Does choice of hearing selection criterion and reporting criteria affect the hearing preservation rate in vestibular schwannoma surgery?

With increasing refinement in the surgery of vestibular schwannoma the aims of complete tumor removal and facial nerve preservation have been largely fulfilled. However, the reputation of and place for hearing-preservation su rgery still remain uncertain. A major part of this uncertainty is the resul t of difficulties in interpretation of the various reported results of hear ing-preservation surgery. Meaningful comparison between series is difficult because of the varied number of postoperative reporting criteria commonly in use today. Although it is acknowledged that the postoperative reporting criteria affect the hearing-preservation rates, what is not readily appreci ated is that preoperative selection criteria for hearing-preservation cases can also significantly affect the success rate of hearing-preservation aco ustic neuroma surgery. This article models the many possible outcomes of he aring-preservation schwannoma surgery by use of the previously reported Cam bridge series as an illustrative example. With these models some understand ing can be gained of the effect of choosing various preoperative and postop erative hearing criteria on the overall hearing-preservation success rate.