J Neurol Surg B 2019; 80(02): 149-155
DOI: 10.1055/s-0038-1677550
Invited Review
Georg Thieme Verlag KG Stuttgart · New York

Hearing Preservation in Vestibular Schwannoma Surgery

Joe Saliba
1  Department of Otolaryngology - Head and Neck Surgery, University of California, San Diego, California, United States
,
Rick A. Friedman
1  Department of Otolaryngology - Head and Neck Surgery, University of California, San Diego, California, United States
,
Roberto A. Cueva
2  Department of Otolaryngology - Head and Neck Surgery, Southern California Kaiser Permanente Medical Group, San Diego, California, United States
› Author Affiliations
Further Information

Publication History

18 April 2018

09 December 2018

Publication Date:
10 January 2019 (eFirst)

Abstract

Modern imaging techniques allow early detection of small vestibular schwannomas (VSs) with minimal or no hearing impairment. While controversy surrounds the management of these tumors, given their benign nature and unpredictable natural history, microsurgical excision is the only modality that offers the opportunity to cure the tumor and preserve hearing. Hearing preservation in VS surgery may be accomplished via the middle fossa or retrosigmoid approaches. Appropriate patient selection and surgical approach is critical in achieving the best hearing outcomes. This article highlights the preoperative assessment, patient selection and prognostic factors, intraoperative monitoring of hearing, and surgical approaches to optimize hearing preservation during VS removal.