Hearing preservation in vestibular schwannoma surgery: fact or fantasy?

This study reviews 57 papers dealing with the issue of hearing preservation in vestibular schwannoma surgery published in otolaryngologic and neurosurgical literature between the years 1977 and 1994. The authors', in this review, have made an attempt to verify whether the claims of hearing preservation are real, whether there is a price to be paid in terms of morbidity and whether there are univocal criteria for reporting results. The review shows that there is a wide disarray in reporting hearing results and the claims of hearing preservation are often unreal and misleading. On retabulating the results of a few series according to the minimal prerequisites for normal hearing (PTA < or = 30 dB and SDS > or = 70 per cent) and according to other various commonly reported criteria, it became evident that rates of hearing preservation differed a lot depending upon criteria. While any measurable hearing could be preserved in many cases, only a few had normal hearing preserved.