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Long-term vestibulocochlear functional outcome following retro-sigmoid approach to resection of vestibular schwannoma

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Abstract

The objective of this study was to evaluate long-term vestibulocochlear functional outcomes of patients operated for unilateral vestibular schwannoma via the retro-sigmoid approach. Patients who underwent vestibular schwannoma resection via retro-sigmoid approach between 2004 and 2008 at our institution, without prior surgical or radio-surgical therapy were considered to be eligible for this study. Preoperative auditory and vestibular symptoms were assessed retrospectively. Postoperative symptoms were prospectively assessed using a standardised questionnaire, pure tone audiometry, video-oculography, and rotary chair testing. Out of a total of 203 patients, 120 were eligible for this study, of whom 64 responded to follow-up requests and could be enrolled. Serviceable hearing was reported in 42 patients (66 %) preoperatively and was maintained in 18 (43 %) postoperatively. While no significant change in rate of tinnitus and balance impairment between pre- and postoperative periods was detected, vertigo decreased significantly (40 to 28 %, p < 0.001). Postoperative video-oculography demonstrated vestibular paresis in 80 %. Rotary chair testing demonstrated normal or central compensation in 84 %. Absence of central compensation was associated with postoperative balance disturbance (p = 0.035). Increasing tumour size and patient age, also decreasing quality of preoperative hearing were independent factors predictive of a postoperative non-serviceable hearing (p = 0.020, p = 0.039 and p = 0.002, respectively). Resection of vestibular schwannoma via the retro-sigmoid approach is associated with improvement in postoperative vertiginous symptoms. Absence of central compensation leads to increased postoperative balance disturbances. Preservation of serviceable postoperative hearing is associated with good preoperative hearing status, younger age, and smaller tumours.

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Acknowledgments

We would like to thank Mr. Eik Vettorazzi, Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, for the help with the statistical analyses. We are also thankful to the medical technologists, Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, who were responsible for the audiometry, video-oculography and rotary chair testing.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards”.

Informed consent

“Informed consent was obtained from all individual participants included in the study”.

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Authors and Affiliations

  1. Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Tammam Abboud, Jan Regelsberger & Manfred Westphal

  2. Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Jakob Matschke

  3. Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Nathan Jowett & Carsten Dalchow

  4. Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA, USA

    Nathan Jowett

Authors
  1. Tammam Abboud
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  2. Jan Regelsberger
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  3. Jakob Matschke
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  4. Nathan Jowett
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  5. Manfred Westphal
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  6. Carsten Dalchow
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Correspondence to Tammam Abboud.

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Abboud, T., Regelsberger, J., Matschke, J. et al. Long-term vestibulocochlear functional outcome following retro-sigmoid approach to resection of vestibular schwannoma. Eur Arch Otorhinolaryngol 273, 719–725 (2016). https://doi.org/10.1007/s00405-015-3561-5

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  • DOI: https://doi.org/10.1007/s00405-015-3561-5

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