Pathophysiology of Postoperative Hearing Disorders after Vestibular Schwannoma Resection: Insights from Auditory Brainstem Response and Otoacoustic Emissions.
Idir DjennaouiMathilde PuechmailleChloé TrillatJustine BécaudNicolas SaroulToufic KhalilPaul AvanThierry MomPublished in: Journal of clinical medicine (2024)
Background : In order to better understand the pathophysiology of surgically induced hearing loss after vestibular schwannoma (VS) surgery, we postoperatively analyzed the hearing status in a series of patients where hearing was at least partially preserved. Methods : Hearing was assessed through tonal audiometry, speech discrimination score, maximum word recognition score (dissyllabic word lists-MaxIS), otoacoustic emissions (OAEs), and auditory brainstem response (ABR). The magnetic resonance imaging (MRI) tumor characterization was also noted. Results : In a series of 24 patients operated on for VS over 5 years, depending on the results of this triple hearing exploration, we could identify, after surgery, patients with either a myelin alteration or partial damage to the acoustic fibers, others with a likely partial cochlear ischemia, and some with partial cochlear nerve ischemia. One case with persisting OAEs and no preoperative ABR recovered hearing and ABR after surgery. Long follow-up (73 ± 57 months) revealed a mean hearing loss of 30 ± 20 dB with a drastic drop of MaxIS. MRI revealed only 25% of fundus invasion. Conclusion : a precise analysis of hearing function, not only with classic audiometry but also with ABR and OEAs, allows for a better understanding of hearing damage in VS surgery.
Keyphrases
- hearing loss
- magnetic resonance imaging
- end stage renal disease
- ejection fraction
- minimally invasive
- chronic kidney disease
- newly diagnosed
- oxidative stress
- contrast enhanced
- peritoneal dialysis
- patients undergoing
- prognostic factors
- computed tomography
- single cell
- multiple sclerosis
- patient reported outcomes
- coronary artery disease
- magnetic resonance
- white matter
- heavy metals
- atrial fibrillation
- working memory