Classification for Hearing Preservation in a Patient with an Acoustic Neuroma

Description

A patient with an acoustic neuroma (vestibular schwannoma) should be evaluated for hearing before and after surgery. The Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery has offered guidelines for recording the level of hearing preservation.

Hearing thresholds are recorded as the average of pure tone hearing thresholds by air conduction at 0.5, 1, 2 and 3 kHz.

Speech discrimination is based on the best word recognition at a presentation level up to 40 decibels or maximum comfortable loudness, whichever is less.

Parameters:

(1) speech discrimination in percent

(2) pure-tone threshold in decibels

Speech Discrimination	Pure-Tone Threshold	Class
>= 70%	<= 30 db	A
>= 50%	> 30 and <= 50 dB	B
>= 50 and < 70%	<= 30 dB	B
>= 50%	> 50 dB	C
< 50%	any	D

where:

• The second criteria for Class B is not listed in Table 1 but is evident in Figure 1.

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Description

Specialty

ICD-10