Intraoperative Hearing Monitoring Using ABR and TT-ECochG and Hearing Preservation during Vestibular Schwannoma Resection
Abstract
:1. Introduction
2. Material and Methods
2.1. Patients’ Presentation
2.2. Audiological Test Methodology
2.3. Methodology of Intraoperative Hearing Monitoring
2.4. Statistical Analyses
3. Results
3.1. Vestibular Schwannoma Dimensions in MRI
3.2. Analysis of Audiological Tests before and after Vestibular Schwannoma Removal
3.3. Characteristics of Electrophysiological Tests
3.3.1. Auditory Brainstem Responses—ABR
3.3.2. Transtympanic Electrocochleography
3.4. Assessment of the Relationship between Audiological Tests and Electrophysiological Tests Used for Intraoperative Hearing Monitoring
3.5. Assessment of the Relationship between ABR and TT-ECochG during Intraoperative Hearing Monitoring
3.6. Assessment of the Relationship between Audiological and Electrophysiological Tests Used for Intraoperative Hearing Monitoring and Vestibular Schwannoma Dimensions
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Ave | Med | Range | Q1–Q3 | SD | Test Wilcoxona | |
---|---|---|---|---|---|---|
Pre PTA-4 [dB HL] | 25.02 | 22.50 | 2.50–63.75 | 11.25–37.50 | 15.53 | |
Post PTA-4 [dB HL] | 55.05 | 43.75 | 10.00–130.00 | 22.50–70.00 | 39.48 | |
Post–Pre PTA-4 [dB] | 30.03 | 15.00 | −6.25–126.25 | 6.25–38.75 | 36.46 | Z = 7.20 *; p < 0.001 |
Pre Speech Audiometry 60 dB SPL [%] | 70.93 | 90.00 | 00.00–100.00 | 50.00–100.00 | 33.68 | |
Post Speech Audiometry 60 dB SPL [%] | 38.93 | 30.00 | 0.00–100.00 | 0.00–80.00 | 37.42 | |
Post–Pre Speech Audiometry 60 dB SPL [%] | −32.00 | −20.00 | −100.00–45.00 | −55.00–5.00 | 32.40 | Z = 6.60 *; p < 0.001 |
AAO—HNS Hearing Classification | Pre PTA-4 | Post PTA-4 | Pre Speech Audiometry 60 dB SPL | Post Speech Audiometry 60 dB SPL | Pre PTA-4 + Speech Audiometry 60 dB SPL | Post PTA-4 + Speech Audiometry 60 dB SPL |
---|---|---|---|---|---|---|
Class A | 50 (66.67%) | 24 (32.00%) | 32 (42.67%) | 24 (32.00%) | 47 (62.67%) | 24 (32.00%) |
Class B | 20 (26.67%) | 20 (26.67%) | 6 (8.00%) | 8 (10.67%) | 9 (12.00%) | 8 (10.67%) |
Class C | 5 (6.67%) | 15 (20.00%) | 12 (16.00%) | 1 (1.33%) | 2 (2.66%) | 1 (1.33%) |
Class D | 0 (0.00%) | 16 (21.33%) | 25 (33.33%) | 42 (56.00%) | 17 (22.67%) | 42 (56.00%) |
χ2 Test Pre vs. Post | χ2 = 27.54; df = 9; p < 0.001 |
N | Ave | Med | Range | Q1–Q3 | SD | Test Wilcoxona | |
---|---|---|---|---|---|---|---|
Pre ABR I/III/V [ms] | 75/60/75 | 1.92/4.85/6.98 | 1.88/4.71/6.92 | 1.55–2.63/ 3.98–6.1/ 5.88–8.38 | 1.75–2.02/ 4.44–5.25/ 6.5–7.42 | 0.23/0.52/0.58 | |
