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Criteria for hearing preservation in acoustic schwannoma surgery: The concept of useful hearing

Published online by Cambridge University Press:  29 June 2007

A. E. Hinton ,
R. T. Ramsden ,
R. H. Lye  and
J. E. M. Dutton
A. E. Hinton*
Affiliation:
University Departments of Otolaryngology and Neurosurgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.
R. T. Ramsden
Affiliation:
University Departments of Otolaryngology and Neurosurgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.
R. H. Lye
Affiliation:
University Departments of Otolaryngology and Neurosurgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.
J. E. M. Dutton
Affiliation:
University Departments of Otolaryngology and Neurosurgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.
*
Mr Anthony E. Hinton, F.R.C.S., The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA
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Abstract

In the quest for hearing preservation in patients with acoustic schwannomas it is essential that surgeons do not lose sight of the concept of ‘useful’ hearing. There is an important difference between hearing preservation which pleases the surgeon and that which will be appreciated by the patient.

Tumour size, pure tone audiogram average differences between ears and speech discrimination scores have been recorded in a series of 114 patients with unilateral acoustic schwannomas. Criteria for useful hearing are presented in terms of pure tone audiogram average difference and speech discrimination scores.

There were 11 patients (10 per cent) with a speech discrimination score of 50 per cent or more, a pure tone audiogram average difference of 30 dB or better and a tumour size of no more than 2 cm. Only one patient (0.9 per cent) had a speech discrimination score of 50 per cent or more, a pure tone audiogram average difference of 20 dB or better and a tumour size of no more than 1 cm.

It is concluded that hearing preservation techniques may be applicable to between 1 and 10 per cent of patients with unilateral acoustic schwannomas.

Keywords

NeuromaacousticHearing preservation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 106 , Issue 6 , June 1992 , pp. 500 - 503
Copyright
Copyright © JLO (1984) Limited 1992

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References

Baldwin, D. L., King, T. T., Morrison, A. W. (1990) Hearing conservation in acoustic neuroma surgery via the posterior fossa. Journal of Laryngology and Otology, 104: 463–467.CrossRefGoogle ScholarPubMed
Dutton, J. E., Ramsden, R. T., Lye, R., Morris, K.. Keith, A. O., Page, R., Vafadis, J. (1991) Acoustic neuroma surgery 1978–1990. Journal of Laryngology and Otology, 105: 165–73.Google Scholar
Forton, G., Offeciers, F. E., Marquet, J. (1990) Acoustic neuroma: a histopathological study. Acta Otorhinolaryngologica Belgium. 44: 399–402.Google ScholarPubMed
Gatehouse, S. Modelling of disability in unilateral hearing loss. Audiology. In press.Google Scholar
Hughes, G. B., Sismanis, A., Glasscock, M. E., Hays, J. W., Jackson, C. G. (1982) Management of bilateral acoustic tumours. Laryngoscope, 92: 1351–1359.CrossRefGoogle Scholar
Kemink, J. L., Langman, A. W., Niparko, J. K., Graham, M. D. (1991) Operative management of acoustic neuromas: the priority of neurologic function over complete resection. Otolaryngology—Head and Neck Surgery, 104: 96–9.Google Scholar
Lye, R. H., Dutton, J., Ramsden, R. T. Occleshaw, J. V., Ferguson, I. T., Taylor, I. (1982) Facial nerve preservation during surgery for removal of acoustic nerve tumours. Journal of Neurosurgery, 57: 739–746.Google Scholar
Morrison, A. W. (1975) Management of sensorineural deafness. Butterworth: London and Boston, p. 82.Google Scholar
Ramsden, R. T. (1987) Acoustic tumours. In Scott-Brown's Otolaryngology, 5th edn., (Booth, J. B., Kerr, A. G., eds.) Vol. 3 Otology, Butterworth: London, p. 529.Google Scholar
Sanna, M., Zini, C., Landolfi, M., Piazza, F. (1991) Hearing preservation: critical revision of the literature. Copenhagen Acoustic Neuroma Conference Abstracts Book 119.Google Scholar
Schuknecht, H. F. Woellner, R. C. (1955) An experimental and clinical study of deafness from lesions of the cochlear nerve. Journal of Laryngology and Otology, 69: 75–97.CrossRefGoogle ScholarPubMed
Shelton, C., House, W. F. (1990) Hearing improvement after acoustic tumor removal. Otolaryngology–Head and Neck Surgery, 103:963–5.CrossRefGoogle ScholarPubMed