PMID: 16639278Apr 28, 2006Paper

Small acoustic neuromas: surgical outcomes versus observation or radiation

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
Ted A MeyerB J Gantz

Abstract

Evaluate factors affecting outcomes of small acoustic neuroma (AN) removal via a middle cranial fossa (MCF) approach, and compare results to published data on observation and radiation therapy. Retrospective chart review. Academic tertiary referral center. 162 consecutive patients (ages 19-70) with unilateral AN (0.2-2.5 cm in largest dimension) removed through a MCF approach were reviewed focusing on preservation of hearing, facial nerve function and complications. One hundred thirteen patients had pre-operative word recognition scores (WRS)>70%. Both tumor size and pre-operative WRS were related to post-operative WRS (p<0.01). Overall, at least some hearing was preserved in 94 (60%) of the 156 patients who had hearing before surgery. If the WRS was also >70% (N=113), 56 (50%) maintained WRS>70%. Importantly, WRS for 12 others improved to >70% after surgery. When the patients were stratified by tumor size, the patients with small tumors (2-10 mm) faired better than the overall group. At least some hearing was preserved in 65 (72%) of the 90 patients. If the WRS was also >70% (N=66), 39 (59%) maintained WRS>70%. WRS for eight others improved to >70% after surgery. When the tumor was 1.1-1.4 cm (N=34), the chance of preserving s...Continue Reading

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