Comparison of contrast-enhanced T1-weighted and 3D constructive interference in steady state images for predicting outcome after hearing-preservation surgery for vestibular schwannoma

AbstractBackground:Vestibular schwannomas are a rare cause of asymmetrical hearing loss, and routine screening with magnetic resonance imaging can be costly. This paper reports results on vestibular schwannoma screening at our institution and compares the cost of screening to a utility of hearing benefit.Method:All screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss between 2006 and 2011 were retrospectively reviewed. The cost per new vestibular schwannoma diagnosis was calculated. The cost per patient for those who benefitted from intervention was estimated based on rates of hearing preservation reported in the literature.Results:Forty-five (4.3 per cent) of 1050 screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss were positive for vestibular schwannoma, and the cost per new diagnosis was $11 436. The estimated screening cost per patient for those who benefitted from surgery or radiation was $147 030, while US federal compensation for unilateral hearing loss was $44 888.Conclusion:Although we achieved a lower screening cost per new diagnosis than reported in the current literature, there remains disparity between the screening cost per benefitted patient and the ‘benefit’ of hearing.

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Usefulness of the radiological planning for hearing preservation surgery in vestibular schwannoma

Surgical and Radiologic Anatomy ◽

10.1007/s00276-016-1668-z ◽

2016 ◽

Vol 38 (9) ◽

pp. 1007-1011

Author(s):

Kamil Krystkiewicz ◽

Tymon Skadorwa ◽

Paweł Szaro ◽

Bogdan Ciszek

Keyword(s):

Vestibular Schwannoma ◽

Hearing Preservation ◽

Hearing Preservation Surgery

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Hearing preservation surgery in vestibular schwannoma

The Journal of Laryngology & Otology ◽

10.1017/s002221510600332x ◽

2006 ◽

Vol 120 (5) ◽

pp. 366-370 ◽

Cited By ~ 22

Author(s):

Tarek Khrais ◽

Mario Sanna

Keyword(s):

Vestibular Schwannoma ◽

Tumour Size ◽

Hearing Preservation ◽

Neck Surgery ◽

Hearing Level ◽

Review Of Literature ◽

Tertiary Referral Centre ◽

Class A ◽

Strong Inverse Relationship ◽

Hearing Preservation Surgery

Objectives: To study the effect of pre-operative hearing level and tumour size on the hearing outcome of hearing preservation surgery for vestibular schwannoma.Study design and setting: A review of literature conducted at Gruppo Otologico, a tertiary referral centre for neurotology and skull base surgery.Results: A total of 1993 patients in 16 publications addressing the topic of hearing preservation surgery in vestibular schwannoma were analysed. The American Academy of Otolaryngology–Head and Neck Surgery hearing classification system was the classification upon which we based our analysis.Conclusion: Defining hearing preservation as class-A hearing, there was a strong inverse relationship between pre-operative hearing and post-operative hearing levels and between tumour size and post-operative hearing levels.

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Differentiation Between Paraclinoid and Cavernous Sinus Aneurysms with Contrast-Enhanced 3D Constructive Interference in Steady- State MR Imaging

American Journal of Neuroradiology ◽

10.3174/ajnr.a0756 ◽

2007 ◽

Vol 29 (1) ◽

pp. 130-133 ◽

Cited By ~ 28

Author(s):

T. Hirai ◽

Y. Kai ◽

M. Morioka ◽

S. Yano ◽

M. Kitajima ◽

...

Keyword(s):

Steady State ◽

Mr Imaging ◽

Cavernous Sinus ◽

Constructive Interference ◽

Contrast Enhanced

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3D-constructive interference into steady state (3D-CISS) labyrinth signal alteration in patients with vestibular schwannoma

Auris Nasus Larynx ◽

10.1016/j.anl.2017.09.011 ◽

2018 ◽

Vol 45 (4) ◽

pp. 702-710 ◽

Cited By ~ 2

Author(s):

Franca Wagner ◽

Evelyn Herrmann ◽

Roland Wiest ◽

Andreas Raabe ◽

Corrado Bernasconi ◽

...

Keyword(s):

Steady State ◽

Vestibular Schwannoma ◽

Constructive Interference

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Cochlear Fossa Enhancement at MR Evaluation of Vestibular Schwannoma: Correlation with Success at Hearing-Preservation Surgery

Radiology ◽

10.1148/radiology.215.2.r00ma20458 ◽

2000 ◽

Vol 215 (2) ◽

pp. 458-462 ◽

Cited By ~ 26

Author(s):

Frédérique Dubrulle ◽

Olivier Ernst ◽

Christophe Vincent ◽

François M. Vaneecloo ◽

Jean Paul Lejeune ◽

...

Keyword(s):

Vestibular Schwannoma ◽

Hearing Preservation ◽

Hearing Preservation Surgery

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Retrolabyrinthine Meatotomy as Part of Retrosigmoid Approach to Expose the Whole Internal Auditory Canal: Rationale, Technique, and Outcome in Hearing Preservation Surgery for Vestibular Schwannoma

Operative Neurosurgery ◽

10.1093/ons/opx091 ◽

2017 ◽

Vol 14 (1) ◽

pp. 36-44 ◽

Cited By ~ 12

Author(s):

Antonio Mazzoni ◽

Elisabetta Zanoletti ◽

Luca Denaro ◽

Alessandro Martini ◽

Domenico d’ Avella

Keyword(s):

Vestibular Schwannoma ◽

Internal Auditory Canal ◽

Residual Tumor ◽

Hearing Preservation ◽

Retrosigmoid Approach ◽

Long Term Results ◽

Consecutive Series ◽

Unfavorable Condition ◽

Hearing Preservation Surgery

Abstract BACKGROUND Vestibular schwannoma extending to the fundus of the internal auditory canal is currently considered an unfavorable condition for hearing preservation surgery via a retrosigmoid approach because the lateral end of the canal is hard to view directly during microsurgery. OBJECTIVE To present an improved retrolabyrinthine meatotomy (RLM) technique that enables the full length of the cochlear and facial nerves to be inspected up to their orifices on the fundus. Long-term results are briefly reported. METHODS A consecutive series of 100 cases with various degrees of fundus involvement underwent surgery via a retrosigmoid approach and RLM. The follow-up ranged from 4 to 14 yr. Outcomes on hearing and facial nerve function were recorded, and preoperative MRI findings of the tumor on the fundus were correlated with the surgical findings and the long-term radicality of the tumor resection. RESULTS Residual tumor on the fundus was identified in 3 cases, all belonging to the group with tumors adhering to the fundus. The functional results were in line with the best reported outcomes of this surgery. CONCLUSION RLM via a retrosigmoid approach seemed adequate for the purposes of hearing preservation surgery and enabled the full course of the facial and cochlear nerves through the internal auditory canal to be exposed to direct view. Tumors adhering to the vestibular quadrant of the fundus were more difficult to remove, and there were a few cases of local residual tumor.

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