Hearing preservation and facial nerve function in vestibular schwannoma surgery

The objective of this study was the assessment of hearing preservation in vestibular schwannoma surgery. This study reports a prospective cohort of 40 patients with clinically useful hearing from a consecutive series of 191 patients with unilateral vestibular schwannoma. The patients were managed in a tertiary centre by a combined team of Neurosurgeon, Otologist and Neuro-monitoring Scientist via a neuro-oto-surgical-retrosigmoid approach. Pure tone speech audiometry was conducted preoperatively and 6 months to 9 years following surgery. Using the AA0-HNS classification, useful hearing, i.e. grades A, B and C, was preserved in 47.5% of patients. Thirty-eight per cent achieved grade A or B. Using appropriate surgical and monitoring techniques, it is possible to preserve useful hearing in approximately 50% of patients following removal of a vestibular schwannoma via the retro-sigmoid approach.