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Abstract：
Preoperative hearing function shows wide variations among patients diagnosed with vestibular schwannoma. Besides the preoperative tumor size there are other factors that influence the preoperative hearing function that are frequently discussed. A comprehensive analysis of a large cohort of vestibular schwannomas has the potential to describe new insights and influence the preoperative management. We analyzed clinical factors, imaging data and the expression of the proliferation marker MIB1 as potential influencing factors on the preoperative hearing function in a retrospective cohort of 523 primary sporadic vestibular schwannomas. The results of the preoperative audiometry were quantified using the Gardner-Robertson Score. Uni- and multivariate analyses were performed. Serviceable hearing (Gardner-Robertson class 1 or 2) was documented in 391 patients (74.8%). Factors associated with non-serviceable hearing (Gardner-Robertson class 3-5) were patients of older age (p < 0.0001), larger preoperative tumor volume (p = 0.0013) and widening of the internal acoustic meatus compared to the healthy side (p = 0.0353). Gender and differences in the expression of the proliferation marker MIB1 had no influence on preoperative hearing. In the multivariate nominal logistic regression older age (OR 27.60 (CI 9.17-87.18), p < 0.0001), larger preoperative tumor volume (OR 20.20 (CI 3.43-128.58), p = 0.0011) and widening of the internal acoustic canal (OR 7.86 (CI 1.77-35.46), p = 0.0079) remained independent factors associated with non-serviceable hearing. Widening of the internal acoustic canal is an independent factor for non-serviceable preoperative hearing in vestibular schwannoma patients together with older age and larger preoperative tumor volume.
摘要：
术前听力功能在诊断为前庭神经鞘瘤的患者中显示出很大的差异。除了术前肿瘤大小外，还有其他因素会影响术前听力功能，这是经常讨论的。对大量前庭神经鞘瘤的综合分析有可能描述新的见解并影响术前管理。我们分析了临床因素，在523例原发性散发性前庭神经鞘瘤的回顾性队列中，影像学数据和增殖标志物MIB1的表达是术前听力功能的潜在影响因素。术前听力测量的结果使用Gardner-Robertson评分进行量化。进行了单因素和多因素分析。在391名患者（74.8％）中记录了可使用的听力（Gardner-Robertson1级或2级）。与不可用听力相关的因素（Gardner-Robertson3-5级）是年龄较大的患者（p<0.0001），与健康侧相比，术前肿瘤体积更大（p=0.0013），内耳道扩大（p=0.0353）。性别及增殖标记物MIB1表达的差别对术前听力无影响。在多变量名义逻辑回归中，年龄较大(OR27.60(CI9.17-87.18)，p<0.0001),术前肿瘤体积较大（OR20.20（CI3.43-128.58），p=0.0011）和内部声道的加宽（OR7.86（CI1.77-35.46），p=0.0079）仍然是与不可用听力相关的独立因素。对于年龄较大，术前肿瘤体积较大的前庭神经鞘瘤患者，内部声管的加宽是无法使用的术前听力的独立因素。
