{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T21:55:05Z","timestamp":1793742905760,"version":"4.6.1"},"reference-count":48,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>Objective: to evaluate recent contributions to the literature on prognostic factors of hearing preservation in small vestibular schwannoma microsurgery. Methods: review of the most recent studies. Results: factors such as tumor size, preoperative hearing status, tumor growth rate, tumor origin, surgical approach, radiological characteristics, results of preoperative neurophysiological tests, preoperative symptoms and demographic features have been investigated and some of them reported to be significant in the prediction of hearing preservation. Conclusions: tumor size and preoperative hearing status are the most impactful factors and play a key role in patient selection for hearing preservation surgery. Other features such as fundal extension, tumor origin and impaired ABR could have prognostic value on hearing preservation. Tumor growth rate, preoperative impedance, cVEMPs and age have also recently been found to be significant, but more studies are needed. The role of preoperative tinnitus, vertigo and gender is lacking and controversial, whereas the differences between available surgical approaches have been smoothed out in recent years.<\/jats:p>","DOI":"10.3390\/audiolres13040042","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T01:47:14Z","timestamp":1688435234000},"page":"473-483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prognostic Factors for Hearing Preservation Surgery in Small Vestibular Schwannoma"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0143-3751","authenticated-orcid":false,"given":"Stefano","family":"Concheri","sequence":"first","affiliation":[{"name":"Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Deretti","sequence":"additional","affiliation":[{"name":"Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Tealdo","sequence":"additional","affiliation":[{"name":"Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Zanoletti","sequence":"additional","affiliation":[{"name":"Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/B978-0-444-53502-3.00013-6","article-title":"Tumors of the cerebellopontine angle","volume":"105","author":"Samii","year":"2012","journal-title":"Handb. Clin. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3171\/2013.1.JNS121370","article-title":"Vestibular schwannomas in the modern era: Epidemiology, treatment trends, and disparities in management","volume":"119","author":"Babu","year":"2013","journal-title":"J. Neurosurg."},{"key":"ref_3","first-page":"e1846","article-title":"Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis","volume":"9","author":"Foley","year":"2017","journal-title":"Cureus"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1001\/archotol.130.2.216","article-title":"What Is the Real Incidence of Vestibular Schwannoma?","volume":"130","author":"Tos","year":"2004","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1227\/NEU.0b013e3181f22660","article-title":"True Incidence of Vestibular Schwannoma?","volume":"67","author":"Stangerup","year":"2010","journal-title":"Neurosurgery"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1097\/00129492-200307000-00019","article-title":"New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma","volume":"24","author":"Kanzaki","year":"2003","journal-title":"Otol. Neurotol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"506","DOI":"10.3171\/jns.1998.88.3.0506","article-title":"Neurotopographic considerations in the microsurgical treatment of small acoustic neurinomas","volume":"88","author":"Koos","year":"1998","journal-title":"J. Neurosurg."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"(1995). Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). Otolaryngol. Head Neck Surg., 113, 179\u2013180.","DOI":"10.1016\/S0194-5998(95)70101-X"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1177\/000348948809700110","article-title":"Hearing preservation in unilateral acoustic neuroma surgery","volume":"97","author":"Gardner","year":"1988","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"128","DOI":"10.3171\/2017.2.JNS162287","article-title":"Translabyrinthine microsurgical resection of small vestibular schwannomas","volume":"129","author":"Schwartz","year":"2018","journal-title":"J. Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"481","DOI":"10.14639\/0392-100X-N2322","article-title":"Early surgery and definitive cure in small sporadic vestibular schwannoma","volume":"42","author":"Zanoletti","year":"2022","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1227\/NEU.0b013e31822f7d5f","article-title":"Facial nerve function after vestibular schwannoma surgery following failed conservative management","volume":"70","author":"Kaltoft","year":"2012","journal-title":"Neurosurgery"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1093\/ons\/opx091","article-title":"Retrolabyrinthine meatotomy as part of retrosigmoid approach to expose the whole internal auditory canal: Rationale, technique, and outcome in hearing preservation surgery for vestibular schwannoma","volume":"14","author":"Mazzoni","year":"2018","journal-title":"Oper. Neurosurg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1097\/MAO.0000000000002602","article-title":"Hearing