paul's Rotary Hearing Clinic, University of British Columbia, Vancouver, British Columbia, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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