Hearing preservation in patients with vestibular schwannomas with sudden sensorineural hearing loss

OBJECTIVE: We evaluated hearing outcomes in patients with sudden hearing lo ss and vestibular schwannoma who underwent a hearing preservation operation for tumor resection in an effort to determine whether a history of sudden sensorineural hearing loss has an impact on subsequent hearing preservation surgery. METHODS: Retrospective chart review of 45 patients operated between 1990 an d 1998. Patients were divided into "Recovery" (n = 22) and "No Recovery" (n = 23) groups based on preoperative hearing recovery. Hearing preservation was assessed using the AAO-HNS hearing classification system. RESULTS., Measurable hearing was preserved in 73% of patients, with 47% hav ing good postoperative hearing (AAO-HNS Classes A-B). There was no signific ant difference in hearing outcome from patients presenting with progressive hearing loss (45% Classes A-B). There was also no difference in postoperat ive hearing between the "Recovery" and "No Recovery" groups. CONCLUSIONS: Patients with sudden hearing loss and vestibular schwannoma ha ve the same chance of hearing preservation after tumor removal as those wit h progressive loss. Preoperative recovery of hearing is not predictive of h earing preservation. Available data support the nerve compression theory as the mechanism of sudden hearing loss in patients with vestibular schwannom a.