Preservation of Hearing by the Retrosigmoid Approach in Acoustic Neuroma Surgery

Sterkers, J M; Sterkers, Olivier; Maudelonde, Claire; Corlieu, P

doi:10.1159/000409849

Cited by 15 publications

(4 citation statements)

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“…This is relatively consistent with the 35% obtained in a review by Glasscock et al, 16 who also use both middle fossa and retrosigmoid approaches. Hearing preservation in middle cranial fossa series is generally higher, varying from 50% 13 to 59%, 19 than in retrosigmoid series in which success rates for hearing preservation vary widely, 12,20–23 with a range of 16.5% 24 to 65% 8 …”

Section: Methodsmentioning

confidence: 96%

Intraoperative Auditory Monitoring in Acoustic Neuroma Surgery

Zappia¹,

Wiet²,

O'Connor³

et al. 1996

Otolaryngol.--head neck surg.

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Intraoperative auditory monitoring is a useful adjunct that is currently evolving. Near-field monitoring techniques such as electrocochleography and direct eighth nerve compound action potential are being used more frequently. The use of these two techniques is compared in 26 patients undergoing hearing preservation acoustic neuroma resection. Overall, 9 (35%) of the 26 patients had their hearing preserved. Three (23%) of the 13 with electrocochleography monitoring and 6 (46%) of the 13 with direct compound action potential monitoring had hearing preserved after surgery. Although there was a suggestion of improved results with direct compound action potential monitoring, the results were not statistically different. It was noted that lack of electrical response at the completion of the procedure (regardless of monitoring technique) was correlated with poor postoperative hearing, whereas the presence of a waveform at termination in no way predicted satisfactory postoperative hearing. The two techniques and their advantages and disadvantages are discussed.

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Section: Methodsmentioning

confidence: 96%

Intraoperative Auditory Monitoring in Acoustic Neuroma Surgery

Zappia¹,

Wiet²,

O'Connor³

et al. 1996

Otolaryngol.--head neck surg.

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“…Preservation of the cochlear nerve in cases of acoustic tumours removed via the middle cranial fossa and posterior fossa routes followed in the next few years (House etal, 1968b;Smith etal, 1973). There are now many large series demonstrating hearing conservation in acoustic neuroma surgery (Sterkers 1984;Palva et al, 1985;Glasscock et al, 1987a;Harker and McCabe, 1988). This progressive reduction in morbidity following surgery has been achieved in part by improvements in operative technique and earlier diagnosis of tumours (Glasscock et al, 1987b).…”

Section: Introductionmentioning

confidence: 99%

Hearing conservation in acoustic neuroma surgery via the posterior fossa

1990

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An increasing number of patients with an acoustic neuroma present with useful hearing in the tumour ear. Surgical removal of these tumours via the posterior fossa route may enable preservation of the cochlear nerve and otic capsule without increasing the morbidity to the facial nerve. The results of treating 51 cases of acoustic neuroma via the posterior fossa is presented. Forty four tumours measured less than 20 mm in diameter in the cerebellopontine angle and surgery was undertaken with hearing preservation as a principle objective. In 26 cases, the cochlear nerve was preserved anatomically and post-operative hearing at levels better than mean pure tone threshold of 50 dB or 50 per cent speech discrimination was recorded in 14 patients. The preservation of hearing represents a worthwhile surgical goal in selected patients with an acoustic neuroma without increasing the operative morbidity.

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“…Hearing preservation in solitary vestibular schwannoma surgery using the retrosigmoid approach (30 to 60 years), with a few cases at either extreme. For patients older than 60 years, the small number is influenced by the increasing tendency to observe slow-growing tumors in the elderly age group, rather than recommend surgery, 13 and the small number in the age groups younger than 20 years reflects the relative rarity of vestibular schwannoma at this period of life.…”

Section: Eugene N Myers MD International Editormentioning

confidence: 99%

“…Under these conditions hearing-preservation surgery through the posterior fossa approach has little to recommend it. However, "star" hearing-preservation patients do occur, and it seems that hearing, on rare occasions, can improve after tumor removal, 13,39,40 although predicting these results before surgery is problematic.…”

Section: Is Preserved Hearing Socially Useful?mentioning

confidence: 99%

Hearing preservation in solitary vestibular schwannoma surgery using the retrosigmoid approach

Myers¹,

Moffat²,

Cruz³

et al. 1999

Otolaryngol.--head neck surg.

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The results of 50 cases of vestibular schwannoma surgery with hearing preservation performed by the retrosigmoid approach at Addenbrooke's Hospital, Cambridge, during a 10-year period are presented. The hearing-preservation rate, using audiometric criteria set by others as "serviceable hearing" (Wade PJ, House W. Otolaryngol Head Neck Surg 1984;92:1184-93; Silverstein H, et al. Otolaryngol Head Neck Surg 1986;95:285-91; Cohen NL, et al. Am J Otol 1993;14:423-33) was 8% (4 of 50 cases). When the more stringent selection criteria of near-normal hearing and reporting criteria of socially useful hearing preservation (pure-tone average < 30 dB/speech discrimination score > 70%) is used, the hearing-preservation rate is 4.8% (1 of 21 cases). The only preoperative factor that may predict a favorable hearing-preservation outcome is normal auditory brain stem response morphology (Fisher's exact 2-tailed test, P < 0.001). The number of suitable candidates for hearing-preservation surgery are few. Reasonable indications for attempted vestibular schwannoma surgery with hearing preservation are discussed.

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Preservation of Hearing by the Retrosigmoid Approach in Acoustic Neuroma Surgery

Cited by 15 publications

References 0 publications

Intraoperative Auditory Monitoring in Acoustic Neuroma Surgery

Intraoperative Auditory Monitoring in Acoustic Neuroma Surgery

Hearing conservation in acoustic neuroma surgery via the posterior fossa

Hearing preservation in solitary vestibular schwannoma surgery using the retrosigmoid approach

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