# Novel standardized indexes of brainstem auditory evoked potentials for predicting hearing preservation in vestibular schwannomas

## TL;DR

This study introduces new standardized brainstem auditory evoked potential measures to improve hearing preservation predictions during vestibular schwannoma surgery.

## Contribution

The paper introduces novel standardized indexes using intraoperative synchronous healthy side BAEPs to enhance prediction reliability.

## Key findings

- Raw V-wave amplitude and latency were not reliable predictors of hearing preservation.
- Standardized V-wave latency and amplitude emerged as stable predictors of hearing preservation.
- Intraoperative amplitude difference predicted postoperative hearing outcomes in patients with preoperative hearing.

## Abstract

Hearing preservation (HP) during vestibular schwannomas (VSs) surgery poses a significant challenge. Although brainstem auditory evoked potentials (BAEPs) on the affected side are commonly employed to monitor cochlear nerve function, their low signal-to-noise ratio (SNR) renders them susceptible to interferences, compromising their reliability. We retrospectively analyzed the data of patients who underwent tumor resection, while binaural brainstem auditory evoked potentials (BAEPs) were simultaneously recorded during surgery. To standardize BAEPs on the affected side, we incorporated the synchronous healthy side as a reference (interval between affected and healthy side ≤ 3 min). A total of 127 patients were enrolled. Comparison of the raw BAEPs data pre- and post-tumor resection revealed that neither V-wave amplitude (Am-V) nor latency (La-V) could serve as reliable predictors of HP simultaneously. However, following standardization, V-wave latency (STIAS-La-V) and amplitude (STIAS-Am-V) emerged as stable predictors of HP. Furthermore, the intraoperative difference in V-wave amplitude (D-Am-V) predicted postoperative HP in patients with preoperative HP and remained predictive after standardization. The utilization of intraoperative synchronous healthy side BAEPs as a reference to eliminate interferences proves to be an effective approach in enhancing the reliability of BAEPs for predicting HP in VSs patients.