Hearing Preservation Following a Transtemporal Resection of an Acoustic Schwannoma: A Case Report

Pg, Smith; Dc, Bigelow; Gr, Kletzker; Jp, Leonetti; Bk, Pugh; Et, Mishler

doi:10.1097/00129492-199309000-00003

Cited by 8 publications

(18 citation statements)

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“…However, there have been a limited number of case reports demonstrating some preservation of hearing after a classical TL approach to acoustic neuroma resection. 5 6 7 8 The present report adds the fifth case to the literature of preservation of some hearing after TL resection. The patients presented by Smith et al 5 and Springborg et al 7 eventually lost their hearing 12 months and 6 years later, respectively.…”

Section: Discussionmentioning

confidence: 64%

“… 5 6 7 8 The present report adds the fifth case to the literature of preservation of some hearing after TL resection. The patients presented by Smith et al 5 and Springborg et al 7 eventually lost their hearing 12 months and 6 years later, respectively. The patients in the other two reports (Rizvi and Goyal 6 and Tringali et al 8 ) had stable hearing 2 years and 5 years, respectively, after surgery.…”

Section: Discussionmentioning

confidence: 64%

“… 4 7 17 Smith et al suggested that the collapse of the saccule and/or the ductus reuniens may have preserved the cochlear fluids. 5 Rizvi et al suggested that in their patient, while attempting to seal off the middle ear with bone wax, they may have sealed off the ductus reuniens, which contributed to the stability of the hearing in their patient. 6 Further study needs to be done to accurately define the critical steps needed in preserving hearing in TL cases.…”

Section: Discussionmentioning

confidence: 97%

“…Since then, there have been a few reports of hearing preservation after a classical TL acoustic neuroma resection. 5 6 7 8 To our knowledge, our article presents the fifth case of a patient with partial hearing preservation after a classical TL resection of a VS. In addition, we discuss the implication of partial hearing preservation and the possibility of cochlear implantation in selected cases.…”

Section: Introductionmentioning

confidence: 90%

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Partial Hearing Preservation after Translabyrinthine Vestibular Schwannoma Resection: Case Report and Review of the Literature

2015

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Objectives To describe a unique case report of a patient who had partial hearing preservation after translabyrinthine (TL) removal of a vestibular schwannoma (VS). Study Design Case report. Methods The patient's chart was reviewed for hearing levels before and after surgery. Preoperative magnetic resonance imaging (MRI) was compared with postoperative MRI for determination of completeness of tumor removal. The literature on hearing preservation after TL resection is reviewed. Results A 42-year-old woman underwent a TL removal of a VS. The patient's preoperative pure tone average (PTA) was 70 dB and word recognition score (WRS) was 40%. Postoperatively, the patient was able to hear ambient noise in the surgical ear. Her bone conduction PTA was 70 dB, but the WRS score dropped to 2%. One year later, she continues to hear ambient noise and sound in the operative ear. Discussion This is the fifth reported case of partial hearing preservation after TL VS resection. It suggests that by preserving the vestibule and the fluids within the vestibule when possible, there maybe enough residual auditory neural structures for a traditional cochlear implant to benefit such a patient. In addition, preserving the incus when possible may help maintain air conduction to help patients with sound localization.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 90%

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Partial Hearing Preservation after Translabyrinthine Vestibular Schwannoma Resection: Case Report and Review of the Literature

2015

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“…However, clinical examples abound of inadvertent violation of the inner ear resulting in normal cochlear function. 1–3 An extreme example was reported by Smith et al 4 : Hearing was preserved at a normal level after translabyrinthine acoustic neuroma resection, despite the fact that the labyrinth was intentionally destroyed. Such fortuitous cases provide evidence of the feasibility of surgery of the inner ear with preservation of function.…”

Section: Introductionmentioning

confidence: 97%

Surgery of the Inner Ear With Hearing Preservation: Serial Histological Changes

Smouha¹

2003

The Laryngoscope

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Hearing Preservation in Patients Who Undergo Labyrinthectomy and Translabyrinthine Procedures

Reddy

Yan

Liu

et al. 2020

JAMA Otolaryngol Head Neck Surg

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fluids, maintenance of a fluid-filled vestibule, and preservation of the cochlear nerve and its vasculature are believed to be necessary to retaining hearing after an inner-ear operation. However, some studies have reported no hearing loss despite the violation of the vestibule, questioning the importance of maintaining a fluid-filled vestibule in preserving hearing.OBJECTIVE To report on the preservation of hearing after a complete labyrinthectomy for Meniere disease and after disruption of the vestibule.EVIDENCE REVIEW This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. A search of PubMed, Scopus, Ovid, and Cochrane Library databases was conducted to identify English-language articles on hearing preservation after labyrinthectomy, published from 1947 through December 11, 2019. The search strategy used a combination of boolean operators and included the following Medical Subject Heading terms and keywords: hearing preservation, labyrinth surgery, labyrinthectomy, vestibule violation, vestibule disruption, translabyrinthine approach, schwannoma removal, and semicircular canal ablation. Studies that included disruption of the vestibule and hearing preservation were included.FINDINGS This systematic review identified 10 studies with 10 patients who underwent surgical removal of cholesteatoma or vestibular schwannoma and displayed postoperative hearing preservation. This study also reported on 1 patient with Meniere disease who retained hearing after undergoing a complete labyrinthectomy. Among these 11 patients, the mean (range) age was 45.1 (27-55) years, and 8 patients (73%) were women. Multiple theories exist that explain the mechanism behind hearing preservation, such as sealing of the ductus reuniens or closure of the remaining vestibule.CONCLUSIONS AND RELEVANCE This systematic review describes a set of patients who did not experience hearing loss after a labyrinthectomy or surgical violation of the vestibule, which seems to contradict prevailing principles for retaining hearing after inner-ear surgical procedures. This finding suggests that hearing preservation is possible after labyrinthine destruction despite the absence of a fluid-filled vestibule and that other mechanisms, such as occlusion of the ductus reuniens with granulation tissue or bone dust, may be sufficient to achieve that outcome.

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Hearing Preservation Following a Transtemporal Resection of an Acoustic Schwannoma: A Case Report

Cited by 8 publications

References 0 publications

Partial Hearing Preservation after Translabyrinthine Vestibular Schwannoma Resection: Case Report and Review of the Literature

Partial Hearing Preservation after Translabyrinthine Vestibular Schwannoma Resection: Case Report and Review of the Literature

Surgery of the Inner Ear With Hearing Preservation: Serial Histological Changes

Hearing Preservation in Patients Who Undergo Labyrinthectomy and Translabyrinthine Procedures

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