Hearing Preservation Outcomes and Prognostic Factors in Acoustic Neuroma Surgery: Predicting Cutoffs.
Journal
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
ISSN: 1537-4505
Titre abrégé: Otol Neurotol
Pays: United States
ID NLM: 100961504
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
pubmed:
3
3
2020
medline:
15
4
2021
entrez:
3
3
2020
Statut:
ppublish
Résumé
To investigate the outcomes of hearing preservation surgery (HPS) for acoustic neuroma and quantify tumor and patient characteristics predictive of hearing preservation after surgery. Retrospective study. Tertiary referral center. A total of 100 consecutive patients diagnosed with acoustic neuroma from 2000 to 2012. Hearing preservation surgery through microscopic retrosigmoid approach combined with a retrolabyrinthine meatotomy. Pre- and postoperative hearing stratified according to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Tokyo classifications. The most accurate cutoff was identified for each tumor and patients' variable affecting the outcome by calculating the Youden index. A multivariable analysis was undertaken at these cutoffs to identify prognostic factors for hearing preservation. Preoperative hearing class was preserved after surgery in 31% (AAO-HNS), and 39% (Tokyo classification) of patients. According to the AAO-HNS classification, the tumor size in the cerebello-pontine angle, pure-tone average (PTA), and speech discrimination score cutoffs for predicting good postoperative hearing function were 7 mm, 21 dB, and 90%, respectively. With the Tokyo classification, only the PTA cutoff differed, with 27 dB. On multivariable analysis, tumor size and PTA were independent prognostic factors for postoperative hearing with high model's goodness of fit (area under the curve = 0.784; 95% CI = 0.68-0.88 and area under the curve = 0.813; 95% CI = 0.72-0.90), according to both the hearing classifications. The estimated cutoffs for tumor size and PTA were independently associated with HPS. These factors should be prospectively investigated before they are adopted as selection criteria for HPS.
Identifiants
pubmed: 32118808
doi: 10.1097/MAO.0000000000002602
pii: 00129492-202006000-00031
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
686-693Références
Kirchmann M, Karnov K, Hansen S, et al. Ten-year follow-up on tumor growth and hearing in patients observed with an intracanalicular vestibular schwannoma. Neurosurgery 2017; 80:49–56.
Meyer TA, Canty PA, Wilkinson EP, et al. Small acoustic neuromas: Surgical outcomes versus observation or radiation. Otol Neurotol 2006; 27:380–392.
Zanoletti E, Cazzador D, Faccioli C, et al. Multioption therapy vs observation for small acoustic neuroma: Hearing-focused management. Acta Otorhinolaryngol Ital 2018; 38:384–392.
Mazzoni A, Zanoletti E, Denaro L, et al. Retrolabyrinthine meatotomy as part of retrosigmoid approach to expose the whole internal auditory canal: Rationale, technique and outcome in hearing preservation surgery for vestibular schwannoma. Oper Neurosurg 2018; 14:36–44.
Hadjipanayis CG, Carlson ML, Link MJ, et al. Congress of neurological surgeons systematic review and evidence-based guidelines on surgical resection for the treatment of patients with vestibular schwannomas. Neurosurgery 2018; 82:E40–E43.
Mazzoni A, Biroli F, Foresti C, et al. Hearing preservation surgery in acoustic neuroma. Slow progress and new strategies. Acta Otorhinolaryngol Ital 2011; 31:76–84.
Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma).American Academy of Otolaryngology-Head and Neck Surgery Foundation, INCOtolaryngol Head Neck Surg 1995; 113:179–180.
Kanzaki J, Tos M, Sanna M, Moffat DA. New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma. Otol Neurotol 2003; 24:642–648.
Zanoletti E, Mazzoni A, Martini A, et al. Surgery of the lateral skull base: A 50-year endeavor. Acta Otorhinolaryngol Ital 2019; 39: (suppl 1): S24–26.
Gurgel RK, Jackler RK, Dobie RA, Popelka GR. A new standardized format for reporting hearing outcome in clinical trials. Otolaryngol Head Neck Surg 2012; 147:803–807.
Fluss R, Faraggi D, Reiser B. Estimation of the Youden index and its associated cutoff point. Biom J 2005; 47:458–472.
Simel DL, Samsa GP, Matchar DB. Likelihood ratios with confidence: Sample size estimation for diagnostic test studies. J Clin Epidemiol 1991; 44:763–770.
Lassaletta L, Fontes L, Melcon E, Sarria MJ, Gavilan J. Hearing preservation with the retrosigmoid approach for vestibular schwannoma: Myth or reality? Otolaryngol Head Neck Surg 2003; 129:397–401.
Yamakami I, Ito S, Higuchi Y. Retrosigmoid removal of small acoustic neuroma: Curative tumor removal with preservation of function. J Neurosurg 2014; 121:554–563.
Brackmann DE, Owens RM, Friedman RA, et al. Prognostic factors for hearing preservation in vestibular schwannoma surgery. Am J Otol 2000; 21:417–424.
Kari E, Friedman RA. Hearing preservation: Microsurgery. Curr Opin Otolaryngol Head Neck Surg 2012; 20:358–366.
Sughrue ME, Yang I, Aranda D, Kane AJ, Parsa AT. Hearing preservation rates after microsurgical resection of vestibular schwannoma. J Clin Neurosci 2010; 17:1126–1129.
Tanaka Y, Hongo K, Tada T, Kobayashi S. What is the best method for reporting tumor diameter in vestibular schwannoma? Neurosurgery 2003; 53:634–637.
Kemink JL, Telian SA, Larouere MJ, Kileny PR, Hoff JT. Hearing preservation following suboccipital removal of acoustic neuromas. Laryngoscope 1990; 100:597–602.
Mangham CA, Skalabrin TA. Indications for hearing preservation in acoustic tumor surgery. Am J Oto1 1992; 13:137–140.
Fischer G, Fischer C, Rémond J. Hearing preservation in acoustic neurinoma surgery. J Neurosurg 1992; 76:910–917.
Nadol JB, Chiong CM, Ojemann RG, et al. Preservation of hearing and facial nerve function in resection of acoustic neuroma. Laryngoscope 1992; 102:1153–1158.
Cohen NL, Lewis WS, Ransohoff J. Hearing preservation in cerebellopontine angle tumor surgery: The NYU experience. Otol Neurotol 1993; 14:423–433.
Post KD, Eisenberg MB, Catalano PJ. Hearing preservation in vestibular schwannoma surgery: What factors influence outcome? J Neurosurg 1995; 83:191–196.
Rastogi P, Cacace AT, Lovely TJ. Factors influencing hearing preservation in acoustic tumor surgery. Skull Base Surg 1995; 5:137–142.
Robinette MS, Bauch CD, Olsen WO, Harner SG, Beatty CW. Nonsurgical factors predictive of postoperative hearing for patients with vestibular schwannoma. Am J Otol 1997; 18:738–745.
Mohr G, Sade B, Dufour JJ, Rappaport JM. Preservation of hearing in patients undergoing microsurgery for vestibular schwannoma: Degree of meatal filling. J Neurosurg 2005; 102:1–5.
Han DY, Yu LM, Yu LM, et al. Acoustic neuroma surgery for preservation of hearing: Technique and experience in the Chinese PLA General Hospital. Acta Otolaryngol 2010; 130:583–592.
Tringali S, Ferber-Viart C, Fuchsmann C, et al. Hearing preservation in retrosigmoid approach of small vestibular schwannomas: Prognostic value of the degree of internal auditory canal filling. Otol Neurotol 2010; 31:1469–1472.
Di Maio S, Malebranche AD, Westerberg B, Akagami R. Hearing preservation after microsurgical resection of large vestibular schwannomas. Neurosurgery 2011; 68:632–640.
Rachinger J, Rampp S, Prell J, et al. Tumor origin and hearing preservation in vestibular schwannoma surgery. J Neurosurg 2011; 115:900–905.
Nguyen QT, Wu AP, Mastrodimos BJ, Cueva RA. Impact of fundal extension on hearing after surgery for vestibular schwannomas. Otol Neurotol 2012; 33:455–458.
Hummel M, Perez J, Hagen R, et al. Auditory monitoring in vestibular schwannoma surgery: Intraoperative development and outcome. World Neurosurg 2016; 96:444–453.
Kutz JW, Scoresby T, Isaacson B, et al. Hearing preservation using the middle fossa approach for the treatment of vestibular schwannoma. Neurosurg 2011; 70:334–341.