Tumors around the cerebellopontine angle (CPA) and temporal bone can potentially affect hearing function. In patients with such tumors other than vestibular schwannomas (VSs), auditory tests were investigated before and after surgery to characterize the auditory effect of each tumor and to determine prognostic factors.
A total of 378 patients were retrospectively evaluated for hearing functions before and after surgery. These 378 patients included 168 with CPA meningioma, 40 with trigeminal schwannoma (TS), 55 with facial nerve schwannoma (FNS), 64 with jugular foramen schwannoma (JFS), and 51 with CPA epidermoid cyst (EPD).
Preoperative hearing loss was observed in 124 (33%) of the 378 patients. Of these 124 patients, 38 (31%) experienced postoperative hearing improvement. Postoperative hearing deterioration occurred in 67 (18%) of the 378 patients. The prognostic factors for postoperative hearing improvement were younger age and the retrocochlear type of preoperative hearing disturbance. Tumor extension into the internal auditory canal was correlated with preoperative hearing loss and postoperative hearing deterioration. Preoperative hearing loss was observed in patients with FNS (51%), JFS (42%), and MGM (37%), and postoperative hearing improvement was observed in patients with JFS (41%), MGM (31%), and FNS (21%). Postoperative hearing deterioration was observed in patients with FNS (27%), MGM (23%), and EPD (16%).
According to the results of this study in patients with CPA and intratemporal tumors other than VS, preoperative retrocochlear hearing disturbance was found to be a prognostic factor for hearing improvement after surgery. Among the tumor types, JFS and MGM had a particularly favorable hearing prognosis. The translabyrinthine approach and cochlear nerve section should be avoided for these tumors, regardless of the patient’s preoperative hearing level.
AAO-HNS = American Academy of Otolaryngology–Head and Neck Surgery; ABR = auditory brainstem response; ATP = anterior transpetrosal approach; CPA = cerebellopontine angle; CN = cranial nerve; CTP = combined transpetrosal approach; DPOAE = distortion product otoacoustic emission; EPD = epidermoid cyst; FNS = facial nerve schwannoma; IAC = internal auditory canal; JFS = jugular foramen schwannoma; LSO = lateral suboccipital retrosigmoid approach; MF = middle fossa approach; MGM = meningioma; NF2 = neuroﬁbromatosis type 2; PTA = pure tone average; SDS = speech discrimination score; TM = transmastoid approach; TS = trigeminal schwannoma; VS = vestibular schwannoma.
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