Clinical features of vestibular schwannomas in patients who experience hearing improvement after surgery.

摘要: Postoperative improvements in hearing patients with vestibular schwannoma are extremely rare. We reviewed nine cases retrospectively to investigate the clinical features of these cases. Hearing improvement was defined as an class according American Academy Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria. The comprised five men four women a mean age 40.4 years. Of tumors, three were solid six cystic; tumor size 29.7 mm. Mean pure tone average (PTA) speech discrimination scores (SDS) 47.5 dB 22.8%, respectively, preoperatively 29.6 83.9%, postoperatively. AAO-HNS distribution B:1 D:8, preoperatively, A: 5 B:4, A lateral suboccipital retrosigmoid approach (park bench) position used all patients. Clinical schwannomas included (1) large cystic (2) sudden onset loss, (3) presence valley shape middle-pitch area on preoperative audiograms, (4) almost intact inner ear function, (5) low SDS relative PTA (6) surgical treatment via within 6 months most recent exacerbation (7) observation I waves preoperative, intraoperative, postoperative auditory brainstem response (ABR) recordings, (8) mainly range SDS. For above features, translabyrinthine cochlear nerve section (unless wave intraoperative ABR trace disappears) should be avoided, regardless patient's level, if surgeon hopes maximize chances preserving or improving hearing.