Long-term hearing prognosis after vestibular schwannoma surgery with retrolabyrinthine approach

Eur Arch Otorhinolaryngol. 2024 Nov;281(11):5699-5707. doi: 10.1007/s00405-024-08786-8. Epub 2024 Jul 8.

Abstract

Purpose: The retrolabyrinthine approach is a surgical method designed to preserve hearing after surgery. When paired with intraoperative monitoring and an endoscope, this approach has demonstrated high rates of postoperative hearing preservation. However, the long-term prognosis of hearing preservation after utilizing this approach for vestibular schwannomas remains unexplored. This study aimed to examine the long-term outcomes of preserved hearing, providing insights into the suitability of the retrolabyrinthine approach for hearing preservation surgery.

Methods: This study included 34 patients with preserved hearing after vestibular schwannoma surgery using the retrolabyrinthine approach at a single center. Long-term hearing prognosis and requirement for additional interventions were retrospectively examined.

Results: Immediate after post-operative hearing preservation rate was 71.7%. Among the 34 patients with preserved hearing post-vestibular schwannoma surgery, four (11.8%) required additional interventions. Other patients experienced a gradual deterioration in their hearing status, with an approximate 10 dB decline during the 5-year follow-up; however, a serviceable hearing level persisted long after the surgery in these individuals.

Conclusions: This study indicated the rationale for the retrolabyrinthine approach as a hearing preservation surgery for vestibular schwannomas, emphasizing its long-term hearing prognosis.

Keywords: Hearing loss; Hearing preservation surgery; Retrolabyrinthine approach; Vestibular schwannoma.

MeSH terms

  • Adult
  • Aged
  • Audiometry, Pure-Tone
  • Ear, Inner / surgery
  • Female
  • Follow-Up Studies
  • Hearing / physiology
  • Humans
  • Male
  • Middle Aged
  • Neuroma, Acoustic* / surgery
  • Otologic Surgical Procedures / methods
  • Postoperative Complications / etiology
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome