Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Scripps Clinic, La Jolla.
Otol Neurotol. 2021 Jul 1;42(6):923-930. doi: 10.1097/MAO.0000000000003088.
Describe the effect of preoperative sudden hearing loss (SHL) on likelihood of hearing preservation (HP) after surgical resection of vestibular schwannoma (VS).
Retrospective chart review.
Tertiary referral center.
Adult patients (≥18 years) who underwent retrosigmoid VS resection for HP between February 2008 and December 2018 were reviewed. All patients had preoperative word recognition score (WRS) of at least 50%. Similarly, HP was defined as postoperative WRS of more than or equal to 50%. Regression analysis was used to describe the effect of SHL on HP, accounting for tumor size, and preoperative hearing quality.
All patients underwent retrosigmoid VS resection for HP.
WRS of at least 50%.
Of 160 patients who underwent retrosigmoid VS resection during the study period, 153 met inclusion criteria. Mean tumor size was 14.0 (±6) mm. Hearing was preserved in 41.8% (n = 64). Forty patients (26.1%) had a history of preoperative SHL. Among 138 patients (90.2%) in whom the cochlear nerve was anatomically preserved during surgery, HP was achieved in 61.8% of those with SHL (21 of 34) and 41.3% of those without SHL (43 of 104) (p = 0.0480). On univariate and multivariate analysis (accounting for tumor size and preoperative hearing quality), SHL was a significant positive predictor of HP (odds ratio 2.292, p = 0.0407 and odds ratio 2.778, p = 0.0032, respectively).
In patients with VS and retained serviceable hearing, SHL is an independent predictor of HP after retrosigmoid microsurgical resection when the cochlear nerve is preserved.
描述术前突发性听力损失（SHL）对听神经保留（HP）后神经鞘瘤（VS）手术切除的可能性的影响。
回顾性图表审查。
三级转诊中心。
2008 年 2 月至 2018 年 12 月期间接受后乙状窦 VS 切除术以保留听力的成年患者（≥18 岁）。所有患者术前言语识别得分（WRS）至少为 50%。同样，HP 定义为术后 WRS 大于或等于 50%。回归分析用于描述 SHL 对 HP 的影响，同时考虑肿瘤大小和术前听力质量。
所有患者均接受后乙状窦 VS 切除术以保留听力。
WRS 至少为 50%。
在研究期间接受后乙状窦 VS 切除术的 160 名患者中，有 153 名符合纳入标准。平均肿瘤大小为 14.0±6mm。41.8%（n=64）听力保留。40 名患者（26.1%）有术前 SHL 病史。在 138 名术中解剖保留耳蜗神经的患者中，SHL 患者（34 例中的 21 例）HP 发生率为 61.8%，无 SHL 患者（104 例中的 43 例）为 41.3%（p=0.0480）。单因素和多因素分析（考虑肿瘤大小和术前听力质量）显示，SHL 是 HP 的显著阳性预测因子（优势比 2.292，p=0.0407 和优势比 2.778，p=0.0032）。
在 VS 患者和保留有用听力的患者中，当保留耳蜗神经时，SHL 是后乙状窦显微切除术后 HP 的独立预测因子。
