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Useful hearing preservation is improved in vestibular schwannoma patients who undergo stereotactic radiosurgery before further hearing deterioration ensues
Introduction The present study evaluates whether hearing deterioration during observation reduces serviceable hearing preservation rates after stereotactic radiosurgery (SRS) in vestibular schwannoma (VS) patients with useful hearing. Methods We retrospectively analyzed 1447 VS patients who underwen...
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| Published in: | Journal of neuro-oncology 2021-05, Vol.152 (3), p.559-566 |
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| creator | Ogino, Akiyoshi Long, Hao Johnson, Stephen Faramand, Andrew Niranjan, Ajay Flickinger, John C. Lunsford, L. Dade Kano, Hideyuki |
| description | Introduction
The present study evaluates whether hearing deterioration during observation reduces serviceable hearing preservation rates after stereotactic radiosurgery (SRS) in vestibular schwannoma (VS) patients with useful hearing.
Methods
We retrospectively analyzed 1447 VS patients who underwent SRS between 1992 and 2017. We identified 100 VS patients who had Grade I Gardner- Robertson (GR) hearing at initial diagnosis but were observed without surgery or SRS. We compared hearing after SRS in 67 patients who retained GR Grade I hearing from initial diagnosis to SRS (the hearing maintenance or HM group) to 33 patients whose hearing worsened from GR grade I to grade II (the hearing deterioration or HD group). We also investigated whether a decline in pure tone average (PTA) or speech discrimination score (SDS) before SRS affected hearing preservation after SRS.
Results
The serviceable hearing (GR I and II) preservation in HM patients was 80%s, 63%, and 51% at 3, 5, and 10 years, respectively. The serviceable hearing preservation in HD patients was 40%, 33%, and 20% at 3, 5, and 10 years, respectively. In multivariate analysis, younger age ( |
| doi_str_mv | 10.1007/s11060-021-03726-6 |
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The present study evaluates whether hearing deterioration during observation reduces serviceable hearing preservation rates after stereotactic radiosurgery (SRS) in vestibular schwannoma (VS) patients with useful hearing.
Methods
We retrospectively analyzed 1447 VS patients who underwent SRS between 1992 and 2017. We identified 100 VS patients who had Grade I Gardner- Robertson (GR) hearing at initial diagnosis but were observed without surgery or SRS. We compared hearing after SRS in 67 patients who retained GR Grade I hearing from initial diagnosis to SRS (the hearing maintenance or HM group) to 33 patients whose hearing worsened from GR grade I to grade II (the hearing deterioration or HD group). We also investigated whether a decline in pure tone average (PTA) or speech discrimination score (SDS) before SRS affected hearing preservation after SRS.
Results
The serviceable hearing (GR I and II) preservation in HM patients was 80%s, 63%, and 51% at 3, 5, and 10 years, respectively. The serviceable hearing preservation in HD patients was 40%, 33%, and 20% at 3, 5, and 10 years, respectively. In multivariate analysis, younger age (< 55 years, p = 0.045) and HM during observation (p = 0.001) improved serviceable hearing preservation rates. Patients whose PTA increased ≥ 15 dB (p = 0.024) or whose SDS declined ≥ 10% (p = 0.019) had reduced serviceable hearing preservation rates.
Conclusions
Hearing deterioration during observation before SRS reduced long term hearing preservation rate in VS patients with GR grade I hearing at initial diagnosis. SRS before hearing deterioration was recommended for hearing preservation.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-021-03726-6</identifier><identifier>PMID: 33733428</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Clinical Study ; Diagnosis ; Hearing ; Hearing Loss - etiology ; Humans ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate analysis ; Neurology ; Neuroma, Acoustic - complications ; Neuroma, Acoustic - diagnostic imaging ; Neuroma, Acoustic - radiotherapy ; Niacinamide ; Oncology ; Preservation ; Radiosurgery ; Radiosurgery - adverse effects ; Retrospective Studies ; Schwann cells ; Surgery ; Treatment Outcome ; Vestibular system</subject><ispartof>Journal of neuro-oncology, 2021-05, Vol.152 (3), p.559-566</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-f175afc1ab6fd81979aa4454fb8bb77d5580346d178bc2c7eb38e7f74e1e0dda3</citedby><cites>FETCH-LOGICAL-c419t-f175afc1ab6fd81979aa4454fb8bb77d5580346d178bc2c7eb38e7f74e1e0dda3</cites><orcidid>0000-0003-4881-951X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33733428$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ogino, Akiyoshi</creatorcontrib><creatorcontrib>Long, Hao</creatorcontrib><creatorcontrib>Johnson, Stephen</creatorcontrib><creatorcontrib>Faramand, Andrew</creatorcontrib><creatorcontrib>Niranjan, Ajay</creatorcontrib><creatorcontrib>Flickinger, John C.</creatorcontrib><creatorcontrib>Lunsford, L. Dade</creatorcontrib><creatorcontrib>Kano, Hideyuki</creatorcontrib><title>Useful hearing preservation is improved in vestibular schwannoma patients who undergo stereotactic radiosurgery before further hearing deterioration ensues</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Introduction
The present study evaluates whether hearing deterioration during observation reduces serviceable hearing preservation rates after stereotactic radiosurgery (SRS) in vestibular schwannoma (VS) patients with useful hearing.
