Hearing aids in patients with vestibular schwannoma: Interest of the auditory brainstem responses

Clin Otolaryngol. 2018 Aug;43(4):1057-1064. doi: 10.1111/coa.13099. Epub 2018 Apr 14.

Abstract

Objective: Hearing loss subsequent to a unilateral vestibular schwannoma (VS) has an impact on the social life of non-operated patients. We investigated the utility of auditory brainstem responses (ABRs) for predicting the results of auditory rehabilitation in such patients.

Design: Prospective study.

Setting: University tertiary medical centre.

Participants: We collected the demographic, audiometric, ABR and imaging data of non-operated patients with unilateral VS. A hearing aid trial was performed over 1 month. We assessed auditory performance following the auditory rehabilitation according to the ABR results. Patients with distinct waves (I, III and V) were included in the "distinct ABR" group and patients with no ABR were included in the "desynchronised ABR" group.

Main outcome measures: Following the trial, audiometric performance and quality of life were evaluated with the Glasgow Benefit Inventory (GBI).

Subjects and method: We collected the demographic, audiometric, ABR and imaging data of non-operated patients with unilateral VS. A hearing aid trial was performed over 1 month. Following the trial, audiometric performance and quality of life were evaluated with the Glasgow Benefit Inventory (GBI). We assessed auditory performance following the auditory rehabilitation according to the ABR results. Patients with distinct waves (I, III and V) were included in the "distinct ABR" group and patients with no ABR were included in the "desynchronised ABR" group.

Results: In total, 25 patients were included in this prospective study; 15 in the "distinct ABR" group and 10 in the "desynchronised ABR" group. The speech recognition threshold (SRT, P < .0001; W = -120) and speech discrimination score (P = .0005; W = 78) were significantly improved in the aided vs unaided conditions. These improvements were not observed in the "desynchronised ABR" group for the SRT (P = .48; W = -10) and word recognition score (P = .06; W = 15). Ninety-three per cent of the patients in the "distinct ABR" group kept significantly (P = .04) the hearing aids following the trial compared to 20% in the "desynchronised ABR" group.

Conclusions: Auditory brainstem responses can help to predict the auditory performance following auditory rehabilitation in unilateral non-operated VS patients.

Keywords: auditory brainstem responses; hearing aid; hearing loss; vestibular schwannoma.