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Extended Retrolabyrinthine Approach: Results of Hearing Preservation Surgery Using a New System for Continuous Near Real-time Neuromonitoring in Patients With Growing Vestibular Schwannomas

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@article{ff6e745c579346d2b6f2050d97ee8664,
title = "Extended Retrolabyrinthine Approach: Results of Hearing Preservation Surgery Using a New System for Continuous Near Real-time Neuromonitoring in Patients With Growing Vestibular Schwannomas",
abstract = "OBJECTIVE: To report hearing preservation results after retrolabyrinthine vestibular schwannoma surgery, using a new system for continuous near real-time monitoring of cochlear nerve function.STUDY DESIGN: Retrospective chart review.SETTING: Tertiary referral center, University Hospital.PATIENTS: Thirty-one consecutive patients with growing vestibular schwannomas and opting for hearing preservation surgery.INTERVENTIONS: Tumor removal by a modified, extended retrolabyrinthine approach, using a new system for continuous near real-time monitoring of cochlear nerve function.MAIN OUTCOME MEASURES: Pure-tone average and speech discrimination (SD) 1-year postoperative. Preservation of word recognition score class. Preservation of serviceable hearing (SD>50{\%}).RESULTS: Any hearing was preserved in 83 and 69{\%} had preserved word recognition score class or better. Serviceable hearing was preserved in 77{\%}. SD was unchanged in 48{\%}, improved in 21{\%}, and poorer in 31{\%}. Of 18 patients with potential for improvement (SD 90{\%} or worse preoperatively), 33{\%} improved (SD increase 10{\%} or more).CONCLUSION: The hearing preservation rate is favorable using the modified, extended retrolabyrinthine approach and a new system for continuous near real-time monitoring of cochlear nerve function for removal of growing vestibular schwannomas, as 77{\%} preserved serviceable hearing 1 year after surgery. Hearing improved after surgery in 33{\%}. Using the new neuromonitoring system, serviceable hearing preservation rate improved from 53 to 77{\%} at our center.",
author = "Sass, {Hjalte C R} and Hidemi Miyazaki and Niels West and S{\o}ren Hansen and M{\o}ller, {Martin N} and Per Cay{\'e}-Thomasen",
year = "2019",
month = "6",
doi = "10.1097/MAO.0000000000002216",
language = "English",
volume = "40",
pages = "S72--S79",
journal = "Otology and Neurotology",
issn = "1531-7129",
publisher = "Lippincott Williams & Wilkins",
number = "5S Suppl 1",

}

RIS

TY - JOUR

T1 - Extended Retrolabyrinthine Approach

T2 - Results of Hearing Preservation Surgery Using a New System for Continuous Near Real-time Neuromonitoring in Patients With Growing Vestibular Schwannomas

AU - Sass, Hjalte C R

AU - Miyazaki, Hidemi

AU - West, Niels

AU - Hansen, Søren

AU - Møller, Martin N

AU - Cayé-Thomasen, Per

PY - 2019/6

Y1 - 2019/6

N2 - OBJECTIVE: To report hearing preservation results after retrolabyrinthine vestibular schwannoma surgery, using a new system for continuous near real-time monitoring of cochlear nerve function.STUDY DESIGN: Retrospective chart review.SETTING: Tertiary referral center, University Hospital.PATIENTS: Thirty-one consecutive patients with growing vestibular schwannomas and opting for hearing preservation surgery.INTERVENTIONS: Tumor removal by a modified, extended retrolabyrinthine approach, using a new system for continuous near real-time monitoring of cochlear nerve function.MAIN OUTCOME MEASURES: Pure-tone average and speech discrimination (SD) 1-year postoperative. Preservation of word recognition score class. Preservation of serviceable hearing (SD>50%).RESULTS: Any hearing was preserved in 83 and 69% had preserved word recognition score class or better. Serviceable hearing was preserved in 77%. SD was unchanged in 48%, improved in 21%, and poorer in 31%. Of 18 patients with potential for improvement (SD 90% or worse preoperatively), 33% improved (SD increase 10% or more).CONCLUSION: The hearing preservation rate is favorable using the modified, extended retrolabyrinthine approach and a new system for continuous near real-time monitoring of cochlear nerve function for removal of growing vestibular schwannomas, as 77% preserved serviceable hearing 1 year after surgery. Hearing improved after surgery in 33%. Using the new neuromonitoring system, serviceable hearing preservation rate improved from 53 to 77% at our center.

AB - OBJECTIVE: To report hearing preservation results after retrolabyrinthine vestibular schwannoma surgery, using a new system for continuous near real-time monitoring of cochlear nerve function.STUDY DESIGN: Retrospective chart review.SETTING: Tertiary referral center, University Hospital.PATIENTS: Thirty-one consecutive patients with growing vestibular schwannomas and opting for hearing preservation surgery.INTERVENTIONS: Tumor removal by a modified, extended retrolabyrinthine approach, using a new system for continuous near real-time monitoring of cochlear nerve function.MAIN OUTCOME MEASURES: Pure-tone average and speech discrimination (SD) 1-year postoperative. Preservation of word recognition score class. Preservation of serviceable hearing (SD>50%).RESULTS: Any hearing was preserved in 83 and 69% had preserved word recognition score class or better. Serviceable hearing was preserved in 77%. SD was unchanged in 48%, improved in 21%, and poorer in 31%. Of 18 patients with potential for improvement (SD 90% or worse preoperatively), 33% improved (SD increase 10% or more).CONCLUSION: The hearing preservation rate is favorable using the modified, extended retrolabyrinthine approach and a new system for continuous near real-time monitoring of cochlear nerve function for removal of growing vestibular schwannomas, as 77% preserved serviceable hearing 1 year after surgery. Hearing improved after surgery in 33%. Using the new neuromonitoring system, serviceable hearing preservation rate improved from 53 to 77% at our center.

U2 - 10.1097/MAO.0000000000002216

DO - 10.1097/MAO.0000000000002216

M3 - Journal article

VL - 40

SP - S72-S79

JO - Otology and Neurotology

JF - Otology and Neurotology

SN - 1531-7129

IS - 5S Suppl 1

ER -

ID: 58981042