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Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vestibular schwannoma is a posterior cranial fossa tumour, which is usually manifested by unilateral perceptual hearing loss, tinnitus, vertigo, facial tingling, etc. Therapy of vestibular schwannoma is chosen according to the size of tumour, its location and growth rate. Therapeutic procedures include microsurgical treatment and/or stereotactic radiosurgery and radiotherapy. Unilateral hearing loss occurs postoperatively, but bulbar syndrome may also develop through perioperative functional impairment of the peripheral nerves near the tumour site. The paper presents the role of a Clinical Speech Therapist in the diagnosis and therapy in a patient after vestibular schwannoma surgery with the development of bulbar symptoms.

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Clinical Neuroradiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medizinische Genetik is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We report on a case in which macroscopic and microscopic changes of the vestibulocochlear nerve could be observed after radiosurgery of an intrameatal vestibular schwannoma. This case shows for the first time a morphological correlate for undesirable effects after radiosurgical treatment of a vestibular schwannoma and indicates that despite a certain distance to the actual tumor, degenerative changes in neural structures can be expected., (© 2021. The Author(s).)

Background: Hearing function in patients with vestibular schwannoma is often classified according to the Gardner and Robertson (1988) or the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS, 1995) systems. These classification systems are based on English-language test procedures, there is no German-language equivalent. The aim of the study was to investigate the influence of various target parameters on hearing classification and to derive a recommendation for the use of German-language test methods., Materials and Methods: The rules for speech audiometry based on English-language test procedures were applied to German speech test materials. In 91 patients with vestibular schwannoma, pure tone hearing thresholds, speech recognition thresholds, and speech discrimination at different sound pressure levels were measured. The patients were categorized according to the Gardner and Robertson and AAO-HNS classifications., Results: In both the Gardner-Robertson and the AAO-HNS classifications, the number of patients in the hearing classes with serviceable hearing function (measured as Pure Tone Average across three (3PTA) or four (4PTA) frequencies) was highest when using the 3PTA 0,5;1;2   kHz condition, followed by 4PTA 0,5;1;2;3   kHz , 4PTA 0,5;1;2;4   kHz , and 4PTA 0,5;1;2;"3"kHz . If maximum word recognition score (WRS max ) was used instead of word recognition 40 dB above the sensation level (WRS 40SL ), more patients were classified into the hearing classes with serviceable hearing function, irrespective of the mean pure tone hearing threshold., Conclusion: The Gardner-Robertson and AAO-HNS classifications can be used in German-speaking settings. The Freiburg monosyllabic test can be used to determine speech discrimination scores or maximum word recognition., (© 2020. The Author(s).)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Schwannomas of the eighth cranial nerve are benign tumours commonly found in the internal auditory meatus or in the cerebellopontine angle. In most cases, they arise from the inferior or vestibular portion of the vestibular nerve. Rarely, these tumours present in the inner ear and are then called intralabyrinthine schwannomas. Bilateral schwannomas are known in neurofibromatosis type 2 (NF2). Bilateral and ipsilateral, multilocular sporadic schwannomas of the eighth cranial nerve have been described as extremely rare findings. This report describes the first case of bilateral sporadic intracochlear schwannomas in a patient with no genetic or clinical features of NF2.

This article presents a case of malignant transformation of vestibular schwannoma 13 years after stereotactic radiation therapy, which lead to an acute life-threatening condition. Although the observation is currently only based on case reports, an increasing number of these support the hypothesis that there is a relevant risk of malignant transformation in the long-term course of previously irradiated vestibular schwannomas. Therefore, long-term MRI follow-up should be considered.

Objective: The aim of this study was to evaluate the hearing results after surgery for T1 and T2 vestibular schwannomas (VS) via the middle cranial fossa (MCF) approach at one institution and to review outcomes in the recent literature., Patients and Methods: In our department, 208 consecutive patients have undergone surgery using the MCF approach between December 2005 and February 2015. Audiological testing included pure-tone audiometry, speech-discrimination-tests pre- and postoperatively, as well as a pre- and intraoperative brainstem evoked response audiometry (BERA). Hearing status was categorized according to the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) or Gardner-Robertson classification. Hearing preservation was assessed when postoperative values were still within class A + B., Results: In 167 of the 208 patients, preoperative hearing levels corresponded to class A+B. In 78 tumors, extension of the VS was limited to the internal auditory canal (T1) and in 89 tumors there was an extrameatal growth without touching the brainstem (T2). In 109 patients (65 %), postoperative hearing was still in class A+B. In the group of intrameatal tumors, the hearing preservation rate was even 69 %. The analysis of the literature of the past 16 years revealed comparable results (46-82 %)., Conclusions: Surgery for VS using the MCF approach is an established technique for reliable tumor removal with an adequate rate of hearing preservation. For small tumors without brainstem contact, particularly satisfying results can be achieved. This should be taken into account when discussing the possibility of early hearing preservation surgery.

