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Predictors of hearing functional outcome following surgery for cerebellopontine angle meningioma

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Objective

Cerebellopontine angle (CPA) meningiomas can affect hearing function and require expeditious treatment to prevent permanent hearing loss. The authors sought to determine the factors associated with functional hearing outcome in CPA meningioma patients treated with surgery and/or radiation therapy in the form of either stereotactic radiosurgery or stereotactic radiation therapy.

Methods

Consecutive patients with CPA meningiomas who had presented at our hospital from 2008 to 2018 were identified through retrospective chart review. Hearing function (as defined by pure tone average (PTA) and speech discrimination score (SDS) on Audiogram) was assessed before and after surgery for CPA meningioma. Audiograms with PTA > 50 dB and SDS < 69% were defined as poor hearing functional outcome. Multivariable Cox Proportional Hazards Regression Model was used to assess the associations between pre-operative hearing functional assessment and post-operative hearing functional outcomes.

Results

The study cohort included 31 patients (80.6% females, with a mean age of 61.3 ± 15.2 years) with a median clinical follow-up of 5 months (range: 1 week-98 months). The mean pre-operative PTA and SDS were 23.8 ± 11.2 dB and 64.4 ± 22.2% respectively. At the last visit, there was significant hearing recovery, with an improvement of 29.7 ± 18.0 dB (p < 0.001) and 87.6 ± 17.8% (p < 0.001) in PTA and SDS respectively. After adjusting for age, gender, tumor volume, location, and tumor classification, Multivariable Cox Proportional Hazards Regression Model was conducted which revealed that patients undergoing surgery through retro sigmoid approach [Hazards Ratio (HR): 32.1, 95% Confidence Interval (CI): 2.11–491.0, p = 0.01] and gross total resection (GTR) (HR: 2.99, 95% CI: 1.09–9.32, p = 0.05) had significantly higher risk of poor hearing functional outcome compared to petrosal approach and near/subtotal resection. Moreover, patients with poor preoperative hearing had 85% higher chance of poor hearing functional outcome postoperatively (HR: 0.15, 95%CI: 0.03–0.59, p = 0.007).

Conclusion

Postoperative improvement in hearing is a reasonable expectation following surgery for CPA meningioma. Preoperative hearing, surgical approach and extent of surgical resection are predictive factors of postoperative hearing function outcome and can therefore aid in identification of patients at higher risk of hearing loss.

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Data availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

CPA:

Cerebellopontine angle

IAC:

Internal auditory canal

PTA:

Pure tone audiogram

SDS:

Speech discrimination score

GTR:

Gross total resection

STR:

Sub total resection

NTR:

Near total resection

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Authors and Affiliations

  1. Department of Neurosurgery, The House Institute Foundation, Los Angeles, CA, USA

    Nida Fatima, Anna La Dine, Zachary R. Barnard, Gautam U. Mehta & Gregory P. Lekovic

  2. Department of Otolaryngology and Neurotology, House Institute, Los Angeles, CA, USA

    Anne K. Maxwell, Eric P. Wilkinson, Derald E. Brackmann & William H. Slattery

Authors
  1. Nida Fatima
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  2. Anne K. Maxwell
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  3. Anna La Dine
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  4. Zachary R. Barnard
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  5. Gautam U. Mehta
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  6. Eric P. Wilkinson
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  7. Derald E. Brackmann
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  9. Gregory P. Lekovic
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Contributions

NF, AKM, GPL: Manuscript Writing; ZRB, GPL, WS: Data Collection; NF and GPL: Data/Statistical Analysis; EPW, DEB, NF, WS, GM, ALD: Editing and Final Revision; Supervision: WS and GPL.

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Correspondence to Gregory P. Lekovic.

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Fatima, N., Maxwell, A.K., La Dine, A. et al. Predictors of hearing functional outcome following surgery for cerebellopontine angle meningioma. J Neurooncol 157, 165–176 (2022). https://doi.org/10.1007/s11060-022-03958-0

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  • DOI: https://doi.org/10.1007/s11060-022-03958-0

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