Change in hearing handicap after translabyrinthine vestibular schwannoma excision

Objective: To evaluate the change in hearing handicap after translabyrinthine vestibular schwannoma excision. Study Design: Prospective administration of the Hearing Handicap Inventory preoperatively and at 3 and 12 months postoperatively. Setting: A tertiary referral neuro-otology clinic. Patients: A total of 119 consecutive patients who had vestibular schwannomas excised between May 1998 and July 2002 and who had completed Hearing Handicap Inventories preoperatively and at 3 and 12 months postoperatively. Interventions: Translabyrinthine excision of a unilateral sporadic vestibular schwannoma; pre- and postoperative hearing therapy and rehabilitation. Main Outcome Measures: Hearing Handicap Inventory scores. Results: Sixty-one percent of patients showed no change in their hearing handicap between preoperative and 3-month post-operative measures. Fifty-eight percent showed no change between preoperative and 12-month postoperative measures. Twenty-five percent of patients had a worsening in their hearing handicap when comparing preoperative and 12-month postoperative scores, and these patients were those with a better hearing class preoperatively. Seventeen percent of patients showed an improvement in their hearing handicap over this same time period, and the reasons for this remain unclear. Neither age nor tumor size had an effect on change in hearing handicap. Conclusions: The findings of the current study can be used during preoperative patient counseling. In particular, the clinician is now able to take an informed and positive stance about the hearing handicap to be expected postoperatively.