Middle Fossa Approach for Resection of Vestibular Schwannoma

Autor: Stéphane Schapira, Marion Devambez, Elias Haddad, Jean-Pascal Lebreton, Frédérique Dubrulle, François-Michel Vaneecloo, Jean-Paul Lejeune, Nicolas-Xavier Bonne, Célia Guérin, Christophe Vincent
Rok vydání: 2012
Předmět:
Zdroj: Otology & Neurotology. 33:849-852
ISSN: 1531-7129
DOI: 10.1097/mao.0b013e318254ede3
Popis: Objective To analyze the impact of patient selection and auditory monitoring on hearing results after middle fossa craniotomy approach for resection of a vestibular schwannoma (VS). Study design Retrospective case review. Setting Tertiary referral center. Patients Patients undergoing a middle fossa craniotomy for resection of VS at a single institution between 1995 and 2006 were included in the study population. Patients presenting with Neurofibromatosis Type 2 or who underwent a combined approach (middle fossa and retrosigmoid) were excluded. Main outcome measures Hearing preservation as measured by serial audiograms. Results Seventy-seven patients were identified. Before excluding patients with cochlear fossa enhancement and the use of auditory monitoring, 47% of the patients maintained serviceable hearing (American Academy of Otolaryngology-Head and Neck Surgery Class A or B). By selecting tumors that did not involve the cochlear fossa and using auditory monitoring, serviceable postoperative hearing was preserved in 76% of the patients. Conclusion Modification of our selection criteria for surgery and the use of auditory monitoring have improved our hearing results for patients undergoing a middle fossa approach for resection of VS from 47% to 76%.
Databáze: OpenAIRE