Is it worthwhile to attempt hearing preservation in larger acoustic neuromas

摘要: Objective To determine the hearing outcome in patients undergoing surgery via retrosigmoid approach for acoustic neuromas with a substantial component cerebellopontine angle. Study design Retrospective case review. Setting Tertiary referral center. Patients The medical records of all neuroma removal at tertiary center were retrospectively reviewed. Sixty-four both angle >or=15 mm and preoperative audiometry class A or B (American Academy Otolaryngology-Head Neck Surgery) identified. Main measures Postoperative average pure tone threshold word recognition scores, categorized according to classification American Surgery, used assess outcome. Results Overall, only 6.3% (4 63) retained good (class B) postoperatively. Hearing preservation rate smallest (15- 19-mm) group was 17.6% (3 17), which better than that larger groups. No successful achieved tumors >or=25 (0 23). Conclusions Surgeon patient alike would always choose technique if there no potential increased morbidity making attempt. When compared non-hearing translabyrinthine approach, had higher incidence persistent headache. In addition, efforts conserve auditory nerve prolong operating time, increase postoperative vestibular dysfunction, carry slightly risk tumor recurrence. Nevertheless, even though probability success is disappointingly small, when excellent present we favor offering option conservation attempt has been well informed pros cons endeavor. Factors weighing against undertaking this effort include (>or=25 mm), deep involvement fundus, wide erosion porus, marginal residual hearing.