Hearing preservation after removal of small vestibular schwannomas by retrosigmoid approach: comparison of two different ABR neuromonitoring techniques

Hearing preservation after removal of small vestibular schwannomas: the role of ABR neuromonitoring

“…This issue features an article by Mastronardi et al [7]. The authors evaluated the hearing preservation (HP) after removal of vestibular schwannomas (VS) with a maximum diameter of < 2 cm.…”

“…Mastronardi et al [7] claimed that the use of LS-CE-Chirp ABR as an intraoperative neuromonitoring technique might be superior to Click ABR by providing faster feedback and shorter latency. In fact, the shorter latency of evoked waves by CE-Chirp in comparison with the classical Click is indeed expected since the onset and offset times of CE-Chirp has been pre-adjusted to give such results [15].…”

“…Moreover, with the aid of special software systems, the use of combined analog filter and digital filter (WF 25 and WF 50) would enable neurophysiologists to obtain interpretable Click ABR traces in 5 s with the summation of fewer sweeps [8]. This will alert the surgeon even faster compared to LS-CE-Chirp ABR system based on the results reported by Mastronardi et al [7].…”

Current Understanding of Hearing Loss in Sporadic Vestibular Schwannomas: A Systematic Review

“…While the intraoperative monitoring of facial nerve has become a standard technique in the surgery of SVS, some clinicians tried intraoperative brainstem auditory evoked response and cochlear compound action potentials to identify the location of cochlear nerves and monitor its functional status ( 76 , 78 ). Current literature supports its therapeutic value on hearing preservation in small-medium-sized tumors, but its role in the large SVS remains to be determined ( 76 , 77 , 79 ). Cochlear implants (CI), as the most successful neural prosthesis, also play an important role in the hearing rehabilitation for SVS patients after surgery.…”

Treatment of small and medium-sized vestibular schwannoma—a need for better evidence

“…The total removal of a small vestibular schwannoma while preserving hearing and facial function is undoubtedly a very good result, but the complaints of tinnitus and dizziness may persist. In the present issue of Acta, two expert groups report outcomes of microsurgery for small vestibular schwannoma and review selected literature [6,18]. Both deal with retrospective case series showing the outcomes achieved by experienced surgeons.…”