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Intraoperative Monitoring of Auditory Function During Lateral Skull Base Surgery.

Abstract

OBJECTIVE

We present a unique case of a patient with a jugular foramen tumor with serviceable hearing. This study discusses the audiometric results and intraoperative electrocochleographic (ECochG) findings recorded during tumor removal to illustrate the potential utility of this technique in skull base surgery.

PATIENTS

A 22-year-old female patient presented with a jugular foramen schwannoma and associated symptoms of right-sided otalgia, mild hearing loss, and blurry vision.

INTERVENTIONS

Intraoperative ECochG responses during an infratemporal fossa approach: click and tone burst (1, 2, 4 kHz) stimuli were used and presented at 90 dB nHL.

MAIN OUTCOME MEASURES

Intraoperative ECochG testing using frequency-specific tone bursts and clicks before and after tumor resection.

RESULTS

The compound action potential magnitudes, cochlear microphonic, and summation potential were recorded pre- and post-tumor removal. For statistical analysis, a paired t test with significance set at p < 0.05 was used. The compound action potential magnitudes increased at all test frequencies (p < 0.01) while the summation potential and cochlear microphonic remained relatively stable (p > 0.05). Audiometric testing demonstrated an improvement of the preoperative mild right-sided hearing loss after tumor resection (pure-tone average for 0.5, 1, 2, and 4 kHz of 30 dB HL preoperation and 7.5 dB HL after tumor resection).

CONCLUSIONS

Intraoperative ECochG may allow for real-time monitoring during complex skull base surgery.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. Department of Otolaryngology-Head and Neck Surgery, University Hospital of Foggia, Foggia, Italy.Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.Department of Otolaryngology-Head and Neck Surgery, University Hospital of Foggia, Foggia, Italy.Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31498299

Citation

Trecca, Eleonora M C., et al. "Intraoperative Monitoring of Auditory Function During Lateral Skull Base Surgery." Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2019.
Trecca EMC, Riggs WJ, Hiss MM, et al. Intraoperative Monitoring of Auditory Function During Lateral Skull Base Surgery. Otol Neurotol. 2019.
Trecca, E. M. C., Riggs, W. J., Hiss, M. M., Mattingly, J. K., Cassano, M., Prevedello, D. M., & Adunka, O. F. (2019). Intraoperative Monitoring of Auditory Function During Lateral Skull Base Surgery. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, doi:10.1097/MAO.0000000000002441.
Trecca EMC, et al. Intraoperative Monitoring of Auditory Function During Lateral Skull Base Surgery. Otol Neurotol. 2019 Sep 7; PubMed PMID: 31498299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraoperative Monitoring of Auditory Function During Lateral Skull Base Surgery. AU - Trecca,Eleonora M C, AU - Riggs,William J, AU - Hiss,Meghan M, AU - Mattingly,Jameson K, AU - Cassano,Michele, AU - Prevedello,Daniel M, AU - Adunka,Oliver F, Y1 - 2019/09/07/ PY - 2019/9/10/entrez JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology JO - Otol. Neurotol. N2 - OBJECTIVE: We present a unique case of a patient with a jugular foramen tumor with serviceable hearing. This study discusses the audiometric results and intraoperative electrocochleographic (ECochG) findings recorded during tumor removal to illustrate the potential utility of this technique in skull base surgery. PATIENTS: A 22-year-old female patient presented with a jugular foramen schwannoma and associated symptoms of right-sided otalgia, mild hearing loss, and blurry vision. INTERVENTIONS: Intraoperative ECochG responses during an infratemporal fossa approach: click and tone burst (1, 2, 4 kHz) stimuli were used and presented at 90 dB nHL. MAIN OUTCOME MEASURES: Intraoperative ECochG testing using frequency-specific tone bursts and clicks before and after tumor resection. RESULTS: The compound action potential magnitudes, cochlear microphonic, and summation potential were recorded pre- and post-tumor removal. For statistical analysis, a paired t test with significance set at p < 0.05 was used. The compound action potential magnitudes increased at all test frequencies (p < 0.01) while the summation potential and cochlear microphonic remained relatively stable (p > 0.05). Audiometric testing demonstrated an improvement of the preoperative mild right-sided hearing loss after tumor resection (pure-tone average for 0.5, 1, 2, and 4 kHz of 30 dB HL preoperation and 7.5 dB HL after tumor resection). CONCLUSIONS: Intraoperative ECochG may allow for real-time monitoring during complex skull base surgery. SN - 1537-4505 UR - https://www.unboundmedicine.com/medline/citation/31498299/Intraoperative_Monitoring_of_Auditory_Function_During_Lateral_Skull_Base_Surgery L2 - http://dx.doi.org/10.1097/MAO.0000000000002441 DB - PRIME DP - Unbound Medicine ER -