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Is it worthwhile to attempt hearing preservation in larger acoustic neuromas?

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Is it worthwhile to attempt hearing preservation in larger acoustic neuromas?

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OBJECTIVE: To determine the hearing outcome in patients undergoing surgery via the retrosigmoid approach for acoustic neuromas with a substantial component in the cerebellopontine angle. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: The medical records of all patients undergoing acoustic neuroma removal via the retrosigmoid approach at a tertiary referral center were retrospectively reviewed. Sixty-four patients with both cerebellopontine angle component >or=15 mm and preoperative audiometry of class A or B (American Academy of Otolaryngology-Head and Neck Surgery) were identified. MAIN OUTCOME MEASURES: Postoperative average pure tone threshold and word recognition scores, categorized according to the classification of the American Academy of Otolaryngology-Head and Neck Surgery, were used to assess hearing outcome. RESULTS: Overall, only 6.3% (4 of 63) retained good hearing (class A or B) postoperatively. Hearing preservation rate in the smalle

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