Pre ABR I–III/ III–V/I–V [ms] | 60/60/75 | 2.95/2.06/5.05 | 2.79/2.05/4.95 | 2.10–4.00/ 1.32–2.8/ 4.06–6.15 | 1.75–2.02/ 2.60–3.32/ 4.65–5.53 | 0.49/0.27/0.55 | |
Intra ABR I/III/V [ms] | 75/42/75 | 2.28/5.22/7.35 | 2.13/5.10/7.25 | 1.68–4.47/ 4.17–7.83/ 6.20–9.68 | 2.00–2.38/ 4.67–5.65/ 6.85–7.78 | 0.48/0.73/0.71 | Pre vs. Intra I: Z = 7.17 *; p < 0.001 Pre vs. Intra III: Z = 3.28 *; p < 0.01 Pre vs. Intra V: Z = 4.63 *; p < 0.001 |
Intra ABR I–III/ III–V/I–V [ms] | 42/42/75 | 3.05/2.04/5.07 | 2.94/2.03/5.00 | 1.95–5.53/ 1.55–2.86/ 3.72–7.38 | 2.70–3.37/ 1.83–2.22/ 4.70–5.37 | 0.63/0.29/0.61 | |
Post ABR I/III/V [ms] | 61/40/75 | 2.26/5.11/8.27 | 2.15/5.01/7.28 | 1.68–4.17/ 4.15–6.58/ 6.22–12.80 | 1.90–2.52/ 4.64–5.49/ 6.85–8.05 | 0.47/0.58/2.24 | Pre vs. Post I: Z = 6.45 * p < 0.001 Pre vs. Post III: Z = 2.54 *; p < 0.05 Pre vs. Post V: Z = 5.22 *; p < 0.001 |
Post ABR I–III/ III–V/I–V [ms] | 40/40/75 | 2.92/2.05/6.42 | 2.88/2.02/5.02 | 1.95–3.97/ 1.65–2.95/ 3.65–12.80 | 2.63–3.11/ 1.90–2.21/ 4.77–5.75 | 0.43/0.26/3.01 | Pre vs. Post I–V: Z = 2.37 *; p < 0.05 Intra vs. Post I–V: Z = 2.08 *; p < 0.05 |
ABR I–V Intra–pre [ms] | 75 | 0.02 | 0.06 | −2.35–1.83 | −0.31–0.37 | 0.66 | |
ABR I–V Post–intra [ms] | 75 | 1.36 | 0.06 | −3.04–8.48 | −0.15–0.42 | 3.01 | |
ABR I–V Post–pre [ms] | 75 | 1.37 | 0.13 | −2.03–8.30 | −0.25–0.91 | 3.03 | |
Pre TT-ECochG Latency [ms] | 75 | 1.92 | 1.88 | 1.55–2.63 | 1.75–2.02 | 0.23 | |
Pre TT-ECochG Amplitude [µV] | 75 | 7.93 | 4.79 | 0.71–43.67 | 2.04–10.50 | 9.16 | |
Intra TT-ECochG Latency [ms] | 75 | 2.28 | 2.13 | 1.68–4.47 | 2.00–2.38 | 0.48 | Pre vs. Intra Lat: Z = 7.13 *; p < 0.001 |
Intra TT-ECochG Amplitude [µV] | 75 | 4.94 | 3.38 | 0.14–28.71 | 1.56–7.10 | 4.87 | Pre vs. Intra Amp: Z = 3.25 *; p < 0.01 |
Post TT-ECochG Latency [ms] | 75 | 2.89 | 2.27 | 1.68–5.60 | 1.95–2.85 | 1.38 | Pre vs. Post Lat: Z = 7.39 *; p < 0.001 Intra vs. Post Lat: Z = 2.82 *; p < 0.01 |
Post TT-ECochG Amplitude [µV] | 75 | 5.00 | 2.78 | 0.00–38.94 | 1.23–5.57 | 6.57 | Pre vs. Post Amp: Z = 3.29 *; p < 0.01 |
AAO—HNS Classification Hearing Worsening | N | R | t(n-2) | p-Value |
---|---|---|---|---|
AAO—HNS Hearing Worsening vs. TT-ECochG_Intra–pre_AP-Lat | 75 | 0.07 | 0.64 | p > 0.05 |
AAO—HNS Hearing Worsening vs. TT-ECochG_Intra–pre_AP-Amp | 75 | −0.21 | −1.86 | 0.067 |
AAO—HNS Hearing Worsening vs. TT-ECochG_Post–intra_AP-Lat | 75 | 0.26 * | 2.28 | p < 0.05 |
