Hearing Preservation in Acoustic Neuroma Surgery
Hearing Preservation in Acoustic Neuroma Surgery作者机构：Department of Otolaryngology-Head and Neck Surgery PLA General Hospital Beijing 100853
出 版 物：《Journal of Otology》 (中华耳科学杂志（英文版）)
年 卷 期：2006年第1卷第1期
页 面：25-29页
学科分类：1003[医学-口腔医学] 1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：acoustic neuroma cochlear nerve hearing preservation ABR CAP
摘 要：Objective To report the authors experiences in hearing preservation during acoustic neuroma (AN) resection procedures. Methods Two cases of AN removal via retrosigmoid approach were reviewed. Hearing preservation was attempted in the aid of endoscopic technique along with continuous monitoring of the compound action potential (CAP) and auditory brainstem response(ABR) during the surgery. Results The tumor in Case 1 was 1.5 cm in diameter. The average pure-tone hearing threshold was 30 dB HL and ABR was normal. Waves I, III and V of ABR were present following tumor removal. At 7th month follow-up, audiometric thresholds and ABR inter-peak intervals had recovered to pre-operative levels, with normal facial nerve function. The patient in Case 2 had bilateral AN. The tumors measured 4.0 cm(left) and 5.0 cm (right) on MRI scans. The AN on the right side was removed first, followed by removal of the left AN four months later. Intraoperative CAP monitoring was employed during removal of the left AN. While efforts to preserve the cochlear nerve were not successful, CAPs were still present after tumor removal. Conclusions Intraoperatively recorded CAPs are not reliable in predicting postoperative hearing outcomes. In contrast, ABRs are an indicator of function of the peripheral auditory pathway. Presence of waves I, III and V following tumor removal may represent preservation of useful hearing.
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