Hearing preservation and surgical complications after extended middle cranial fossa approach

Choi, Jae Young; Kim, Shi Chan; Yoon, Hyen Chul; Lim, Young Chang; Lee, Won Sang

Abstract

BACKGROUND AND OBJECTIVES: The advent of magnetic resonance imaging has enabled surgeons to detect small intracanalicular tumors. Therefore, many patients with acoustic tumors can be candidates for hearing preservation. This study was designed to analyze hearing results following acoustic tumor removal through the extended middle cranial fossa approach (EMCFA) and to determine the prognostic factors associated with successful hearing preservation. MATERIALS & METHODS: We retrospectively reviewed 11 patients whose tumor was removed via EMCFA (10:acoustic tumor, 1:lymphangioma).
RESULTS
In 9 patients, the tumors were completely removed with EMCFA and in one patient, the suboccipital approach was combined with EMCFA. However, the approach was transformed to the translabyrinthine approach in one patient, because the tumor adhered to the cochlear nerve. The overall success rate of hearing preservation was 60% (6 of 10). In 20% of patients, the hearing was worse and other 20% of patients lost their hearing. Preoperative hearing level, location of tumor and origin of tumor affect the postoperative hearing. But tumor size did not relate to hearing preservation.
CONCLUSION
In most cases, we could preserve the patient's hearing with EMCFA. However, the patients with poor preoperative hearing and tumor originated from the superior vestibular nerve were at risk for hearing loss.