Document Detail


Hearing preservation in retrosigmoid approach of small vestibular schwannomas: prognostic value of the degree of internal auditory canal filling.
MedLine Citation:
PMID:  21113987     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVES: To assess the contribution of preoperative radiologic appearance of vestibular schwannoma (VS) on the magnetic resonance imaging in constructive interference in steady-state sequences and demonstrate if the degree of the internal auditory canal (IAC) filling is correlated with hearing and facial preservation.
PATIENTS: A group of 278 patients who underwent VS surgery in a tertiary referral center.
INTERVENTION: Retrosigmoid approach surgery.
MAIN OUTCOME MEASURES: Patients were classified in 4 groups according to the percentage of IAC filling on the preoperative magnetic resonance imaging as Group IAC 1(IAC empty or filled <25% and with free fundus), Group IAC 2 (IAC filled from 25% to 50% with free fundus), Group IAC 3 (IAC filled from 50% to 75% with free fundus), and Group IAC 4 (complete filling of the IAC without fundus obliteration).
RESULTS: A good correlation was observed between the IAC classification and the rate of hearing and facial preservation. The global rate of postoperative facial palsy was 10.4%. The global rate of hearing preservation in 213 patients with preoperative hearing class A and B was 40.8%. Regression analysis showed that the degree of lateral extension of the VS in the IAC was a strong predictor of hearing preservation ( p < 0.04).
CONCLUSION: The retrosigmoid approach yields good facial outcomes in selected patients with possible hearing preservation. In case of patient with small tumor and IAC empty or filled less than 75% and with free fundus, surgery is the treatment of choice for patients with serviceable hearing and the desire to retain it.
Authors:
Stéphane Tringali; Chantal Ferber-Viart; Carine Fuchsmann; Guillaume Buiret; Sandra Zaouche; Christian Dubreuil
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  31     ISSN:  1537-4505     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1469-72     Citation Subset:  IM    
Affiliation:
Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Département d'Otologie et d'Otoneurotologie, Pierre-Bénite, France. stephane.tringali@chu-lyon.fr
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