Hearing Preservation after Middle Fossa Vestibular Schwannoma Removal

Quist, Tyler S.; Givens, Daniel J.; Gurgel, Richard K.; Chamoun, Roukoz; Shelton, Clough

doi:10.1177/0194599814567874

Cited by 41 publications

(5 citation statements)

References 26 publications

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“…In the long-term analysis from the large Danish cohort of observed patients (86), of the 178 patients with AAO-HNS Class A hearing at the start of observation, Class A hearing was preserved in 46% at 10 years. Quist et al (94) reported five-year follow-up results of patients treated by middle cranial fossa surgical approach. Of the 49 patients with AAO-HNS Class A or B hearing preoperatively, 55% maintained Class A/B hearing immediately post-operative.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Hearing Preservation After Radiotherapy for Vestibular Schwannoma

Coughlin

Willman

Gubbels

2018

Otology &Amp; Neurotology

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Forty seven articles containing a total of 2,195 patients with preserved Class A/B, 1/2 hearing were identified for analysis. The aggregate crude hearing preservation rate was 58% at an average reporting time of 46.6 months after radiotherapy treatment. Analysis of time-based reporting shows a clear trend of decreased hearing preservation extending to 10-year follow-up. This data encourages a future long-term controlled trial.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of Hearing Preservation After Radiotherapy for Vestibular Schwannoma

Coughlin

Willman

Gubbels

2018

Otology &Amp; Neurotology

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“…The durability of hearing preservation should be reported as well because continued reduction over time in serviceable hearing after GKS is often reported [ 1 , 4 , 27 ], with an acceleration of the decrease between years 5 and 10 [ 8 ], whereas hearing preservation after microsurgery is thought to be more durable [ 5 ]. Moving from class A to class B is still beneficial for the patients because the patients with post-GKS serviceable hearing may benefit from a unilateral hearing aid on the tumor side, whereas CROS or BICROS are more indicated for patients with post-GKS classes C and D.…”

Section: Discussionmentioning

confidence: 99%

“…Hearing outcomes have been reported as more durable after surgery than after GKS [ 4 , 5 ] with variable hearing preservation rates. Some authors have reported good outcomes with speech discrimination over 50% [ 6 , 7 ]; others have observed poor long-term results with speech discrimination at 10 years under 3% [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Hearing Outcomes from Gamma Knife Treatment for Intracanalicular Vestibular Schwannomas with Good Initial Hearing

Toulemonde,

Reyns,

Risoud

et al. 2024

JCM

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Background: The objective of this study was to describe the long-term hearing outcomes of gamma knife treatment for unilateral progressing vestibular schwannomas (VS) presenting with good initial hearing using audiologic data. Methods: A retrospective review was performed between 2010 and 2020 to select patients with progressing unilateral VS and good hearing (AAO-HNS class A) treated with stereotactic gamma knife surgery (GKS). Their audiograms were analyzed along with treatment metrics and patient data. Results: Hearing outcomes with a median follow-up of 5 years post-treatment showed statistically significant loss of serviceable hearing: 34.1% of patients maintained good hearing (AAO-HNS class A), and 56.1% maintained serviceable hearing (AAO-HNS class A and B). Non-hearing outcomes are favorable with excellent tumor control and low facial nerve morbidity. Conclusions: Hearing declines over time in intracanalicular VS treated with GKS, with a significant loss of serviceable hearing after 5 years. The mean cochlear dose and the presence of cochlear aperture obliteration by the tumor are the main statistically significant factors involved in the hearing outcomes.

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“…1) is similar to previous published rates. Three studies with at least 5-year follow-up in MCF patients with initially successful HP found that class A/B was maintained at 5 years in 70% (n = 16 of 23) (14), 75% (n = 12 of 16) (16), and 84% (n = 27 of 32) (17). In a review of RS patients with initially preserved class A/B hearing, 87% (n = 47 of 54) maintained A/B at a minimum of 6 years follow-up (9).…”

Section: Discussionmentioning

confidence: 99%

“…However, with serial observation and radiation, there is uncertainty in the duration of maintaining serviceable hearing. Long-term data are slowly accumulating regarding hearing outcomes with each management approach (6–10), but outcomes beyond 5 (11–18) and 10 (18,19) years remain limited. As VS diagnoses are made at earlier time points in the tumors' natural history, long-term HP data will aid in counseling patients presenting with serviceable hearing.…”

Section: Introductionmentioning

confidence: 99%

Hearing Preservation After Intervention in Vestibular Schwannoma

et al. 2022

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ObjectiveThis study aimed to assess the durability of audiological outcomes after radiation and surgery in the management of vestibular schwannoma.Study DesignRetrospective review.SettingTertiary academic center.PatientsAdults with sporadic vestibular schwannoma and serviceable hearing at the time of intervention.InterventionsGamma Knife, middle cranial fossa, or retrosigmoid approaches.Main Outcome MeasuresPure-tone audiometry and speech discrimination scores.ResultsPostintervention serviceable hearing (class A/B) was preserved in 70.4% (n = 130; mean follow-up, 3.31 yr; range, 0–15.25 yr). Of the 49 patients treated with radiation, 19 (39.6%) had serviceable hearing at last follow-up, compared with 38 (46.9% of 81) who underwent retrosigmoid (n = 36 [44.4%]) and middle cranial fossa (n = 45 [55.6%]) approaches (odds ratio [OR], 1.40; 95% confidence interval [CI], 0.67–2.82; p = 0.47). A matched analysis by age, tumor volume, and preintervention hearing (n = 38) also found no difference in hearing preservation (HP) likelihood between surgery and radiation (OR, 2.33; 95% CI, 0.24–35.91; p = 0.59). After initial HP, 4 (9.5%) surgical versus 10 (37.0%) radiated patients subsequently lost residual serviceable (A/B) hearing (OR, 0.18; 95% CI, 0.06–0.69; p = 0.01) at a mean 3.74 ± 3.58 and 4.73 ± 3.83 years after surgery and radiation, respectively. Overall, 5- and 10-year HP rates (A/B) after initially successful HP surgery were 84.4 and 63.0%, respectively. However, survival estimates declined to 48.9% at 5 years and 32.7% at 10 years when patients with immediate postoperative serviceable hearing loss were also included, which were comparable to radiation-HP rates at 5 and 10 years of 28.0 and 14.2%, respectively (p = 0.75).ConclusionsAfter vestibular schwannoma intervention, overall HP was similar between radiated and surgical cohorts. However, when successful, surgical approaches offered more durable hearing outcomes at long-term follow-up.

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Hearing Preservation after Middle Fossa Vestibular Schwannoma Removal

Abstract: For patients with VS in whom serviceable hearing is preserved following the MCF approach, the long-term hearing outcome remains durable in most patients.

Cited by 41 publications

References 26 publications

Systematic Review of Hearing Preservation After Radiotherapy for Vestibular Schwannoma

Systematic Review of Hearing Preservation After Radiotherapy for Vestibular Schwannoma

Hearing Outcomes from Gamma Knife Treatment for Intracanalicular Vestibular Schwannomas with Good Initial Hearing

Hearing Preservation After Intervention in Vestibular Schwannoma

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