{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:33:45Z","timestamp":1793147625756,"version":"4.5.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the safety and short-term predictive value of continuous intraoperative monitoring of the dorsal cochlear nucleus action potential (DNAP) using a 4-contact depth electrode during retrosigmoid vestibular schwannoma resection, and to compare its accuracy in predicting postoperative hearing outcomes with that of standard auditory brainstem response (ABR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Adult patients with a preoperative word recognition score (WRS) \u2265 50% who underwent primary retrosigmoid vestibular schwannoma resection were included in this retrospective cohort study. A multimodal monitoring protocol comprising ABR, cochlear nerve action potential mapping, and continuous DNAP monitoring was used. Short-term hearing outcomes were assessed 5\u20137 days postoperatively based on two criteria: serviceable hearing (American Academy of Otolaryngology\u2013Head and Neck Surgery class A or B) and speech function preservation (WRS \u2265 50%). Multivariate Firth logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors and determine the optimal predictive threshold for DNAP amplitude. In patients with available follow-up, 6-month hearing outcomes were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Overall, 153 patients (93 female, mean age 42 years [range 18\u201368 years]) were included in this analysis, with a mean tumor diameter of 2.2 cm (range 1.5\u20134.3 cm). Stable baseline DNAP signals were successfully recorded in 80.4% (123\/153) of patients compared with 60.8% (93\/153) for ABR. No procedure-related complications were attributable to the depth electrode. At 5\u20137 days postoperatively, serviceable hearing was achieved in 41.2% (63\/153) and speech function in 56.2% (86\/153) of patients. At the 6-month follow-up, the corresponding rates were 40.9% (56\/137) and 56.2% (77\/137), respectively, among patients with available audiometric data. In the multivariable analyses, DNAP preservation remained the most consistent independent predictor of both early and 6-month hearing-related outcomes. ROC analysis identified an optimal DNAP residual amplitude ratio cutoff of 0.41 for early postoperative outcomes. In the group with available 6-month follow-up, DNAP retained favorable diagnostic performance and consistently higher sensitivity than that of ABR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>DNAP monitoring via a 4-contact depth electrode was a safe and reliable technique that provided robust nearly real-time feedback during hearing-preservation vestibular schwannoma surgery. A DNAP residual amplitude ratio &gt; 0.41 was strongly associated with favorable early hearing outcomes, and its diagnostic advantage remained evident at the 6-month follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.5.jns253148","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:01:16Z","timestamp":1792540876000},"page":"1-11","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative dorsal cochlear nucleus action potential monitoring in hearing preservation retrosigmoid surgery for vestibular schwannoma: a predictive analysis of short-term hearing outcomes"],"prefix":"10.3171","author":[{"given":"Xiaofan","family":"Pang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senlin","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixuan","family":"Zong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuhui","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuekang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenke","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanjun","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Surgical Neurophysiology, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Audiol Res","first-page":"696","article-title":"Intra-operative cochlear nerve function monitoring in hearing preservation surgery: a systematic review of the literature","volume":"12","author":"Ariano M","year":"2022","unstructured":"Ariano M, Franchella S, Tealdo G, Zanoletti E. 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