Management of Vestibular Schwannoma with Normal Hearing.

IF 1.6 4区医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Audiology and Neuro-Otology Pub Date : 2023-01-01 DOI:10.1159/000524925

Nervana Salem, Ahmed Galal, Gianluca Piras, Vittoria Sykopetrites, Vittoria Di Rubbo, Mohamed Talaat, Ossama Sobhy, Mario Sanna

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引用次数: 1

Abstract

Introduction: This work aimed to study the management of vestibular schwannoma (VS) patients with normal hearing (NH).

Methods: A retrospective study was undertaken in a Quaternary referral center for skull base pathologies. Among 4,000 VS patients 162 met our strict audiological criteria for NH. These patients were divided into 2 management groups, wait and scan (W&S) (45/162, 25%) and operated patients (123/162, 75%), and 6 patients were included in both groups.

Results: Our management strategy achieved the goals for treatment of VS. First goal, all tumors were completely removed except for 2 intentional residuals. Second goal, facial nerve (FN) function preservation (House Brackmann I, II, and III) was 95.9%. Third goal, possible hearing preservation (HP) attempts occurred in (50/122) (40.9%) with an HP rate in 44% of the patients. Additionally, there were only 2 cases of postoperative complications with no CSF leakage. The prospect of HP in NH patients did not differ with respect to tumor size. However, patients with normal preoperative ABR seemed to have better chances of HP and good FN function and vice versa. HP rate was superior for the MCFA as opposed to the RS + RLA. W&S group demonstrated hearing stability in 88.9% of the patients and FN function stability of HB I in 100% of the patients.

Conclusions: Surgical resection is a reasonable and definitive management option for VS with NH. Nevertheless, choosing to manage cases with observation remains an appropriate management option for NH patients. ABR might be considered as an adjuvant tool indicating better prognosis for HP.

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听力正常的前庭神经鞘瘤的治疗。

前言:本研究旨在探讨听力正常(NH)的前庭神经鞘瘤(VS)患者的治疗。方法:在一家第四纪颅底病理转诊中心进行回顾性研究。在4000例VS患者中，162例符合我们严格的NH听力学标准。将患者分为等待扫描组(W&S)(45/162, 25%)和手术组(123/162,75%)2个管理组，两组各6例。结果:我们的治疗策略达到了治疗vs的目标。第一目标，除2例故意残留外，所有肿瘤均被完全切除。第二个目标，面神经(FN)功能保存(House Brackmann I, II, III)为95.9%。第三个目标，可能的听力保护(HP)尝试发生在(50/122)(40.9%)患者中，HP率为44%。术后并发症2例，无脑脊液漏。NH患者HP的前景与肿瘤大小无关。然而，术前ABR正常的患者似乎有更好的机会HP和FN功能良好，反之亦然。与RS + RLA相比，MCFA的HP率更高。W&S组88.9%的患者听力稳定，100%的患者HB I FN功能稳定。结论:手术切除是VS合并NH的合理和明确的治疗选择。然而，选择对病例进行观察仍然是NH患者的适当管理选择。ABR可作为HP预后较好的辅助工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Audiology and Neuro-Otology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.20%

发文量

审稿时长

>12 weeks

期刊介绍： ''Audiology and Neurotology'' provides a forum for the publication of the most-advanced and rigorous scientific research related to the basic science and clinical aspects of the auditory and vestibular system and diseases of the ear. This journal seeks submission of cutting edge research opening up new and innovative fields of study that may improve our understanding and treatment of patients with disorders of the auditory and vestibular systems, their central connections and their perception in the central nervous system. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines.