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Optimal outcomes for hearing preservation in the management of small vestibular schwannomas

Published online by Cambridge University Press:  20 May 2016

K A Peng  and
E P Wilkinson
K A Peng
Affiliation:
House Clinic, Los Angeles, California, USA
E P Wilkinson*
Affiliation:
House Clinic, Los Angeles, California, USA
*
Address for correspondence: Dr Eric P Wilkinson, House Clinic, 2100 W. 3rd St #111, Los Angeles, California, USA Fax: +1 213 484 5900 E-mail: [email protected]
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Abstract

Objective:

To undertake a systematic review of the role of microsurgery, in relation to observation and stereotactic radiation, in the management of small vestibular schwannomas with serviceable hearing.

Methods:

The Medline database was searched for publications that included the terms ‘vestibular schwannoma’ and/or ‘acoustic neuroma’, occurring in conjunction with ‘hearing’. Articles were manually screened to identify those concerning vestibular schwannomas under 1.5 cm in greatest dimension. Thereafter, only publications discussing both pre-operative and post-operative hearing were considered.

Results:

Twenty-six papers were identified. Observation is an acceptable strategy for small tumours with slow growth where hearing preservation is not a consideration. In contrast, microsurgery, including the middle fossa approach, may provide excellent hearing outcomes, particularly when a small tumour has begun to cause hearing loss. Immediate post-operative hearing usually predicts long-term hearing. Recent data on stereotactic radiation suggest long-term deterioration of hearing following definitive therapy.

Conclusion:

In patients under the age of 65 years with small vestibular schwannomas, microsurgery via the middle fossa approach offers durable preservation of hearing.

