![]() We suggest that the procedure should be offered to patients with hearing progression based on their SDSs and/or associated progressive increases in their wave III and V latencies on ABRs.Īcoustic neuroma Deafness Hearing Middle fossa craniotomy Neurofibromatosis type 2 Vestibular schwannoma.Ĭopyright © 2019 by the Congress of Neurological Surgeons. IAC decompression allows early objective hearing responses in select patients. ABRs improved in 4 patients following decompression. SDSs improved from 85% to 92.5% on average (n = 12) and from 55% to 77.5% in the hearing progression group (n = 4). In addition, 3-T imaging can be completed with shorter acquisition times. In the hearing maintenance group, the SDSs remained stable. Our institution conducts the vast majority of internal auditory canal (IAC) MRI examinations with 3-T magnets, which allow for a superior signal-to-noise ratio and higher spatial resolution compared with 1.5-T imaging. In patients with prior hearing progression, hearing responses were observed in 3 of the 4 patients during the first year. Treatment was proposed to stop hearing progression based on the speech discrimination scores (SDSs n = 4) or for hearing maintenance (n = 8). All had a progressive change of their ABRs documented from the diagnosis of NF2 over a mean period of 6.25 yr. All had NF2 according to the Manchester criteria. Twelve NF2 patients were operated on from 2011 to 2016 for IAC decompression. Retrospective chart review of middle fossa craniotomy for IAC osteodural decompression in NF2-related vestibular schwannomas. I have some documentation from AMA stating that if 'two separate and distinct MRI studies are performed (brain and IACs) it would be apropriate to code brain. To evaluate the course of auditory brainstem responses (ABRs) and the early hearing response during the first year following IAC decompression for small to medium-sized vestibular schwannomas occurring in neurofibromatosis type 2 (NF2). I need help to figure out what is the correct way to code and bill the MRI IAC ( internal Auditory Canal ) when I have both the MRI of brain and IAC's requested by the refering physician. Hearing response following an osteodural decompression of the internal auditory canal (IAC) is controversial.
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