Methods
We retrospectively analyzed 1447 VS patients who underwent SRS between 1992 and 2017. We identified 100 VS patients who had Grade I Gardner- Robertson (GR) hearing at initial diagnosis but were observed without surgery or SRS. We compared hearing after SRS in 67 patients who retained GR Grade I hearing from initial diagnosis to SRS (the hearing maintenance or HM group) to 33 patients whose hearing worsened from GR grade I to grade II (the hearing deterioration or HD group). We also investigated whether a decline in pure tone average (PTA) or speech discrimination score (SDS) before SRS affected hearing preservation after SRS.
Results
The serviceable hearing (GR I and II) preservation in HM patients was 80%s, 63%, and 51% at 3, 5, and 10 years, respectively. The serviceable hearing preservation in HD patients was 40%, 33%, and 20% at 3, 5, and 10 years, respectively. In multivariate analysis, younger age (< 55 years, p = 0.045) and HM during observation (p = 0.001) improved serviceable hearing preservation rates. Patients whose PTA increased ≥ 15 dB (p = 0.024) or whose SDS declined ≥ 10% (p = 0.019) had reduced serviceable hearing preservation rates.
Conclusions
Hearing deterioration during observation before SRS reduced long term hearing preservation rate in VS patients with GR grade I hearing at initial diagnosis. SRS before hearing deterioration was recommended for hearing preservation.</description><subject>Clinical Study</subject><subject>Diagnosis</subject><subject>Hearing</subject><subject>Hearing Loss - etiology</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neurology</subject><subject>Neuroma, Acoustic - complications</subject><subject>Neuroma, Acoustic - diagnostic imaging</subject><subject>Neuroma, Acoustic - radiotherapy</subject><subject>Niacinamide</subject><subject>Oncology</subject><subject>Preservation</subject><subject>Radiosurgery</subject><subject>Radiosurgery - adverse effects</subject><subject>Retrospective Studies</subject><subject>Schwann cells</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Vestibular system</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kcFu1TAQRS1ERR-FH2CBLLHpJtSOnThZogoKUiU2VGIXOfH4PVeJHWaSV_Vb-FlcUorEgtUsfO69M76MvZHivRTCXJCUohaFKGUhlCnron7GdrIyqjDKqOdsJ2RtiqrV30_ZS6JbIYQ2Sr5gpyq_K102O_bzhsCvIz-AxRD3fEYgwKNdQoo8EA_TjOkIjofIj0BL6NfRIqfhcGdjTJPlc2YhLsTvDomv0QHuE6cFENJihyUMHK0LiVbcA97zHnxC4H7F5QD4lOsgK0LCLRgirUCv2Im3I8Hrx3nGbj59_Hb5ubj-evXl8sN1MWjZLoWXprJ-kLavvWtka1prta6075u-N8ZVVSOUrp00TT-Ug4FeNWC80SBBOGfVGTvffPOpP3Lu0k2BBhhHGyGt1JWVKBuhhVAZffcPeptWjHm7TMm2qqWu2kyVGzVgIkLw3YxhsnjfSdE9VNdt1XW5uu53dV2dRW8frdd-Avck-dNVBtQG0PzwZYB_s_9j-wumUqmU</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Ogino, Akiyoshi</creator><creator>Long, Hao</creator><creator>Johnson, Stephen</creator><creator>Faramand, Andrew</creator><creator>Niranjan, Ajay</creator><creator>Flickinger, John C.</creator><creator>Lunsford, L. Dade</creator><creator>Kano, Hideyuki</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4881-951X</orcidid></search><sort><creationdate>20210501</creationdate><title>Useful hearing preservation is improved in vestibular schwannoma patients who undergo stereotactic radiosurgery before further hearing deterioration ensues</title><author>Ogino, Akiyoshi ; Long, Hao ; Johnson, Stephen ; Faramand, Andrew ; Niranjan, Ajay ; Flickinger, John C. ; Lunsford, L. Dade ; Kano, Hideyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-f175afc1ab6fd81979aa4454fb8bb77d5580346d178bc2c7eb38e7f74e1e0dda3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Clinical Study</topic><topic>Diagnosis</topic><topic>Hearing</topic><topic>Hearing Loss - etiology</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neurology</topic><topic>Neuroma, Acoustic - complications</topic><topic>Neuroma, Acoustic - diagnostic imaging</topic><topic>Neuroma, Acoustic - radiotherapy</topic><topic>Niacinamide</topic><topic>Oncology</topic><topic>Preservation</topic><topic>Radiosurgery</topic><topic>Radiosurgery - adverse effects</topic><topic>Retrospective Studies</topic><topic>Schwann cells</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Vestibular system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ogino, Akiyoshi</creatorcontrib><creatorcontrib>Long, Hao</creatorcontrib><creatorcontrib>Johnson, Stephen</creatorcontrib><creatorcontrib>Faramand, Andrew</creatorcontrib><creatorcontrib>Niranjan, Ajay</creatorcontrib><creatorcontrib>Flickinger, John C.</creatorcontrib><creatorcontrib>Lunsford, L. Dade</creatorcontrib><creatorcontrib>Kano, Hideyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuro-oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ogino, Akiyoshi</au><au>Long, Hao</au><au>Johnson, Stephen</au><au>Faramand, Andrew</au><au>Niranjan, Ajay</au><au>Flickinger, John C.</au><au>Lunsford, L. Dade</au><au>Kano, Hideyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Useful hearing preservation is improved in vestibular schwannoma patients who undergo stereotactic radiosurgery before further hearing deterioration ensues</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>152</volume><issue>3</issue><spage>559</spage><epage>566</epage><pages>559-566</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Introduction
The present study evaluates whether hearing deterioration during observation reduces serviceable hearing preservation rates after stereotactic radiosurgery (SRS) in vestibular schwannoma (VS) patients with useful hearing.
Methods
We retrospectively analyzed 1447 VS patients who underwent SRS between 1992 and 2017. We identified 100 VS patients who had Grade I Gardner- Robertson (GR) hearing at initial diagnosis but were observed without surgery or SRS. We compared hearing after SRS in 67 patients who retained GR Grade I hearing from initial diagnosis to SRS (the hearing maintenance or HM group) to 33 patients whose hearing worsened from GR grade I to grade II (the hearing deterioration or HD group). We also investigated whether a decline in pure tone average (PTA) or speech discrimination score (SDS) before SRS affected hearing preservation after SRS.
Results
The serviceable hearing (GR I and II) preservation in HM patients was 80%s, 63%, and 51% at 3, 5, and 10 years, respectively. The serviceable hearing preservation in HD patients was 40%, 33%, and 20% at 3, 5, and 10 years, respectively. In multivariate analysis, younger age (< 55 years, p = 0.045) and HM during observation (p = 0.001) improved serviceable hearing preservation rates. Patients whose PTA increased ≥ 15 dB (p = 0.024) or whose SDS declined ≥ 10% (p = 0.019) had reduced serviceable hearing preservation rates.
Conclusions
Hearing deterioration during observation before SRS reduced long term hearing preservation rate in VS patients with GR grade I hearing at initial diagnosis. SRS before hearing deterioration was recommended for hearing preservation.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33733428</pmid><doi>10.1007/s11060-021-03726-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4881-951X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Clinical Study Diagnosis Hearing Hearing Loss - etiology Humans Medicine Medicine & Public Health Middle Aged Multivariate analysis Neurology Neuroma, Acoustic - complications Neuroma, Acoustic - diagnostic imaging Neuroma, Acoustic - radiotherapy Niacinamide Oncology Preservation Radiosurgery Radiosurgery - adverse effects Retrospective Studies Schwann cells Surgery Treatment Outcome Vestibular system |
| title | Useful hearing preservation is improved in vestibular schwannoma patients who undergo stereotactic radiosurgery before further hearing deterioration ensues |
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