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Vestibular schwannoma and the only hearing ear

Published online by Cambridge University Press:  29 June 2007

Sanjaya Bhatia
Affiliation:
Gruppo Otologico, Piacenza, Italy. (presently clinical research fellows).
Sandeep Karmarkar
Affiliation:
Gruppo Otologico, Piacenza, Italy. (presently clinical research fellows).
Abdelkader Taibah
Affiliation:
Gruppo Otologico, Piacenza, Italy.
Alessandra Russo
Affiliation:
Gruppo Otologico, Piacenza, Italy.
Mario Sanna*
Affiliation:
Gruppo Otologico, Piacenza, Italy.
*
Address for correspondence: Mario Sanna, M.D., Gruppo Otologico, Via Emmanueli, 42, 29100 Piacenza, Italy. Fax: 39 523 453708

Abstract

With the recent advances in the management of vestibular schwannomas, it is possible not only to save the facial nerve function but also preserve hearing in a small percentage of cases. Difficulties arise while managing patients with vestibular schwannoma in their only hearing ear. In this article we summarize our experience in managing seven of these patients. We recommend a watch and wait policy with a regular follow-up with audiometric testing and gadolinium-enhanced magnetic resonance imaging (MRI). Gamma knife radiosurgery is advised in cases with deterioration of hearing or increase in tumour size. Surgery is usually avoided unless there are brainstem compression symptoms.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1996

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References

Gardner, G., Moretz, W. H., Robertson, J. H., Clark, C., Shea, J. J. (1986) Nonsurgical management of small and intracanalicular acoustic tumors. Otolaryngology – Head and Neck Surgery 94: 328333.CrossRefGoogle ScholarPubMed
Gardner, G., Robertson, J. H. (1988) Hearing preservation in unilateral acoustic neuroma surgery. Annals of Otology, Rhinology and Laryngology 97: 5566.CrossRefGoogle ScholarPubMed
Hirsch, A., Norén, G. (1992) Audiological evaluation after stereotactic radiosurgery in acoustic neurinomas. In Acoustic Neuroma(Tos, M., Thomsen, J., eds.), Kugler publications, Amsterdam/New York, pp 293295.Google Scholar
Jackler, R. K. (1994) Acoustic neuroma (Vestibular schwannoma). In Neurotology, (Jackler, R. K., Brackmann, D. E., eds.), Mosby-Yearbook, Inc., St Louis/Baltimore/Boston, pp 729786.Google Scholar
Jahrsdoerfer, R. A., Benjamin, R. S. (1988) Chemotherapy of bilateral acoustic neuromas. Otolaryngology – Head and Neck Surgery 98: 273281.CrossRefGoogle ScholarPubMed
Linthicum, F. H. Jr, Brackmann, D. E. (1980) Bilateral acoustic tumours. A diagnostic and surgical challenge. Archives of Otolaryngology 106: 729733.CrossRefGoogle ScholarPubMed
Lunsford, L. D., Linskey, M. E., Flickinger, J. C. (1992) Stereotactic radiosurgery for acoustic nerve sheath tumors. In Acoustic Neuroma, (Tos, M., Thomsen, J., eds.) Kugler publications, Amsterdam/New York, pp 279287.Google Scholar
Miyamoto, R. T., Roos, K. L., Campbell, R. L. (1992) Hearing preservation in neurofibromatosis-2. In Skull Base Surgery Anatomy, Diagnosis and Treatment. (Samii, M., ed.), Karger publication, Basel, pp 916918.Google Scholar
Nadol, J. B., Levine, R., Ojemann, R. G., Martuza, R. L., Montgomery, W. W., Sandoval, P. K. (1987) Preservation of hearing in surgical removal of acoustic neuromas of the internal auditory canal and cerebellar pontine angle. Laryngoscope 97: 12871294.CrossRefGoogle ScholarPubMed
Naguib, B. M., Saleh, E., Aristegui, M., Mazzoni, A., Sanna, M. (1994) Decision making in acoustic neuroma management: The only hearing ear. Skull Base Surgery 4: 3235.CrossRefGoogle ScholarPubMed
Norén, G., Greitz, D., Hirsch, A., Lax, I. (1992) Gamma knife radiosurgery in acoustic neuromas. In Acoustic Neuroma, (Tos, M., Thomsen, J., eds.), Kugler publications, Amsterdam/New York, pp 289292.Google Scholar
Norén, G. (1994) Gamma knife surgery in acoustic neuromas. In Skull Base Surgery Anatomy, Diagnosis and Treatment. (Samii, M., ed), Karger publication, Basel, pp 877879.Google Scholar
Pensak, M. L., John, M. T., Keith, R. W., VanLoveren, H. R. (1991) Management of the acoustic neuroma in an only hearing ear. Skull Base Surgery 1: 9396.CrossRefGoogle Scholar
Sanna, M., Zini, C., Gamoletti, R., Landolfi, M., Shaan, M., Piazza, F. (1992) Hearing preservation: a critical review of the literature. In Acoustic Neuroma (Tos, M., Thomsen, J., eds.), Kugler publications, Amsterdam/New York, pp 631638.Google Scholar
Sanna, M., Zini, C., Mazzoni, A., Gandolfi, A., Pareschi, R., Pasanisi, E., Gamoletti, R. (1987) Hearing preservation in acoustic neuroma surgery. Middle fossa versus suboccipital approach. American Journal of Otology 8: 500507.Google ScholarPubMed
Shelton, C., Histelberger, W. E., House, W. F., Brackmann, D. E. (1990) Hearing preservation after acoustic tumour removal. Laryngoscope 100: 115119.CrossRefGoogle Scholar
Valvassori, G. E., Shannon, M. (1991) Natural history of acoustic neuroma. Skull Base Surgery 1: 165167.CrossRefGoogle Scholar
Wiet, R. J., Young, N. M., Monsell, E. M., O'Connor, C. A., Kazan, R. (1989) Age consideration in acoustic neuroma surgery: The horns of a dilemma. American Journal of Otology 10: 177180.Google ScholarPubMed