{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:49:09Z","timestamp":1786124949270,"version":"build-2736575974"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T00:00:00Z","timestamp":1624579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Hearing loss is a significant disability that inflects dysfunction and affects the patient quality of life. Consequently, hearing preservation and the potential of hearing restoration are prized quests in the management of vestibular schwannoma.\n                    <jats:sup>1<\/jats:sup>\n                    Although small intracanalicular vestibular schwannomas are commonly observed, progressive hearing loss occurs despite the absence of tumor growth; hence, surgical resection can be performed with the sole aim of hearing preservation in well-informed and eager patients. Hearing preservation by surgical resection has proven to be durable.\n                    <jats:sup>1-4<\/jats:sup>\n                    In this group of patients, we concur with Yamakami et al\n                    <jats:sup>2<\/jats:sup>\n                    that vascularized meatal flap to reconstruct the canal helps prevent scarring of the cochlear nerve and provides cerebrospinal fluid (CSF) bathing to the cochlear nerve, yielding better long-term hearing preservation.\n                  <\/jats:p>\n                  <jats:p>\n                    \u2003With larger tumors and more severe hearing loss at presentation, microsurgical resection should aim at preserving the cochlear nerve, a goal frequently achievable, which offers the potential for hearing restoration with cochlear implants.\n                    <jats:sup>3<\/jats:sup>\n                    The results of cochlear implants in restoration of severe hearing loss have been to say the least most impressive.\n                    <jats:sup>5<\/jats:sup>\n                    We demonstrate these 2 frequently encountered clinical situations with 2 surgical videos showing specific surgical tenets, including intra-arachnoidal dissection, medial to lateral manipulation of the tumor, preservation of the labyrinthine artery, as well as reconstruction of the internal auditory canal.\n                    <jats:sup>2,3,6,7<\/jats:sup>\n                    The patients consented to the surgery and to the publication of their picture in a surgical video.\n                  <\/jats:p>\n                  <jats:p>\u2003Illustration in video \u00a9 1997 O. Al-Mefty. Used with permission. All rights reserved.<\/jats:p>","DOI":"10.1093\/ons\/opab230","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T18:23:43Z","timestamp":1624645423000},"page":"E328-E329","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["\u201cSave the Nerve\u201d: Technical Nuances for Hearing Preservation and Restoration in Vestibular Schwannoma Surgery: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"21","author":[{"given":"Rami O","family":"Almefty","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4640-0563","authenticated-orcid":false,"given":"Walid","family":"Ibn Essayed","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ossama","family":"Al-Mefty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,10]]},"reference":[{"issue":"4","key":"bib1-20250821","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1097\/00006123-199704000-00006","article-title":"Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve\u2014preservation and restitution of function","volume":"40","author":"Samii","year":"1997","journal-title":"Neurosurgery"},{"issue":"3","key":"bib2-20250821","doi-asserted-by":"crossref","first-page":"554","DOI":"10.3171\/2014.6.JNS132471","article-title":"Retrosigmoid removal of small acoustic neuroma: curative tumor removal with preservation of function","volume":"121","author":"Yamakami","year":"2014","journal-title":"J Neurosurg"},{"issue":"3","key":"bib3-20250821","doi-asserted-by":"crossref","first-page":"821","DOI":"10.3171\/2014.12.JNS142826","article-title":"Letter to the editor: save the nerve","volume":"123","author":"Upadhyay","year":"2015","journal-title":"J Neurosurg"},{"issue":"3","key":"bib4-20250821","doi-asserted-by":"crossref","first-page":"579","DOI":"10.3171\/2012.9.JNS12919","article-title":"Long-term hearing outcomes following stereotactic radiosurgery for vestibular schwannoma: patterns of hearing loss and variables influencing audiometric decline","volume":"118","author":"Carlson","year":"2013","journal-title":"J Neurosurg"},{"issue":"2","key":"bib5-20250821","first-page":"237","article-title":"Cochlear implants and spoken language processing abilities: review and assessment of the literature","volume":"28","author":"Peterson","year":"2010","journal-title":"Restor Neurol Neurosci"},{"issue":"1 Suppl Operative","key":"bib6-20250821","first-page":"ons16","article-title":"Transmastoid retrosigmoid approach to the cerebellopontine angle: surgical technique","volume":"73","author":"Abolfotoh","year":"2013","journal-title":"Neurosurgery"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/21\/4\/E328\/40331538\/opab230.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab230","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:47:52Z","timestamp":1786121272000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab230"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,25]]},"references-count":6,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opab230","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,25]]},"assertion":[{"value":"2021-01-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}