Acuteness of preoperative factors to predict hearing preservation in acoustic neuroma surgery

Objectives: To determine in patients with acoustic neuromas the predictive factors of hearing preservation according to clinical, radiological, and el ectrophysiological parameters and to evaluate, for each of these predictive factors, the percentage of patients with preserved hearing. Study Design: The study involved 107 candidates for hearing preservation attempt. Mean ag e was 49.7 +/- 11.4 years. Quantitative and qualitative parameters were pro spectively studied. Quantitative parameters were age, duration of functiona l complaints, hearing loss assessed by pure tone and speech audiometry, and auditory brainstem responses (ABRs). Qualitative parameters (expressed in percentage of presence) were sex, functional complaints, vestibular deficit revealed by vestibular testings, well-shaped ABRs, wave I, III, or V of AB Rs, and transient evoked otoacoustic emissions (TEOAEs), Methods: Patients were divided into two groups according to whether their hearing was preserv ed (52.3%) or not preserved (47.7%). First, quantitative and qualitative fa ctors were compared between both groups to identify predictive factors. Sec ond, all patients were considered together and the percentage of hearing pr eservation was determined according to the presence of each predictive fact or. Results: The results confirmed the predictive value of classic paramete rs such as preoperative hearing level, radiological data, and trace of ABRs . They also emphasized the predictive role of other parameters such as shor t duration of hearing loss, presence of wave III in ABRs, and presence of T EOAEs. Conclusions: The size of the tumor and the preoperative hearing leve ls are longstanding predictive factors of hearing preservation in acoustic neuroma surgery, and candidates for hearing preservation are therefore now selected according to these factors, This study added more recent predictiv e factors and, among the 10 factors identified as predictive, the most rele vant to hearing preservation were the presence of TEOAEs (69.7%), short dur ation of hearing loss (66.7%), and presence of wave III in ABRs (66.7%).