Acoustic Neuroma Surgery: A Hearing Conservation Approach

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With refinements in early diagnosis of small acoustic neuromas, increasing effort is being directed toward hearing preservation in the resection of small acoustic neuromas, according to a recent report presented at the Western Section Meeting of the Triological Society. Kevin McKennan, MD, of Sacramento, Calif, reviewed his experience with 47 patients who had acoustic neuromas smaller than 2 cm in diameter and who had salvageable hearing. Fifteen of these patients retained useful hearing after acoustic neuroma removal. Useful hearing was described as pure tone levels better than 50 dB and speech discrimination scores of 50% or better. Dr McKennan had greater success in hearing preservation with the suboccipital approach than he did with the middle fossa approach. He reviewed multiple factors that could possibly predict the success of hearing preservation efforts. He found that hearing preservation was more likely if the tumor size was less than 1 cm and if