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J Neurol Surg B Skull Base
DOI: 10.1055/a-2399-0081
Original Article

Characterizing Hearing Outcomes Following Treatment of Cerebellopontine Angle Meningiomas

Michael Papazian
1   Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, United States
,
Justin Cottrell
1   Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, United States
,
Lydia Pan
1   Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, United States
,
Emily Kay-Rivest
2   Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Canada
,
David R. Friedmann
1   Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, United States
,
Daniel Jethanamest
1   Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, United States
,
Douglas Kondziolka
3   Department of Neurosurgery, NYU Langone Health, New York, New York, United States
,
Donato Pacione
3   Department of Neurosurgery, NYU Langone Health, New York, New York, United States
,
Chandranath Sen
3   Department of Neurosurgery, NYU Langone Health, New York, New York, United States
,
John G. Golfinos 
3   Department of Neurosurgery, NYU Langone Health, New York, New York, United States
,
J. Thomas Roland Jr.
1   Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, United States
,
Sean O. McMenomey
1   Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, United States
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Abstract

Objectives To characterize treatment and hearing outcomes for cerebellopontine angle (CPA) meningiomas with inherent risks of hearing loss and identify predictors of hearing loss for surgically treated lesions.

Design Retrospective chart review.

Setting Tertiary care medical center.

Participants Adult patients with CPA meningiomas impinging upon cranial nerve VIII and/or pretreatment hearing loss managed with microsurgery or stereotactic radiosurgery (SRS) with Gamma Knife at our center between 2012 and 2023.

Main Outcome Measures Hearing preservation rate was determined from analysis of patients with pretreatment serviceable hearing for whom hearing-preserving treatment was attempted. Surgical patients were further analyzed using multivariable Cox proportional hazards regression models to identify factors predictive of postoperative hearing loss.

Results We identified 80 patients with CPA meningiomas meeting inclusion criteria who were managed with either microsurgery (43, 54%) or radiosurgery (37, 46%). Following SRS, hearing was preserved in 88% of cases. Following microsurgery, hearing was preserved in 71% of patients—all patients who lost hearing had tumors involving the internal auditory canal (IAC). Among surgical patients only, multivariable analysis accounting for preoperative hearing, recurrence status, lesion size, and patient age, the preoperative imaging finding that the CPA meningioma surrounded the vestibulocochlear nerve was significantly associated with hearing loss (hazard ratio: 10.3, 95% confidence interval: 1.3–81.4, p = 0.02).

Conclusion Most patients with meningiomas of the CPA can experience preservation of hearing, even when there is risk of hearing loss based on pretreatment evaluation. IAC invasion and surrounding of eighth nerve by tumor may portend poorer hearing outcomes in surgically managed patients.

Keywords

CPA - meningioma - hearing preservation

Previous Presentation

An abstract containing data from this manuscript was presented at the 2024 North American Skull Base Society Meeting on February 16, 2024 (Atlanta, Georgia, United States).


Supplementary Material



Publication History

Received: 30 May 2024

Accepted: 19 August 2024

Accepted Manuscript online:
21 August 2024

Article published online:
10 September 2024

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