Journal article
The Effect of Immediate Microsurgical Resection of Vestibular Schwannoma on Hearing Preservation
Otology & neurotology, Vol.44(6), pp.600-604
07/2023
DOI: 10.1097/MAO.0000000000003893
PMID: 37205868
Abstract
Objective
Evaluate for differences in postoperative hearing in patients who undergo immediate versus delayed hearing preservation microsurgical resection of vestibular schwannomas (VS).
Study Design
Retrospective single-institution cohort study spanning November 2017 to November 2021.
Setting
Single-institution tertiary care hospital.
Patients
Sporadic VS in patients with American Academy of Otolaryngology–Head and Neck Surgery hearing classification A or B, with tumor size less than or equal to 2 cm and undergoing hearing preservation microsurgical resection.
Interventions
Delayed surgical intervention defined by time from first diagnostic MRI to date of surgery being greater than 3 months
Main Outcome Measures
Preoperative and postoperative audiometric performance.
Results
In total, 193 patients met inclusion criteria. Within the cohort, 70 (36%) proceeded with surgery within 3 months of diagnostic MRI with a mean observation time of 62 days, whereas 123 (63%) underwent surgery after 3 months with a mean observation time of 301 days. There was no difference in preoperative hearing between the two groups with word recognition score 99% in early intervention group and 100% in delayed intervention group (p = 0.6). However, 64% of those who proceeded with immediate surgery had successful hearing preservation, compared to a 42% of those who had delayed intervention (p < 0.01). In a multivariable logistic regression accounting for preoperative word recognition score, tumor size, and age at diagnosis, the odds of hearing preservation were lower in those who delayed surgery compared to immediate surgery (odds ratio, 0.31; 95% confidence interval, 0.15–0.61).
Conclusions
Patients who underwent microsurgical resection within 3 months of diagnosis demonstrated a hearing preservation advantage compared to those who did not. Findings of this study highlight the counseling challenges associated with the timing of surgical treatment of VS in patients presenting with good preoperative hearing and small tumors.
Details
- Title: Subtitle
- The Effect of Immediate Microsurgical Resection of Vestibular Schwannoma on Hearing Preservation
- Creators
- Omid Moshtaghi - University of California San DiegoPeter R. Dixon - University of California San DiegoAlexander D. Claussen - University of California San DiegoOlivia La Monte - University of California San DiegoAshley Tadano - University of California San DiegoDominique Gillette - University of California San DiegoKareem Tawfik - University of California San DiegoMarc S. Schwartz - University of California San DiegoRick A. Friedman - University of California San Diego
- Resource Type
- Journal article
- Publication Details
- Otology & neurotology, Vol.44(6), pp.600-604
- DOI
- 10.1097/MAO.0000000000003893
- PMID
- 37205868
- NLM abbreviation
- Otol Neurotol
- ISSN
- 1531-7129
- eISSN
- 1537-4505
- Publisher
- Lippincott Williams & Wilkins
- Language
- English
- Electronic publication date
- 05/19/2023
- Date published
- 07/2023
- Academic Unit
- Communication Sciences and Disorders; Otolaryngology
- Record Identifier
- 9984748254902771
Metrics
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