Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022, 166(3):347-352 | DOI: 10.5507/bp.2021.067

Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature review

Zdenek Fik, Jan Lazak, Silvie Hruba, Zdenek Cada, Eduard Zverrna, Jan Betka
Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic

Objectives: Hearing preservation after vestibular schwannoma (VS) surgery remains a surgical challenge. In some patients with preserved inner ear function, hearing improvement is achievable. As it is currently impossible to determine which patients will present this outcome, predictions must rely on previously published reports. Our case report describes a patient who experienced hearing improvement from an unuseful level to a useful one after vestibular schwannoma surgery.

Methods: Surgery was performed via suboccipital retrosigmoid approach. The patient underwent a basic audiovestibular protocol before and after the surgery - pure tone and speech audiometry, otoacoustic emissions, auditory brainstem responses, electronystagmography - together with a detailed questionnaire study. Usefulness of hearing was evaluated using the AAO-HNS guidelines, supplemented by a frequency of 4 kHz.

Results: Hearing was preserved and even improved from an unuseful level to a useful one. Based on the available literature, the most informative predictive factors for such a result seem to be: sudden sensorineural hearing loss prior to surgery, elicitable otoacoustic emissions and the origin from the superior vestibular nerve.

Conclusion: There are a limited number of studies on this topic and it is still impossible to regularly improve hearing in properly selected patients. Furthermore, the importance of postoperative hearing quality compared to other symptoms and complications remains debatable.

Keywords: vestibular schwannoma, hearing improvement, retrosigmoid approach, quality of life

Received: February 20, 2021; Revised: September 3, 2021; Accepted: November 16, 2021; Prepublished online: December 9, 2021; Published: September 14, 2022  Show citation

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Fik, Z., Lazak, J., Hruba, S., Cada, Z., Zverrna, E., & Betka, J. (2022). Hearing improvement after vestibular schwannoma surgery in the era of the hearing preservation rule - case report and literature review. Biomedical papers, 166(3), 347-352. doi: 10.5507/bp.2021.067
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