Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature review

Objectives. Hearing preservation after vestibular schwannoma (VS) surgery remains a surgical challenge. In some patients with preserved inner ear function, hearing improvement is achievable. As it is currently impossible to determine which patients will present this outcome, predictions must rely on...

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Main Authors: Zdenek Fik, Jan Lazak, Silvie Hruba, Zdenek Cada, Eduard Zverrna, Jan Betka
Format: Article
Language:English
Published: Palacký University Olomouc, Faculty of Medicine and Dentistry 2022-09-01
Series:Biomedical Papers
Subjects:
Online Access:https://biomed.papers.upol.cz/artkey/bio-202203-0015_hearing-improvement-after-vestibular-schwannoma-surgery-in-the-era-of-the-hearing-preservation-rule-case-repo.php
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author Zdenek Fik
Jan Lazak
Silvie Hruba
Zdenek Cada
Eduard Zverrna
Jan Betka
author_facet Zdenek Fik
Jan Lazak
Silvie Hruba
Zdenek Cada
Eduard Zverrna
Jan Betka
author_sort Zdenek Fik
collection DOAJ
description Objectives. Hearing preservation after vestibular schwannoma (VS) surgery remains a surgical challenge. In some patients with preserved inner ear function, hearing improvement is achievable. As it is currently impossible to determine which patients will present this outcome, predictions must rely on previously published reports. Our case report describes a patient who experienced hearing improvement from an unuseful level to a useful one after vestibular schwannoma surgery. Methods. Surgery was performed via suboccipital retrosigmoid approach. The patient underwent a basic audiovestibular protocol before and after the surgery - pure tone and speech audiometry, otoacoustic emissions, auditory brainstem responses, electronystagmography - together with a detailed questionnaire study. Usefulness of hearing was evaluated using the AAO-HNS guidelines, supplemented by a frequency of 4 kHz. Results. Hearing was preserved and even improved from an unuseful level to a useful one. Based on the available literature, the most informative predictive factors for such a result seem to be: sudden sensorineural hearing loss prior to surgery, elicitable otoacoustic emissions and the origin from the superior vestibular nerve. Conclusion. There are a limited number of studies on this topic and it is still impossible to regularly improve hearing in properly selected patients. Furthermore, the importance of postoperative hearing quality compared to other symptoms and complications remains debatable.
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spelling doaj.art-a3f4bbede3bd48a1bba55d63f1017c1a2022-12-22T03:16:56ZengPalacký University Olomouc, Faculty of Medicine and DentistryBiomedical Papers1213-81181804-75212022-09-01166334735210.5507/bp.2021.067bio-202203-0015Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature reviewZdenek Fik0Jan Lazak1Silvie Hruba2Zdenek Cada3Eduard Zverrna4Jan Betka5Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech RepublicDepartment of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech RepublicDepartment of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech RepublicDepartment of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech RepublicDepartment of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech RepublicDepartment of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech RepublicObjectives. Hearing preservation after vestibular schwannoma (VS) surgery remains a surgical challenge. In some patients with preserved inner ear function, hearing improvement is achievable. As it is currently impossible to determine which patients will present this outcome, predictions must rely on previously published reports. Our case report describes a patient who experienced hearing improvement from an unuseful level to a useful one after vestibular schwannoma surgery. Methods. Surgery was performed via suboccipital retrosigmoid approach. The patient underwent a basic audiovestibular protocol before and after the surgery - pure tone and speech audiometry, otoacoustic emissions, auditory brainstem responses, electronystagmography - together with a detailed questionnaire study. Usefulness of hearing was evaluated using the AAO-HNS guidelines, supplemented by a frequency of 4 kHz. Results. Hearing was preserved and even improved from an unuseful level to a useful one. Based on the available literature, the most informative predictive factors for such a result seem to be: sudden sensorineural hearing loss prior to surgery, elicitable otoacoustic emissions and the origin from the superior vestibular nerve. Conclusion. There are a limited number of studies on this topic and it is still impossible to regularly improve hearing in properly selected patients. Furthermore, the importance of postoperative hearing quality compared to other symptoms and complications remains debatable.https://biomed.papers.upol.cz/artkey/bio-202203-0015_hearing-improvement-after-vestibular-schwannoma-surgery-in-the-era-of-the-hearing-preservation-rule-case-repo.phpvestibular schwannomahearing improvementretrosigmoid approachquality of life
spellingShingle Zdenek Fik
Jan Lazak
Silvie Hruba
Zdenek Cada
Eduard Zverrna
Jan Betka
Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature review
Biomedical Papers
vestibular schwannoma
hearing improvement
retrosigmoid approach
quality of life
title Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature review
title_full Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature review
title_fullStr Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature review
title_full_unstemmed Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature review
title_short Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature review
title_sort hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule case report and literature review
topic vestibular schwannoma
hearing improvement
retrosigmoid approach
quality of life
url https://biomed.papers.upol.cz/artkey/bio-202203-0015_hearing-improvement-after-vestibular-schwannoma-surgery-in-the-era-of-the-hearing-preservation-rule-case-repo.php
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