Hearing preservation in patients treat with surgery for vestibular schwannomas by the transmastoid retrolabyrinthine approach

摘要

Hearing preservation has become a goal in modern surgery for acoustic neuroma. AIM: We have analyzed the post-operative hearing of patients who underwent surgery through the transmastoid retrolabyrinthine approach. STUDY DESIGN: Contenporany cohort transversal. PATIENTS AND METHOD: This study is a prospective analysis of 41 patients with small vestibular schwannoma and useful hearing operated through a transmastoid retrolabyrinthine approach between 1994 and 2004. All patients had unilateral tumors smaller than 1.5 cm. The following parameters were included in our protocol: 1-Total removal of the tumor, 2- intra-operative difficulties or complications, 3-immediate post-operative complications, 4- Audiologic evaluation 90 days after surgery. RESULTS: A good exposure of the internal auditory canal was possible in almost all cases. In six patients we had to change the approach to a translabyrinthine one, with total removal of the tumor in all patients. Hearing was preserved in 34.1% of the cases at the same preoperative levels. CONCLUSION: The retrolabyrinthine approach offered security to the facial nerve, no morbidity and good percentage of hearing preservation. It is also easier changeable to a translabyrinthine approach when a widely space is necessary.