Management of vestibular schwannoma (VS) should always be interdisciplinary and results better than the natural course. Particularly in small VS, either microsurgical resection or radiosurgery (RS) can be employed. RS is a special method (initially only possible stereotactically) for delivering high-precision radiation from many directions to the target point (the isocenter) in a single high dose. With the development of three different systems-Gamma Knife (Elekta, Stockholm, Sweden), special linear accelerators, and CyberKnife (Accuray, Sunnyvale, CA, USA)-the options were extended to 1-5 fractions for RS and multisession RS (msRS), and to up to 6 weeks of conventional fractionation as stereotactic radiotherapy (SRT). Whereas RS uses high ablative single doses, SRT is based on the well-known radiobiological effects of multiple fractions comprising lower single doses up to a required much higher total dose. Evaluation showed that RS and SRT achieve similarly high rates of tumor control of around 90% and low rates of side effects (1-7%). Therefore, SRT is unnecessary for small but clearly progressing VS, which has made RS a very comfortable, effective treatment option. In addition to SRT, larger VS can be treated comparably effectively with CyberKnife-based msRS. Since modern MRI frequently discovers small VS as "incidental findings", the initial biding strategy (wait and scan) is of particular importance. Only with increasing symptoms and detectable tumor growth is the treatment indication established, at which time the decision for surgery and RS/SRT should be taken interdisciplinary under consideration of the patient's wishes.

Background: Surgical procedures in the cerebello-pontine angle (CPA), e. g. for vestibular schwannoma, have an increased risk for damage to the cochlear nerve. Consequently, hearing deterioration up to complete deafness may result with severe impact on quality of life. Methods for intraoperative monitoring of function may minimize such risks., Objective: Review of current methods for intraoperative monitoring of the cochelar nerve and summary of new developments., Materials and Methods: Analysis and summary of literature, discussion of new methods., Results: Early auditory evoked potentials using click stimuli remain the standard method for intraoperative monitoring of cochlear nerve function. Amplitude and latency changes indicate a risk of postoperative hearing deterioration; however demonstrate only limited further differentiation of hearing quality. As novel methods, near-field recordings may allow faster feedback and auditory steady state responses potentially enable frequency specific testing., Conclusions: Intraoperative monitoring of the cochlear nerve is an integral component of CPA surgery. It enables detection of potential nerve damage and thus contributes to avoiding postoperative functional deficits. Development and implementation of novel and additional approaches may further improve its clinical value.

Background: Microsurgical resection of vestibular schwannomas is demanding, even if not all of these tumors represent a challenge for experienced surgeons. In order to make the right decisions when it comes to balancing the extent of tumor resection with preservation of function, the surgeon must possess detailed knowledge of the surgical techniques and also have mastered these., Objective: The current article describes the state-of-the-art of the three major microsurgical techniques for resection of vestibular schwannomas, their pearls and their perils., Materials and Methods: The literature-based review of the three surgical techniques is complemented by a discussion of operative nuances and weighting of advantages and possible complications based on the authors' own experience., Results: The translabyrinthine, retrosigmoidal, and subtemporal microsurgical approaches are well documented in the literature regarding their modifications and the achievable surgical results. Hearing preservation is possible with the latter two approaches. The choice of approach and the preservation of neural function depend primarily on the size of the tumor and pre-existing neurologic deficits. Preoperative diagnostics and preparation differ only for semi-sitting patient positioning, where transesophageal echocardiography is required. The classic surgical techniques have been supplemented by fine-tuned electrophysiologic monitoring, endoscopic views, special microinstruments, and intraoperative image guidance., Conclusion: The choice of surgical approach often depends on the personal preference and experience of the surgeon. Preoperative hearing and tumor extension are the main objective selection criteria.

Background: The aim of this study was to compare the clinical history and the findings in audiovestibular function tests in patients suffering from intralabyrinthine schwannoma or delayed endolymphatic hydrops (DEH)., Patients and Methods: Five patients diagnosed with intralabyrinthine schwannoma by magnetic resonance imaging (MRI) and five patients diagnosed with DEH by locally enhanced inner ear MRI (LEIM) were retrospectively studied., Results: All patients with intralabyrinthine schwannoma or DEH initially presented with hearing loss. Vertigo occurred in two patients with intralabyrinthine schwannoma and in all patients with DEH. While audiometry achieved poorer results for patients with intralabyrinthine schwannomas, vestibular function tests revealed normal results in about half of the patients in both groups., Conclusion: Patients with intralabyrinthine schwannomas may present with clinical symptoms similar to patients suffering from other inner ear disorders like delayed endolymphatic hydrops and may obtain similar findings in audiovestibular function tests. High-resolution MR imaging with locally applied contrast agent may provide evidence of both underlying pathologies.