Grey P L, Baguley D M, Moffat D A, Hardy D G, Beynon G J
Department of Otoneurological and Skull Base Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom.
Am J Otol. 1996 Jul;17(4):634-8.
Meningiomas are the second most common cerebellopontine angle (CPA) tumor. The reported rates of hearing preservation following surgical removal vary between 32% and 100%. There is only one recent report discussing vestibular function after CPA meningioma removal. In this series of 31 patients with CPA meningiomas, 16 patients had their tumors removed via the retrosigmoid approach. All 16 had audiovestibular assessment pre- and postsurgery and were the subjects of this study. Class A hearing is socially useful hearing and is defined as a pure tone average (PTA; average of 500 Hz and 1, 2 and 4 kHz) of < 30 dB and speech discrimination scores (SDS) of > 70%. Class B hearing is serviceable hearing, defined as PTA of < 50 dB and SDS of > 50%. Nine patients had class A hearing, and two had class B hearing presurgery. Socially useful hearing was preserved in six of nine (67%) patients in whom it was present before surgery, and serviceable or better hearing was preserved in eight of 11 (73%). Vestibular symptomatology and examination findings improved despite a decrease in the number of patients with intact caloric function postsurgery. Patients who retained vestibular function on caloric testing were symptomatically better than those who lost caloric function. These results confirm that excellent audiovestibular function is possible after CPA meningioma surgery.
脑膜瘤是桥小脑角（CPA）第二常见的肿瘤。手术切除后听力保留的报告率在32%至100%之间。近期仅有一篇报告讨论了CPA脑膜瘤切除术后的前庭功能。在这组31例CPA脑膜瘤患者中，16例患者通过乙状窦后入路切除肿瘤。这16例患者均在手术前后进行了听觉前庭评估，是本研究的对象。A级听力对社交有用，定义为纯音平均听阈（PTA；500Hz、1kHz、2kHz和4kHz的平均值）<30dB且言语辨别得分（SDS）>70%。B级听力为可用听力，定义为PTA<50dB且SDS>50%。9例患者术前为A级听力，2例为B级听力。术前具有A级听力的9例患者中有6例（67%）保留了对社交有用的听力，11例患者中有8例（73%）保留了可用或更好的听力。尽管术后冷热试验功能正常的患者数量减少，但前庭症状和检查结果有所改善。冷热试验保留前庭功能的患者症状比丧失冷热试验功能的患者更好。这些结果证实，CPA脑膜瘤手术后可以实现优异的听觉前庭功能。