Preservation Outcomes and Prognostic Factors in Acoustic Neuroma Surgery: Predicting Cutoffs","volume":"41","author":"Zanoletti","year":"2020","journal-title":"Otol. Neurotol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1288\/00005537-199006000-00009","article-title":"Hearing Preservation Following Suboccipital Removal of Acoustic Neuromas","volume":"100","author":"Kemink","year":"1990","journal-title":"Laryngoscope"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1097\/MAO.0b013e318068b2b0","article-title":"Vestibular schwannoma volume as a predictor of hearing outcome after surgery","volume":"28","author":"Gjuric","year":"2007","journal-title":"Otol. Neurotol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2378","DOI":"10.1002\/lary.27805","article-title":"Tumor growth rate: A new prognostic indicator of hearing preservation in vestibular schwannoma surgery","volume":"129","author":"Lovato","year":"2019","journal-title":"Laryngoscope"},{"key":"ref_18","first-page":"738","article-title":"Nonsurgical factors predictive of postoperative hearing for patients with vestibular schwannoma","volume":"18","author":"Robinette","year":"1997","journal-title":"Am. J. Otol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/jns.2005.102.1.0001","article-title":"Preservation of hearing in patients undergoing microsurgery for vestibular schwannoma: Degree of meatal filling","volume":"102","author":"Mohr","year":"2005","journal-title":"J. Neurosurg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1177\/0194599820978246","article-title":"Preoperative Radiographic Predictors of Hearing Preservation after Retrosigmoid Resection of Vestibular Schwannomas","volume":"165","author":"Ren","year":"2021","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_21","first-page":"76","article-title":"Hearing preservation surgery in acoustic neuroma. Slow progress and new strategies","volume":"31","author":"Mazzoni","year":"2011","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"747","DOI":"10.17219\/acem\/90768","article-title":"Audiologic prognostic factors for hearing preservation following vestibular schwannoma surgery","volume":"28","author":"Lachowska","year":"2019","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1227\/NEU.0b013e31820777b1","article-title":"Hearing preservation after microsurgical resection of large vestibular schwannomas","volume":"68","author":"Malebranche","year":"2011","journal-title":"Neurosurgery"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1097\/MAO.0000000000002284","article-title":"Prognostic Factors of Long-Term Hearing Preservation in Small and Medium-Sized Vestibular Schwannomas after Microsurgery","volume":"40","author":"Huo","year":"2019","journal-title":"Otol. Neurotol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1097\/MLG.0b013e3181453a07","article-title":"Nerve of origin, tumor size, hearing preservation, and facial nerve outcomes in 359 vestibular schwannoma resections at a tertiary care academic center","volume":"117","author":"Jacob","year":"2007","journal-title":"Laryngoscope"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3231","DOI":"10.1007\/s10143-022-01834-z","article-title":"Preoperative vestibular evoked myogenic potentials (VEMPs), caloric test, and pure tone audiometry to identify the vestibular nerve branch of schwannoma origin: Preliminary results in a series of 26 cases","volume":"45","author":"Cianfrone","year":"2022","journal-title":"Neurosurg. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1097\/MAO.0b013e3181e8fc3f","article-title":"Fundal fluid as a predictor of hearing preservation in the middle cranial fossa approach for vestibular schwannoma","volume":"31","author":"Goddard","year":"2010","journal-title":"Otol. Neurotol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"900","DOI":"10.3171\/2011.7.JNS102092","article-title":"Tumor origin and hearing preservation in vestibular schwannoma surgery","volume":"115","author":"Rachinger","year":"2011","journal-title":"J. Neurosurg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.otc.2007.03.007","article-title":"Surgical Approaches and Complications in the Removal of Vestibular Schwannomas","volume":"40","author":"Bennett","year":"2007","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/j.jocn.2010.01.018","article-title":"Hearing preservation rates after microsurgical resection of vestibular schwannoma","volume":"17","author":"Sughrue","year":"2010","journal-title":"J. Clin. Neurosci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"E14","DOI":"10.3171\/2012.6.FOCUS12163","article-title":"Surgery for vestibular schwannomas: A systematic review of complications by approach","volume":"33","author":"Ansari","year":"2012","journal-title":"Neurosurg. Focus"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1007\/s00701-009-0344-z","article-title":"Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: Comparison of middle fossa and restrosigmoid approaches","volume":"151","author":"Noudel","year":"2009","journal-title":"Acta Neurochir."