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

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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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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