Preoperative Sudden Hearing Loss May Predict Hearing Preservation After Retrosigmoid Resection of Vestibular Schwannoma.

OBJECTIVES

Describe the effect of preoperative sudden hearing loss (SHL) on likelihood of hearing preservation (HP) after surgical resection of vestibular schwannoma (VS).

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary referral center.

PATIENTS

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.

INTERVENTIONS

All patients underwent retrosigmoid VS resection for HP.

MAIN OUTCOME MEASURES

WRS of at least 50%.

RESULTS

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).

CONCLUSION

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.