Contralateral Sensorineural Hearing Loss (SNHL) after Vestibular Schwannoma Surgery: Report of 4 cases

Abstract

We performed a review of the VS operated in our institution between 2004 and 2015, finding a total of 185 cases. Four of these patients developed a contralateral SNHL after VS surgery (Table 1). They were 3 men and 1 woman, with an average tumour size of 19,5 mm (range 7,8-30mm). Three of them were operated by a retrosigmoid approach, and the other one by a translabyrinthine approach. At the time of diagnosis of the VS, 2 patients had normal hearing (pure tone average (PTA): 20 and 22 dB) and 2 has mild hearing loss (PTA: 26 and 40 dB). After surgery all patients developed a complete hearing loss in the operated ear. The median time of appearance of the contralateral SNHL was 16 months (range 2-54 months) with an average of hearing loss in the contralateral ear at the moment of diagnosis of 46dB. Moreover, 3 patients developed tinnitus in the contralateral ear and 2 of them developed also episodic vertigo. AbstractContralateral sensorineural hearing loss after vestibular schwannoma (VS) resection has been described, resulting in a severe complication, especially if hearing preservation in the operated side was not a reachable outcome. There exist several theories that would explain this complication, without any guideline of treatment established. We report four patients treated in our institution who developed a severe contralateral SNHL after surgery. After medical treatment only one patient recovered hearing (moderate SNHL) and the other 3 presented a severe SNHL. Cochlear implant was the only treatment of choice in two of them.