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July 1987

Preservation of Hearing in Surgical Removal of Tumors of the Internal Auditory Canal and Cerebellar Pontine Angle

Arch Otolaryngol Head Neck Surg. 1987;113(7):701. doi:10.1001/archotol.1987.01860070015002

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Speaking at the recent Eastern Section meeting of the Triological Society, Joseph B. Nadol, Jr, MD, Boston, and associates reported their findings regarding 72 patients in whom unilateral acoustic neuroma of the internal canal and/or cerebellar pontine angle was totally removed as judged by visual inspection and in whom an attempt was made to preserve hearing aided by intraoperative evokedresponse monitoring. The success in preserving preoperative hearing levels or some measure of useful hearing was negatively correlated with increasing tumor size. Likewise, the preservation of the facial nerve, both anatomically and physiologically, was statistically easier with smaller tumors. Other preoperative clinical parameters, including the degree of severity of auditory evoked potentials and clinical or electrophysiologic assessment of the facial nerve, had no predictive value for postoperative hearing results.

Intraoperative monitoring of electrocochleography and brain-stem auditory evoked potentials was valuable, not only to warn the operating surgeons of impending injury to

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