Degree of preoperative hearing loss predicts time to early mobilization following vestibular schwannoma microsurgery

Robert J. Macielak, Jason H. Barnes, Jamie J. Van Gompel, Brian A. Neff, Michael Link, Colin L. Driscoll, Matthew L. Carlson, Neil S. Patel

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To test the hypothesis that severe to profound preoperative hearing loss predicts less acute postoperative vestibulopathy following microsurgical removal of vestibular schwannoma (VS) allowing for earlier postoperative mobilization and hospital discharge. Methods: Patients with VS who underwent microsurgery and were found to have preoperative severe to profound hearing loss (pure tone average [PTA] > 70 dB HL) were matched 1:1 by age and tumor size to a group of randomly selected controls with preoperative serviceable hearing. Results: A total of 57 patients met inclusion criteria and were matched to controls. Median age at the time of microsurgery was 56 years. The median PTA and WRS for cases were 91 dB HL (interquartile range [IQR] 78–120) and 0% (IQR 0–0), respectively. Median tumor size was 14.2 mm (IQR 10.9–20.9). A total of 35 (61%) patients exhibited nystagmus after surgery associated with acute vestibular deafferentation. Median time to ambulation in the hallway was 2 days. Controls exhibited similar tumor size (12.7 mm, p = 0.11) and age (57 years, p = 0.52). Preoperative hearing loss did not predict severity or duration of postoperative nystagmus or days to discharge; however, those with Class D hearing exhibited a shorter time to ambulation (p = 0.04). Conclusion: Following microsurgical removal of VS, preoperative profound hearing loss was associated with a shorter time to postoperative mobilization; however, there were no observed associations with duration or severity of nystagmus and time to hospital discharge. Although not a predictor of nystagmus, preoperative profound hearing loss may portend quicker recovery from clinically significant postoperative vestibulopathy.

Original languageEnglish (US)
Article number103073
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume42
Issue number6
DOIs
StatePublished - Nov 1 2021

Keywords

  • Acoustic neuroma
  • Non-serviceable hearing
  • Vertigo
  • Vestibular schwannoma
  • Vestibulopathy

ASJC Scopus subject areas

  • Otorhinolaryngology

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