Long-term prognosis of preserved useful hearing after surgery in patients with vestibular schwannoma: a study of 91 case
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ORIGINAL ARTICLE - TUMOR - SCHWANNOMA
Long-term prognosis of preserved useful hearing after surgery in patients with vestibular schwannoma: a study of 91 cases Norio Ichimasu 1 & Michihiro Kohno 1,2 & Nobuyuki Nakajima 1 & Ken Matsushima 1 & Yujiro Tanaka 1 & Kiyoaki Tsukahara 3 & Taro Inagaki 3 & Masanori Yoshino 2 & Osamu Nagata 4 Received: 30 March 2020 / Accepted: 30 July 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
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. Keywords Acoustic neurinoma . Preserved useful hearing . Prognosis . Vestibular schwannoma . Hearing function . Surgery
This article is part of the Topical Collection on Tumor - Schwannoma * Michihiro Kohno [email protected] 1
Department of Neurosurgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku, Tokyo 160-0023, Japan
2
Department of Neurosurgery, Tokyo Metropolitan Police Hospital, Tokyo, Japan
3
Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
4
Department of Anesthesiology, Center Hospital of National Center for Global Health and Medicine, Tokyo, Japan
Abbreviations AAO-HNS American Academy of Otolaryngology-Head and Neck Surgery ABR Auditory brainstem responses DPOAE Distortion product o
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