This article presents an overview of the points to be made both for and against the consideration of hearing conservation in acoustic tumor surgery based on current available data in the literature. Age, general health, tumor size, and hearing-in the tumor ear and in the contralateral ear as well as the interaural relationship-are the presurgical factors discussed. Either the middle fossa or posterior fossa approach may be utilized for hearing conservation. The technical factors relating to surgical anatomy, specific risks, and the probability that hearing may be preserved by these approaches have been abstracted from a review of the literature. Finally, the patient's considerations and his need for the conservation of his hearing are presented, including realistic alternatives to surgical conservation.
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