• Neurosurgery · Sep 2019

    Hearing Response Following Internal Auditory Canal Decompression in Neurofibromatosis Type 2.

    • Nicolas-Xavier Bonne, Michaël Risoud, Michael Hoa, Pierre-Emmanuel Lemesre, Rabih Aboukais, Emilie Le Rhun, Frédérique Dubrulle, Marc Baroncini, Jean-Paul Lejeune, and Christophe Vincent.
    • CHU Lille, Otologie et Otoneurologie, Université de Lille, Inserm U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France.
    • Neurosurgery. 2019 Sep 1; 85 (3): E560-E567.

    BackgroundHearing response following an osteodural decompression of the internal auditory canal (IAC) is controversial.ObjectiveTo evaluate the course of auditory brainstem responses (ABRs) and the early hearing response during the first year following IAC decompression for small to medium-sized vestibular schwannomas occurring in neurofibromatosis type 2 (NF2).MethodsRetrospective chart review of middle fossa craniotomy for IAC osteodural decompression in NF2-related vestibular schwannomas.ResultsTwelve NF2 patients were operated on from 2011 to 2016 for IAC decompression. All had NF2 according to the Manchester criteria. All had a progressive change of their ABRs documented from the diagnosis of NF2 over a mean period of 6.25 [0.36;10.9] yr. Treatment was proposed to stop hearing progression based on the speech discrimination scores (SDSs; n = 4) or for hearing maintenance (n = 8). In patients with prior hearing progression, hearing responses were observed in 3 of the 4 patients during the first year. One patient kept on progressing. In the hearing maintenance group, the SDSs remained stable. SDSs improved from 85% [20-100] to 92.5% [60-100] on average (n = 12) and from 55% [20-80] to 77.5% [50-100] in the hearing progression group (n = 4). ABRs improved in 4 patients following decompression.ConclusionIAC decompression allows early objective hearing responses in select patients. We suggest that the procedure should be offered to patients with hearing progression based on their SDSs and/or associated progressive increases in their wave III and V latencies on ABRs.Copyright © 2019 by the Congress of Neurological Surgeons.

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