Cargando…
Hearing preservation in acoustic neuroma resection: Analysis of petrous bone measurement and intraoperative application
BACKGROUND: There is an increased risk for labyrinthine injury for the resection of acoustic neuromas (AN) on the suboccipital, retrosigmoid approach. Prognostic factors should be analyzed for the postoperative hearing function. METHODS: We examined 51 patients with ANs using preoperative intact hea...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234277/ https://www.ncbi.nlm.nih.gov/pubmed/28144470 http://dx.doi.org/10.4103/2152-7806.195572 |
_version_ | 1782494973942300672 |
---|---|
author | Tanrikulu, Levent Lohse, Peer Fahlbusch, Rudolf Naraghi, Ramin |
author_facet | Tanrikulu, Levent Lohse, Peer Fahlbusch, Rudolf Naraghi, Ramin |
author_sort | Tanrikulu, Levent |
collection | PubMed |
description | BACKGROUND: There is an increased risk for labyrinthine injury for the resection of acoustic neuromas (AN) on the suboccipital, retrosigmoid approach. Prognostic factors should be analyzed for the postoperative hearing function. METHODS: We examined 51 patients with ANs using preoperative intact hearing function. Audiological data were obtained by pure tone audiogram (PTA) and speech audiogram. The preoperative and postoperative anatomical localization of the labyrinth was measured with specific distances regarding the tumor and corresponding anatomy of the posterior fossa by high-resolution magnetic resonance imaging (MRI). RESULTS: Postoperative MRI controls confirmed no injuries to the labyrinth (0%). The postoperative hearing results showed 100% hearing preservation for T1-tumors (<1 ml/<1.1 cm), 50% for T2-tumors (1–4 ml/1.1–1.8 cm), 40% for T3-tumors (4–8 ml/1.8–2.3 cm) and 18% for T4-tumors (>8 ml/>2.3 cm). Postoperative deafness was seen in all cases with ventral tumor extension higher than 5.5 mm. Postoperative loss of hearing was seen in all cases with hearing preservation with 6–8% of speech discrimination and an increase in the hearing threshold of 12 dB in the PTA compared to the preoperative hearing status. CONCLUSION: Petrous bone measurement by high-resolution MRI data enables safe surgical exposure of the internal acoustic canal with avoidance of injury to the labyrinth and a better postoperative prognosis, especially for intrameatal ANs and for the resection of intrameatal portions of larger neuromas. The prognostic factors enable the patients and the surgeon a better estimation of postoperative results regarding deafness and postoperative hypacusis and support a consolidated treatment planning. |
format | Online Article Text |
id | pubmed-5234277 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-52342772017-01-31 Hearing preservation in acoustic neuroma resection: Analysis of petrous bone measurement and intraoperative application Tanrikulu, Levent Lohse, Peer Fahlbusch, Rudolf Naraghi, Ramin Surg Neurol Int Original Article BACKGROUND: There is an increased risk for labyrinthine injury for the resection of acoustic neuromas (AN) on the suboccipital, retrosigmoid approach. Prognostic factors should be analyzed for the postoperative hearing function. METHODS: We examined 51 patients with ANs using preoperative intact hearing function. Audiological data were obtained by pure tone audiogram (PTA) and speech audiogram. The preoperative and postoperative anatomical localization of the labyrinth was measured with specific distances regarding the tumor and corresponding anatomy of the posterior fossa by high-resolution magnetic resonance imaging (MRI). RESULTS: Postoperative MRI controls confirmed no injuries to the labyrinth (0%). The postoperative hearing results showed 100% hearing preservation for T1-tumors (<1 ml/<1.1 cm), 50% for T2-tumors (1–4 ml/1.1–1.8 cm), 40% for T3-tumors (4–8 ml/1.8–2.3 cm) and 18% for T4-tumors (>8 ml/>2.3 cm). Postoperative deafness was seen in all cases with ventral tumor extension higher than 5.5 mm. Postoperative loss of hearing was seen in all cases with hearing preservation with 6–8% of speech discrimination and an increase in the hearing threshold of 12 dB in the PTA compared to the preoperative hearing status. CONCLUSION: Petrous bone measurement by high-resolution MRI data enables safe surgical exposure of the internal acoustic canal with avoidance of injury to the labyrinth and a better postoperative prognosis, especially for intrameatal ANs and for the resection of intrameatal portions of larger neuromas. The prognostic factors enable the patients and the surgeon a better estimation of postoperative results regarding deafness and postoperative hypacusis and support a consolidated treatment planning. Medknow Publications & Media Pvt Ltd 2016-12-12 /pmc/articles/PMC5234277/ /pubmed/28144470 http://dx.doi.org/10.4103/2152-7806.195572 Text en Copyright: © 2016 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Tanrikulu, Levent Lohse, Peer Fahlbusch, Rudolf Naraghi, Ramin Hearing preservation in acoustic neuroma resection: Analysis of petrous bone measurement and intraoperative application |
title | Hearing preservation in acoustic neuroma resection: Analysis of petrous bone measurement and intraoperative application |
title_full | Hearing preservation in acoustic neuroma resection: Analysis of petrous bone measurement and intraoperative application |
title_fullStr | Hearing preservation in acoustic neuroma resection: Analysis of petrous bone measurement and intraoperative application |
title_full_unstemmed | Hearing preservation in acoustic neuroma resection: Analysis of petrous bone measurement and intraoperative application |
title_short | Hearing preservation in acoustic neuroma resection: Analysis of petrous bone measurement and intraoperative application |
title_sort | hearing preservation in acoustic neuroma resection: analysis of petrous bone measurement and intraoperative application |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234277/ https://www.ncbi.nlm.nih.gov/pubmed/28144470 http://dx.doi.org/10.4103/2152-7806.195572 |
work_keys_str_mv | AT tanrikululevent hearingpreservationinacousticneuromaresectionanalysisofpetrousbonemeasurementandintraoperativeapplication AT lohsepeer hearingpreservationinacousticneuromaresectionanalysisofpetrousbonemeasurementandintraoperativeapplication AT fahlbuschrudolf hearingpreservationinacousticneuromaresectionanalysisofpetrousbonemeasurementandintraoperativeapplication AT naraghiramin hearingpreservationinacousticneuromaresectionanalysisofpetrousbonemeasurementandintraoperativeapplication |