Keywords

HearingVestibular SchwannomaAcoustic NeuromaMicrosurgeryMiddle Cranial FossaRadiosurgery
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 7 , July 2016 , pp. 606 - 610
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1American Academy of Otolaryngology-Head and Neck Surgery Foundation. Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). Otolaryngol Head Neck Surg 1995;113:179–80Google Scholar
2Meyer, TA, Canty, PA, Wilkinson, EP, Hansen, MR, Rubinstein, JT, Gantz, BJ.Small acoustic neuromas: surgical outcomes versus observation or radiation. Otol Neurotol 2006;27:380–92Google Scholar
3Gardner, G, Robertson, JH.Hearing preservation in unilateral acoustic neuroma surgery. Ann Otol Rhinol Laryngol 1988;97:55–66Google Scholar
4Glasscock, ME 3rd, Pappas, DG Jr, Manolidis, S, Von Doersten, PG, Jackson, CG, Storper, IS.Management of acoustic neuroma in the elderly population. Am J Otol 1997;18:236–41;discussion 41–2Google ScholarPubMed
5Shirato, H, Sakamoto, T, Sawamura, Y, Kagei, K, Isu, T, Kato, T et al. Comparison between observation policy and fractionated stereotactic radiotherapy (SRT) as an initial management for vestibular schwannoma. Int J Radiat Oncol Biol Phys 1999;44:545–50Google Scholar
6Charabi, S, Thomsen, J, Mantoni, M, Charabi, B, Jorgensen, B, Borgesen, SE et al. Acoustic neuroma (vestibular schwannoma): growth and surgical and nonsurgical consequences of the wait-and-see policy. Otolaryngol Head Neck Surg 1995;113:5–14Google Scholar
7Stangerup, SE, Caye-Thomasen, P, Tos, M, Thomsen, J.Change in hearing during ‘wait and scan’ management of patients with vestibular schwannoma. J Laryngol Otol 2008;122:673–81Google Scholar
8Sughrue, ME, Yang, I, Aranda, D, Lobo, K, Pitts, LH, Cheung, SW et al. The natural history of untreated sporadic vestibular schwannomas: a comprehensive review of hearing outcomes. J Neurosurg 2010;112:163–7Google Scholar
9Walsh, RM, Bath, AP, Bance, ML, Keller, A, Tator, CH, Rutka, JA.The natural history of untreated vestibular schwannomas. Is there a role for conservative management? Rev Laryngol Otol Rhinol (Bord) 2000;121:21–6Google Scholar
10Prasad, D, Steiner, M, Steiner, L.Gamma surgery for vestibular schwannoma. J Neurosurg 2000;92:745–59Google Scholar
11Yang, I, Aranda, D, Han, SJ, Chennupati, S, Sughrue, ME, Cheung, SW et al. Hearing preservation after stereotactic radiosurgery for vestibular schwannoma: a systematic review. J Clin Neurosci 2009;16:742–7Google Scholar
12Meijer, OW, Vandertop, WP, Baayen, JC, Slotman, BJ.Single-fraction vs. fractionated linac-based stereotactic radiosurgery for vestibular schwannoma: a single-institution study. Int J Radiat Oncol Biol Phys 2003;56:1390–6Google Scholar
13Spiegelmann, R, Lidar, Z, Gofman, J, Alezra, D, Hadani, M, Pfeffer, R.Linear accelerator radiosurgery for vestibular schwannoma. J Neurosurg 2001;94:7–13Google Scholar
14Paek, SH, Chung, HT, Jeong, SS, Park, CK, Kim, CY, Kim, JE et al. Hearing preservation after gamma knife stereotactic radiosurgery of vestibular schwannoma. Cancer 2005;104:580–90Google Scholar
15Carlson, ML, Jacob, JT, Pollock, BE, Neff, BA, Tombers, NM, Driscoll, CL et al. Long-term hearing outcomes following stereotactic radiosurgery for vestibular schwannoma: patterns of hearing loss and variables influencing audiometric decline. J Neurosurg 2013;118:579–87Google Scholar
16Hasegawa, T, Kida, Y, Kato, T, Iizuka, H, Yamamoto, T.Factors associated with hearing preservation after Gamma Knife surgery for vestibular schwannomas in patients who retain serviceable hearing. J Neurosurg 2011;115:1078–86Google Scholar
17Shin, M, Ueki, K, Kurita, H, Kirino, T.Malignant transformation of a vestibular schwannoma after gamma knife radiosurgery. Lancet 2002;360:309–10CrossRefGoogle ScholarPubMed
18Yanamadala, V, Williamson, RW, Fusco, DJ, Eschbacher, J, Weisskopf, P, Porter, RW.Malignant transformation of a vestibular schwannoma after gamma knife radiosurgery. World Neurosurg 2013;79:593.e1–8Google Scholar
19Massager, N, Nissim, O, Delbrouck, C, Delpierre, I, Devriendt, D, Desmedt, F et al. Irradiation of cochlear structures during vestibular schwannoma radiosurgery and associated hearing outcome. J Neurosurg 2007;107:733–9Google Scholar
20Lunsford, LD, Niranjan, A, Flickinger, JC, Maitz, A, Kondziolka, D.Radiosurgery of vestibular schwannomas: summary of experience in 829 cases. J Neurosurg 2005;102(suppl):195–9Google Scholar
21House, WF.Surgical exposure of the internal auditory canal and its contents through the middle, cranial fossa. Laryngoscope 1961;71:1363–85Google Scholar
22Slattery, WH 3rd, Brackmann, DE, Hitselberger, W.Middle fossa approach for hearing preservation with acoustic neuromas. Am J Otol 1997;18:596–601Google Scholar
23Wilkinson, EP, Roberts, DS, Cassis, A, Schwartz, MS.Hearing outcomes after middle fossa or retrosigmoid craniotomy for vestibular schwannoma tumors. J Neurol Surg B Skull Base 2016Google Scholar
24Wang, AC, Chinn, SB, Than, KD, Arts, HA, Telian, SA, El-Kashlan, HK et al. Durability of hearing preservation after microsurgical treatment of vestibular schwannoma using the middle cranial fossa approach. J Neurosurg 2013;119:131–8Google Scholar
25Kutz, JW Jr, Scoresby, T, Isaacson, B, Mickey, BE, Madden, CJ, Barnett, SL et al. Hearing preservation using the middle fossa approach for the treatment of vestibular schwannoma. Neurosurgery 2012;70:334–40;discussion 40–1CrossRefGoogle ScholarPubMed
26Woodson, EA, Dempewolf, RD, Gubbels, SP, Porter, AT, Oleson, JJ, Hansen, MR et al. Long-term hearing preservation after microsurgical excision of vestibular schwannoma. Otol Neurotol 2010;31:1144–52CrossRefGoogle ScholarPubMed
27Friedman, RA, Kesser, B, Brackmann, DE, Fisher, LM, Slattery, WH, Hitselberger, WE.Long-term hearing preservation after middle fossa removal of vestibular schwannoma. Otolaryngol Head Neck Surg 2003;129:660–5Google Scholar
28Betchen, SA, Walsh, J, Post, KD.Long-term hearing preservation after surgery for vestibular schwannoma. J Neurosurg 2005;102:6–9Google Scholar
29Brackmann, DE, Owens, RM, Friedman, RA, Hitselberger, WE, De la Cruz, A, House, JW et al. Prognostic factors for hearing preservation in vestibular schwannoma surgery. Am J Otol 2000;21:417–24Google Scholar
30Goddard, JC, Schwartz, MS, Friedman, RA.Fundal fluid as a predictor of hearing preservation in the middle cranial fossa approach for vestibular schwannoma. Otol Neurotol 2010;31:1128–34Google Scholar
31Irving, RM, Jackler, RK, Pitts, LH.Hearing preservation in patients undergoing vestibular schwannoma surgery: comparison of middle fossa and retrosigmoid approaches. J Neurosurg 1998;88:840–5Google Scholar
32Brackmann, DE, Cullen, RD, Fisher, LM.Facial nerve function after translabyrinthine vestibular schwannoma surgery. Otolaryngol Head Neck Surg 2007;136:773–7Google Scholar
33Lee, WJ, Isaacson, JE.Postoperative imaging and follow-up of vestibular schwannomas. Otol Neurotol 2005;26:102–4Google Scholar
34Bennett, ML, Jackson, CG, Kaufmann, R, Warren, F.Postoperative imaging of vestibular schwannomas. Otolaryngol Head Neck Surg 2008;138:667–71Google Scholar
35Nakamura, H, Jokura, H, Takahashi, K, Boku, N, Akabane, A, Yoshimoto, T.Serial follow-up MR imaging after gamma knife radiosurgery for vestibular schwannoma. AJNR Am J Neuroradiol 2000;21:1540–6Google Scholar