AAO—HNS Hearing Worsening vs. TT-ECochG_Post–intra_AP-Amp | 75 | −0.30 * | −2.68 | p < 0.01 |
AAO—HNS Hearing Worsening vs. TT-ECochG_Post–pre_AP-Lat | 75 | 0.21 | 1.8 | 0.075 |
AAO—HNS Hearing Worsening vs. TT-ECochG_Post–pre_AP-Amp | 75 | −0.24 * | −2.15 | p < 0.05 |
ABR, TT-ECochG and Hearing Changes | N | R | t(n-2) | p-Value |
---|---|---|---|---|
Post–intra ABR I–V and PTA-4 diff | 75 | 0.39 | 3.62 | <0.001 |
Post–intra ABR I–V and Post–pre 2 kHz | 75 | 0.34 | 3.05 | <0.01 |
Post–intra ABR I–V and Post–pre 4 kHz | 75 | 0.38 | 3.56 | <0.001 |
Post–pre ABR I–V and PTA-4 diff | 75 | 0.42 | 3.99 | <0.001 |
Post–pre ABR I–V and Post–pre 2 kHz | 75 | 0.41 | 3.82 | <0.001 |
Post–pre ABR I–V and Post–pre 4 kHz | 75 | 0.44 | 4.23 | <0.001 |
Intra–pre ABR I–V and AAO—HNS 60 diff | 75 | −0.03 | −0.22 | >0.05 |
Post–intra ABR I–V and AAO—HNS 60 diff | 75 | 0.19 | 1.67 | >0.05 |
Post–pre ABR I–V and AAO—HNS 60 diff | 75 | 0.15 | 1.30 | >0.05 |
Post–intra AP_Lat and Post SA 60 dB SPL | 75 | −0.42 | −3.92 | <0.001 |
Post–intra AP_Amp and Post SA 60 dB SPL | 75 | 0.33 | 3.03 | <0.01 |
Post–pre AP_Lat and Post SA 60 dB SPL | 75 | −0.36 | −3.34 | <0.01 |
Post–pre AP_Amp and Post SA 60 dB SPL | 75 | 0.31 | 2.84 | <0.01 |
Intra–pre AP_Lat and ABR Intra–pre I–V | 75 | −0.27 | −2.38 | <0.05 |
Post–intra AP_Lat and ABR Post–intra I–V | 75 | 0.4 | 3.73 | <0.001 |
Post–pre AP_Lat and ABR Post–pre I–V | 75 | 0.3 | 2.70 | <0.01 |
Post–intra AP_Amp and ABR Post–intra I–V | 75 | −0.37 | −3.45 | <0.001 |
Post–pre AP_Amp and ABR Post–pre I–V | 75 | −0.23 | −2.06 | <0.05 |
Intra–pre AP_Amp and ABR Intra–pre I–V | 75 | 0.09 | 0.78 | >0.05 |
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Niemczyk, K.; Pobożny, I.; Bartoszewicz, R.; Morawski, K. Intraoperative Hearing Monitoring Using ABR and TT-ECochG and Hearing Preservation during Vestibular Schwannoma Resection. J. Clin. Med. 2024, 13, 4230. https://doi.org/10.3390/jcm13144230
Niemczyk K, Pobożny I, Bartoszewicz R, Morawski K. Intraoperative Hearing Monitoring Using ABR and TT-ECochG and Hearing Preservation during Vestibular Schwannoma Resection. Journal of Clinical Medicine. 2024; 13(14):4230. https://doi.org/10.3390/jcm13144230
Chicago/Turabian StyleNiemczyk, Kazimierz, Izabela Pobożny, Robert Bartoszewicz, and Krzysztof Morawski. 2024. "Intraoperative Hearing Monitoring Using ABR and TT-ECochG and Hearing Preservation during Vestibular Schwannoma Resection" Journal of Clinical Medicine 13, no. 14: 4230. https://doi.org/10.3390/jcm13144230