Hearing preservation in acoustic neuroma surgery: the impact of different patient selection criteria

OBJECTIVES/HYPOTHESIS: The aim of the present study was to assess whether applying the various selection criteria for hearing preservation surgery on the same group of patients with acoustic neuroma leads to significantly different numbers of patients being considered suitable for this kind of surgery. STUDY DESIGN: We used different selection criteria for hearing conservation surgery based on a range of studies in the published literature. We applied these criteria to a consecutive group of patients presenting to our unit with acoustic neuroma. We then calculated the numbers of patients deemed suitable for hearing preservation surgery as a function of these different selection criteria. METHODS: Studies with published selection criteria, total numbers of patients, and numbers of patients suitable for hearing preservation surgery were found in the literature. These selection criteria were applied to our patient data. A chi2 statistical analysis was used to assess whether applying different selection criteria to the same group of patients (the subjects of the present study) resulted in different numbers of patients suitable for hearing preservation surgery. RESULTS: The numbers of patients suitable for hearing preservation showed wide variation, ranging from 8 (10%) to 45 (56%) patients (of the total number of 80 patients in the present study). The chi2 statistical analysis revealed that the various selection criteria did have an effect on the numbers of patients suitable for hearing preservation surgery, and the statistical significance reached the level of P<.001. CONCLUSIONS: Different selection criteria lead to significantly different numbers of patients being considered suitable for hearing preservation surgery. Consensus and agreed selection criteria would help set patient expectations, refine candidate selection, and facilitate the comparison of outcomes across centers.