Prediction of Hearing Preservation in Vestibular Schwannoma Surgery According to Tumor Size and Anatomic Extension
Bozhkov Y, Shawarba J, Feulner J, Winter F, Rampp S, Hoppe U, Dörfler A, Iro H, Buchfelder M, Rössler K (2021)
Publication Type: Journal article
Publication year: 2021
Journal
DOI: 10.1177/01945998211012674
Abstract
Objective: Vestibular schwannoma (VS) surgery is feasible for various tumor sizes that are inappropriate for wait and scan or radiosurgery. The predictive value of 2 grading systems was investigated for postoperative hearing preservation (HP) in a large series. Study Design: Retrospective analysis. Setting: Neurosurgical patient database of the University of Erlangen was queried between 2014 and 2017. Methods: Retrospective single-center analysis on 138 VSs operated on via a retrosigmoidal approach. The mean tumor size was 20.4 mm (SD, 7.6 mm) with fundal infiltration in 67.4%. The overall resection rate was 93.5%. Tumors were classified preoperatively by the 3-tier Erlangen grading system depending on size or the anatomically based 4-tier Koos grading system. Results: Preoperative hearing preservation was found in 70.3% of patients and was significantly correlated to tumor size (P =.001). For Erlangen grading, a mean postoperative serviceable hearing preservation rate of 32% was achieved: 83.3% for tumors <12 mm, 30.3% for tumors between 12 and 25 mm, and 5.3% for tumors >25 mm. In contrast, according to Koos grading, postoperative serviceable hearing preservation was 100% for grade 1 tumors (meatal), 35.6% for grade 2 (cisternal), 23.1% for grade 3 (brainstem contact), and 21.7% for grade 4 (brainstem compression). Of the total cohort, 86% had normal or nearly normal postoperative facial function (House-Brackmann grades 1 and 2). Conclusion: Surgery on small VSs can achieve excellent hearing preservation. Different grading has a significant influence on and correlates with postoperative hearing preservation. Tumor size seems more important than anatomic relationship.
Authors with CRIS profile
Julia Shawarba
Department of Neurosurgery
Julian Feulner
Lehrstuhl für Innere Medizin V
Stefan Rampp
Department of Neurosurgery
Ulrich Hoppe
Professur für Audiologie
Arnd Dörfler
Department of Neuroradiology
Heinrich Iro
Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde
Michael Buchfelder
Lehrstuhl für Neurochirurgie
Involved external institutions
Austria (AT)How to cite
APA:
Bozhkov, Y., Shawarba, J., Feulner, J., Winter, F., Rampp, S., Hoppe, U.,... Rössler, K. (2021). Prediction of Hearing Preservation in Vestibular Schwannoma Surgery According to Tumor Size and Anatomic Extension. Otolaryngology - Head and Neck Surgery. https://doi.org/10.1177/01945998211012674
MLA:
Bozhkov, Yavor, et al. "Prediction of Hearing Preservation in Vestibular Schwannoma Surgery According to Tumor Size and Anatomic Extension." Otolaryngology - Head and Neck Surgery (2021).
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