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BioMed Research International
Volume 2015, Article ID 783169, 9 pages
Clinical Study

Does Attempt at Hearing Preservation Microsurgery of Vestibular Schwannoma Affect Postoperative Tinnitus?

1Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic
2Institute of Experimental Medicine vvi, Institute of Auditory Neuroscience, Czech Academy of Sciences, Vídeňská 1083, 142 20 Prague 4, Czech Republic
3Department of Radiodiagnostics, 2nd Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic
4Department of Electromagnetic Field, Faculty of Electrical Engineering, Czech Technical University, Technická 2, 166 27 Prague 6, Czech Republic

Received 29 September 2014; Accepted 4 December 2014

Academic Editor: Stefan Rampp

Copyright © 2015 Martin Chovanec et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The aim of this study was to analyze the effect of vestibular schwannoma microsurgery via the retrosigmoid-transmeatal approach with special reference to the postoperative tinnitus outcome. Material and Methods. A prospective study was performed in 89 consecutive patients with unilateral vestibular schwannoma indicated for microsurgery. Patient and tumor related parameters, pre- and postoperative hearing level, intraoperative findings, and hearing and tinnitus handicap inventory scores were analyzed. Results. Cochlear nerve integrity was achieved in 44% corresponding to preservation of preoperatively serviceable hearing in 47% and useful hearing in 21%. Main prognostic factors of hearing preservation were grade/size of tumor, preoperative hearing level, intraoperative neuromonitoring, tumor consistency, and adhesion to neurovascular structures. Microsurgery led to elimination of tinnitus in 66% but also new-onset of the symptom in 14% of cases. Preservation of useful hearing and neurectomy of the eighth cranial nerve were main prognostic factors of tinnitus elimination. Preservation of cochlear nerve but loss of preoperative hearing emerged as the main factor for tinnitus persistence and new onset tinnitus. Decrease of THI scores was observed postoperatively. Conclusions. Our results underscore the importance of proper pre- and intraoperative decision making about attempt at hearing preservation versus potential for tinnitus elimination/risk of new onset of tinnitus.