Abstract
Aim: The aim of the study was to conduct a comprehensive analysis of the factors influencing the success rate of hearing preservation in patients undergoing microsurgical removal of vestibular schwannoma (VS). Materials and methods: A total of 81 consecutive patients with serviceable hearing underwent surgical removal of unilateral vestibular schwannoma via retrosigmoid-transmeatal approach between 2008 and 2010.
Patient, tumor and audiometric parameters together with intraoperative findings were prospectively analyzed. Data were statistically processed including a regression analysis of independent variables.
Conclusions: Apart from the experience of the surgical team, size of the tumor, preoperative hearing level and possibility of intraoperative hearing monitoring represented the main factors for hearing preservation. Early identification of the cochlear portion of the CN VIII is key.
For this, the use of endoscopic technique seems to be beneficial. Soft consistency of tumor and lack of adhesions to the neurovascular structures represent crucial intraoperative factors.