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Scientific Oral Presentations

Otology/Neurotology

Session: Scientific Oral Presentations 8 - Otology/Neurotology

Impact of MRI Cochlear FLAIR Signal on Hearing Preservation After Middle Fossa Vestibular Schwannoma Resection

Tuesday, October 1, 2024
11:48 AM – 11:54 AM EDT
Location: MBCC, 231
Disclosure(s):
Nicole E. Ewer, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jason L. Steele, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Heather J. Smith, BMus:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mana Espahbodi, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Richard H. Wiggins, MD, III:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Richard K. Gurgel, MD, MSCI:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Neil S. Patel, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Current literature is limited regarding the relationship between cochlear magnetic resonance imaging (MRI) fluid-attenuated inversion recovery (FLAIR) signal and hearing preservation after resection of vestibular schwannoma (VS). This study aims to explore this relationship.

Methods: A retrospective review was performed of subjects undergoing microsurgical resection of VS via a middle fossa approach from 2016-2022 at a single, academic tertiary care center. House-Brackmann (HB) facial nerve function, word recognition score (WRS), pure tone average (PTA) at 0.5, 1, 2, and 3 kHz, and AAO-HNS hearing class were assessed. Hearing preservation was defined as AAO-HNS class A or B hearing. Binary logistic regression analysis was performed with SPSS version 29.

Results: In total, 36 subjects met inclusion criteria with median age at time of surgery of 44.4 (interquartile range [IQR]: 36.7-53.5) years; 94.4% were White; 8.3% had neurofibromatosis type 2; 97.2% had preoperative HB 1 facial nerve function. Median (IQR) pre-op WRS and PTA were 100 (88.5-100)% and 23.4 (9.1-39.8) dB hearing level (HL) respectively; 58.3% had AAO-HNS class A, and 27.8% had class B. Postoperatively, at time of last follow-up, 77.8% had HB 1 or 2 facial nerve function at a median (IQR) of 6.7 (1.6-31.3) months. First postoperative audiogram results showed median (IQR) WRS of 70.6 (0-100)%, PTA of 70.6 (31.6-115) dB HL at a median (IQR) of 1.53 (1.4-1.8) months. On univariate logistic regression, at the time of the first postoperative audiogram, increased cochlear FLAIR signal was associated with decreased odds of hearing preservation – odds ratio: 0.17, 95% confidence interval: 0.03-0.85. Age at time of surgery, sex, duration of surgery, pre-op hearing class, maximal linear tumor dimension, tumor volume, presence of a fundal cap of cerebrospinal fluid, and extent of resection were not associated with hearing preservation.

Conclusions: Increased cochlear FLAIR signal on VS preoperative imaging is associated with decreased odds of hearing preservation after microsurgical resection via middle fossa approach with a duration of follow-up of 1.5 months.

    Presenting Author(s)

  • Nicole E. Ewer, BS

    Medical Student
    University of Utah School of Medicine
    West Valley City, UT, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Jason L. Steele, BS

    Medical Student Research Fellow/Medical Student
    University of Utah/Rocky Vista University
    Price, Utah, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Heather J. Smith, BMus

    Medical Student
    University of Utah
    Salt Lake City, UT, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Mana Espahbodi, MD

    Assistant Professor
    University of Utah
    Park City, UT, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Richard H. Wiggins, III, MD

    Professor
    University of Utah Department of Radiology and Imaging Sciences
    Salt Lake City, UT, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Richard K. Gurgel, MD, MSCI

    Professor
    University of Utah
    Salt Lake City, Utah, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Neil S. Patel, MD

    Assistant Professor
    Department of Otolaryngology-Head and Neck Surgery, University of Utah, Utah
    Salt Lake City, UT, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.