gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Tumor origin and hearing preservation in vestibular schwannoma surgery

Meeting Abstract

  • J. Rachinger - Klinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale
  • S. Rampp - Klinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale
  • J. Prell - Klinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale
  • C. Scheller - Klinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale
  • A. Alfieri - Klinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale
  • C. Strauss - Klinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocDI.06.05

DOI: 10.3205/11dgnc138, URN: urn:nbn:de:0183-11dgnc1385

Published: April 28, 2011

© 2011 Rachinger et al.
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Outline

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Objective: In vestibular schwannoma surgery, tumor size and preoperative hearing status are widely accepted prognostic factors concerning the preservation of cochlear nerve function. In a previous study we found some evidence that tumor origin might be a relevant prognostic factor for hearing outcome after vestibular schwannoma removal as well. The aim of this work was to further evaluate the importance of tumor origin for hearing preservation.

Methods: A series of 90 patients with vestibular schwannomas, operated upon via the suboccipito-lateral route, was evaluated with respect to cochlear nerve function, tumor size, radiological findings and intraoperative tumor origin. All patients were re-evaluated 12 months following surgery.

Results: During surgery, the inferior vestibular nerve could be identified as the site of tumor origin in 45 patients. In the other 45 patients, the superior vestibular nerve appeared to be the nerve of origin. Concerning age, mean intra- and extrameatal tumor extension, tumor size and preoperative hearing, no statistically significant differences between the two groups could be found. However, tumors originating from the superior vestibular nerve tended to be larger (mean tumor size 26.1 mm vs 22.9 mm, Mann-Whitney U-test, p=0.08). Preservation of cochlear nerve function was attempted in all 90 patients regardless of the extent of preoperative hearing loss. Despite comparable preoperative cochlear nerve status and larger tumor sizes, hearing preservation was achieved in 42% of patients with the tumor origin from the superior vestibular nerve as compared to 16% of those with tumors originating from the inferior vestibular nerve (chi-square test, p=0.005).

Conclusions: Tumor origin is an important prognostic factor for cochlear nerve preservation in vestibular schwannoma surgery.