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1159\/000329362","article-title":"Analysis of hearing preservation and facial nerve function for patients undergoing vestibular schwannoma surgery: The middle cranial fossa approach versus the retrosigmoid approach-personal experience and literature review","volume":"17","author":"Russo","year":"2012","journal-title":"Audiol. Neurotol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1227\/01.NEU.0000374853.97891.FB","article-title":"Critical assessment of operative approaches for hearing preservation in small acoustic neuroma surgery: Retrosigmoid vs middle fossa approach","volume":"67","author":"Sameshima","year":"2010","journal-title":"Neurosurgery"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/S0196-0709(00)80082-4","article-title":"A modified retrosigmoid approach for direct exposure of the fundus of the internal auditory canal for hearing preservation in acoustic neuroma surgery","volume":"21","author":"Mazzoni","year":"2000","journal-title":"Am. J. Otol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/s00234-003-1006-0","article-title":"Comparison of contrast-enhanced T1-weighted and 3D constructive interference in steady state images for predicting outcome after hearing-preservation surgery for vestibular schwannoma","volume":"45","author":"Kocaoglu","year":"2003","journal-title":"Neuroradiology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1097\/MAO.0000000000001811","article-title":"Does a \u201cfundal Fluid Cap\u201d Predict Successful Hearing Preservation in Vestibular Schwannoma Resections Via the Middle Cranial Fossa Approach?","volume":"39","author":"Sun","year":"2018","journal-title":"Otol. Neurotol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1097\/MAO.0b013e3181f7ab47","article-title":"Hearing preservation in retrosigmoid approach of small vestibular schwannomas: Prognostic value of the degree of internal auditory canal filling","volume":"31","author":"Tringali","year":"2010","journal-title":"Otol. Neurotol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1097\/MAO.0b013e318245cf01","article-title":"Impact of fundal extension on hearing after surgery for vestibular schwannomas","volume":"33","author":"Nguyen","year":"2012","journal-title":"Otol. Neurotol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1097\/00129492-200111000-00034","article-title":"Internal auditory canal involvement of acoustic neuromas: Surgical correlates to magnetic resonance imaging findings","volume":"22","author":"Selesnick","year":"2001","journal-title":"Otol. Neurotol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/MAO.0000000000002102","article-title":"Cochlear FLAIR Signal Changes in Hearing Preservation Vestibular Schwannoma Surgery","volume":"40","author":"Dogaru","year":"2019","journal-title":"Otol. Neurotol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"910","DOI":"10.3171\/jns.1992.76.6.0910","article-title":"Hearing preservation in acoustic neurinoma surgery","volume":"76","author":"Fischer","year":"1992","journal-title":"J. Neurosurg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/00129492-199309000-00002","article-title":"Hearing preservation in cerebellopontine angle tumor surgery: The NYU experience 1974\u20131991","volume":"14","author":"Cohen","year":"1993","journal-title":"Otol. Neurotol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e1143","DOI":"10.1097\/MAO.0000000000002017","article-title":"Preoperative assessment of cervical vestibular evoked myogenic potentials (cVEMPs) help in predicting hearing preservation after removal of vestibular schwannomas through a middle fossa craniotomy","volume":"39","author":"Hochet","year":"2018","journal-title":"Otol. Neurotol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1288\/00005537-199502000-00014","article-title":"Hearing preservation in acoustic tumor surgery: Results and prognostic factors","volume":"105","author":"Dornhoffer","year":"1995","journal-title":"Laryngoscope"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"537","DOI":"10.23736\/S0390-5616.17.04187-X","article-title":"Negative influence of preoperative tinnitus on hearing preservation in vestibular schwannoma surgery","volume":"64","author":"Mastronardi","year":"2021","journal-title":"J. Neurosurg. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1288\/00005537-199210000-00010","article-title":"Preservation of hearing and facial nerve function in resection of acoustic neuroma","volume":"102","author":"Nadol","year":"1992","journal-title":"Laryngoscope"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"696","DOI":"10.3390\/audiolres12060066","article-title":"Intra-Operative Cochlear Nerve Function Monitoring in Hearing Preservation Surgery: A Systematic Review of the Literature","volume":"12","author":"Ariano","year":"2022","journal-title":"Audiol. Res."}],"container-title":["Audiology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4349\/13\/4\/42\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:05:14Z","timestamp":1760126714000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4349\/13\/4\/42"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,3]]},"references-count":48,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["audiolres13040042"],"URL":"https:\/\/doi.org\/10.3390\/audiolres13040042","relation":{},"ISSN":["2039-4349"],"issn-type":[{"value":"2039-4349","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,3]]}}}