How Well Does Intraoperative Audiologic Monitoring Predict Hearing Outcome During Middle Fossa Vestibular Schwannoma Resection?

2018 ◽  
Vol 39 (7) ◽  
pp. 908-915 ◽  
Author(s):  
Daniel Q. Sun ◽  
C. Blake Sullivan ◽  
Raymond W. Kung ◽  
Megan Asklof ◽  
Marlan R. Hansen ◽  
...  
2020 ◽  
Vol 133 (3) ◽  
pp. 749-755 ◽  
Author(s):  
Gautam U. Mehta ◽  
Gregory P. Lekovic

Although most widely known as the birthplace of neuro-otology, the House Clinic in Los Angeles has been the site of several major contributions to the field of neurosurgery. From the beginning of the formation of the Otologic Medical Group in 1958 (later renamed the House Ear Clinic), these contributions have been largely due to the innovative and collaborative work of neurosurgeon William E. Hitselberger, MD, and neuro-otologist William F. House, MD, DDS. Together they were responsible for the development and widespread adoption of the team approach to skull-base surgery. Specific neurosurgical advances accomplished at the House Clinic have included the first application of the operative microscope to neurosurgery, the application of middle fossa and translabyrinthine approaches for vestibular schwannoma, and the development of combined petrosal, retrolabyrinthine, and other alternative petrosal approaches and of hearing preservation surgery for vestibular schwannoma. The auditory brainstem implant, invented at the House Clinic in 1979, was the first ever successful application of central nervous system neuromodulation for restoration of function. Technological innovations at the House Clinic have also advanced neurosurgery. These include the first video transmission of microsurgery, the first suction irrigator, the first debulking instrument for tumors, and the House-Urban retractor for middle fossa surgery.


2001 ◽  
Vol 22 (6) ◽  
pp. 917-921 ◽  
Author(s):  
Katrina R. Stidham ◽  
Joseph B. Roberson

CSurgeries ◽  
2018 ◽  
Author(s):  
Cameron Wick ◽  
Samuel Barnett ◽  
J. Walter Kutz Jr. ◽  
Brandon Isaacson

Neurosurgery ◽  
2011 ◽  
Vol 70 (2) ◽  
pp. 334-341 ◽  
Author(s):  
Joe Walter Kutz ◽  
Tyler Scoresby ◽  
Brandon Isaacson ◽  
Bruce E. Mickey ◽  
Christopher J. Madden ◽  
...  

Abstract BACKGROUND: The incidence of small vestibular schwannomas in patients with serviceable hearing is increasing because of the widespread use of MRI. The middle fossa approach provides the patient with an opportunity for tumor removal with hearing preservation. OBJECTIVE: To determine the rate of hearing preservation and facial nerve outcomes after removal of a vestibular schwannoma with the use of the middle fossa approach. METHODS: A retrospective case review at a tertiary, academic medical center was performed identifying patients from 1998 through 2008 that underwent removal of a vestibular schwannoma by the middle fossa approach. Preoperative and postoperative audiograms were compared to determine hearing preservation rates. In addition, facial nerve outcomes at last follow-up were recorded. RESULTS: Forty-six patients underwent a middle fossa craniotomy for the removal of a vestibular schwannoma. Of the 38 patients that had class A or class B hearing preoperatively, 24 (63.2%) retained class A or B hearing and 29 (76.3%) retained class A, B, or C hearing. When tumors were 10 mm or less in patients with class A or B preoperative hearing, 22 of 30 patients (73.3%) retained class A or B hearing. When the tumor size was greater than 10 mm in patients with class A or B preoperative hearing, 2 of 8 patients (25%) retained class A or B hearing. At most recent follow-up, 76.1% of patients had House-Brackmann grade I facial function, 13.0% had House-Brackmann grade II facial function, and 10.9% had House-Brackmann grade III facial function. CONCLUSION: Hearing preservation rates are excellent using the middle fossa approach, especially for smaller tumors. No patient experienced long-term facial nerve function worse than House-Brackmann grade III.


2012 ◽  
Vol 33 (5) ◽  
pp. 849-852 ◽  
Author(s):  
Christophe Vincent ◽  
Nicolas-Xavier Bonne ◽  
Célia Guérin ◽  
Jean-Pascal Lebreton ◽  
Marion Devambez ◽  
...  

2010 ◽  
Vol 124 (5) ◽  
pp. 490-494 ◽  
Author(s):  
S-E Stangerup ◽  
M Tos ◽  
J Thomsen ◽  
P Caye-Thomasen

AbstractAims:This study aimed to evaluate the predictive value of both hearing level (at various frequencies) and speech discrimination for forecasting hearing outcome after a period of observation, in patients with vestibular schwannoma.Subjects:Over a 33-year period, 1144 patients with vestibular schwannoma were allocated to ‘wait and scan’ management, with annual magnetic resonance imaging and audiological examination. Two complete pure tone and speech discrimination audiograms were available for 932 patients.Results:The predictive value of initial hearing level better than 10 dB for forecasting hearing outcome after observation increased from 59 per cent at 250 Hz to 94 percent at 4000 Hz. At diagnosis, hearing level of 10 dB or better at 4000 Hz was found in only 18 of the 932 VS ears, while good speech discrimination was found in 159 patients (17 per cent). Of the latter patients, 138 maintained good hearing after observation.Conclusion:In vestibular schwannoma patients, good high frequency hearing and good speech discrimination at diagnosis are useful tools in predicting good hearing after observation.


CSurgeries ◽  
2018 ◽  
Author(s):  
Cameron Wick ◽  
Sam Barnett ◽  
Walter Kutz ◽  
Brandon Isaacson

2007 ◽  
Vol 13 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Enrico Piccirillo ◽  
Harukazu Hiraumi ◽  
Masashi Hamada ◽  
Alessandra Russo ◽  
Alessandro De Stefano ◽  
...  

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