{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:43:46Z","timestamp":1791330226333,"version":"4.3.1"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives\/Hypothesis<\/jats:title>\n                    <jats:p>To review hearing preservation after microsurgical resection of sporadic vestibular schwannomas according to tumor size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Baseline, intraoperative, and postoperative patient and tumor characteristics were retrospectively collected for a cohort who underwent hearing preservation microsurgery. Serviceable hearing was defined by a pure tone average \u226450\u2009dB and word recognition score \u226550%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 243 patients had serviceable hearing preoperatively. Fifty (21%) tumors were confined to the internal auditory canal, and the median tumor size was 16.2\u2009mm (interquartile range [IQR] 11.3\u201323.2) for tumors with cerebellopontine angle extension. Serviceable hearing was maintained in 64% of patients with tumors confined to the internal auditory canal, 28% with cerebellopontine angle extension &lt;15\u2009mm, and 9% with cerebellopontine angle extension \u226515\u2009mm. On multivariable analysis, the odds ratios of acquiring nonserviceable hearing postoperatively for tumors extending &lt;15\u2009mm and \u226515\u2009mm into the cerebellopontine angle were 5.75 (95% confidence interval [CI] 2.13\u201315.53;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and 22.11 (95% CI 7.04\u201369.42;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), respectively, compared with intracanalicular tumors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The strongest predictor of hearing preservation with microsurgery after multivariable adjustment is tumor size. Approximately 10% of patients with tumors \u226515\u2009mm of cerebellopontine angle extension will retain serviceable hearing after microsurgery. Furthermore, hearing preservation techniques offer cochlear nerve preservation and cochlear patency allowing for possible future cochlear implantation. An attempt at hearing preservation, including avoiding surgical approaches that necessarily sacrifice hearing, is worthwhile even in larger tumors if serviceable hearing is present preoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 132:1657\u20131664, 2022\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.29968","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T05:23:11Z","timestamp":1638422591000},"page":"1657-1664","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Hearing Preservation Microsurgery in Vestibular Schwannomas: Worth Attempting in \u201cLarger\u201d Tumors?"],"prefix":"10.1002","volume":"132","author":[{"given":"Katherine P.","family":"Wallerius","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0393-594X","authenticated-orcid":false,"given":"Robert J.","family":"Macielak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Skye K.","family":"Lawlor","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Lohse","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Neff","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."},{"name":"Department of Neurologic Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8087-7870","authenticated-orcid":false,"given":"Jamie J.","family":"Van Gompel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."},{"name":"Department of Neurologic Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin L. 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