A decade later – assessing hearing preservation in vestibular schwannoma patients post middle cranial fossa surgery

BACKGROUND: Patients with smaller vestibular schwannoma (VS) with preserved hearing can be subjected to hearing preservation surgery using the Middle Cranial Fossa (MCF) approach. AIMS/OBJECTIVES: We aimed to evaluate hearing outcome postoperatively and more than 10 years after MCF surgery. MATERIALS AND METHODS: Eighty-four patients with sporadic unilateral VS treated with MCF surgery between 1998 and 2020 at a single tertiary centre, were retrospectively studied. Pure tone audiometry and word recognition scores (WRS) preoperatively, postoperatively, and after > 10 years of follow-up, were analysed. RESULTS: Sixty (71%) patients had preserved hearing function after MCF surgery. Twenty-three of the 60 patients were followed up for >10 years after surgery. Hearing outcomes of the tumour ear after >10 years of follow up were as follows: median pure tone average (PTA): 61 decibel hearing level (dB HL) (range 6-94 dB HL), and median WRS 71% (range: 0-98%). The age-related decline in pure tone audiometry thresholds was not significantly different between the tumour and contralateral ears. CONCLUSIONS AND SIGNIFICANCE: MCF surgery offers the possibility of retaining hearing function even after >10 years of surgery in patients with preserved hearing. Additional hearing loss at the long-term follow-up was bilateral and symmetrical.