Stangerup S-E, Tos M, Thomsen J, Caye-Thomasen P
ENT Department, Gentofte University Hospital, Copenhagen, Denmark.
J Laryngol Otol. 2010 May;124(5):490-4. doi: 10.1017/S0022215109992611. Epub 2010 Jan 19.
This study aimed to evaluate the predictive value of both hearing level (at various frequencies) and speech discrimination for forecasting hearing outcome after a period of observation, in patients with vestibular schwannoma.
Over a 33-year period, 1144 patients with vestibular schwannoma were allocated to 'wait and scan' management, with annual magnetic resonance imaging and audiological examination. Two complete pure tone and speech discrimination audiograms were available for 932 patients.
The predictive value of initial hearing level better than 10 dB for forecasting hearing outcome after observation increased from 59 per cent at 250 Hz to 94 percent at 4000 Hz. At diagnosis, hearing level of 10 dB or better at 4000 Hz was found in only 18 of the 932 VS ears, while good speech discrimination was found in 159 patients (17 per cent). Of the latter patients, 138 maintained good hearing after observation.
In vestibular schwannoma patients, good high frequency hearing and good speech discrimination at diagnosis are useful tools in predicting good hearing after observation.
本研究旨在评估听力水平（不同频率）和言语辨别能力对前庭神经鞘瘤患者经过一段时间观察后的听力预后的预测价值。
在33年的时间里，1144例前庭神经鞘瘤患者被分配至“等待观察并扫描”管理模式，每年进行磁共振成像和听力学检查。932例患者可获得两份完整的纯音和言语辨别听力图。
初始听力水平优于10 dB对观察后听力预后的预测价值，从250 Hz时的59%增至4000 Hz时的94%。诊断时，932例前庭神经鞘瘤患耳中，仅18例在4000 Hz时听力水平为10 dB或更好，而159例患者（17%）言语辨别能力良好。在后者中，138例患者观察后仍保持良好听力。
在前庭神经鞘瘤患者中，诊断时良好的高频听力和良好的言语辨别能力是预测观察后良好听力的有用指标。
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