total of 13,324 patients were used to verify the feasibility and effectiveness of the treatment using data from three hospital tumor registries. Additionally, five machine learning approaches were used to develop prediction models, including LADT (Logical Analysis of Data Trees), NBT (Naïve Bayes Trees), RF (Random Forests), RT (Random Trees), and FT (Functional Trees).
ResultsThe experimental results indicate that the RF model was of the highest accuracy. The results suggest that six of the most important recurrent risk factors were behavior, age, tumor metastasis, grade, surgical margins, and pathological stage. Conclusion These risk factors should be monitored for early detection and the clinical features summarized in this study as additional effective treatments and appropriate interventions.
We performed a review of the VS operated in our institution between 2004 and 2015, finding a total of 185 cases. Four of these patients developed a contralateral SNHL after VS surgery (Table 1). They were 3 men and 1 woman, with an average tumour size of 19,5 mm (range 7,8-30mm). Three of them were operated by a retrosigmoid approach, and the other one by a translabyrinthine approach. At the time of diagnosis of the VS, 2 patients had normal hearing (pure tone average (PTA): 20 and 22 dB) and 2 has mild hearing loss (PTA: 26 and 40 dB). After surgery all patients developed a complete hearing loss in the operated ear. The median time of appearance of the contralateral SNHL was 16 months (range 2-54 months) with an average of hearing loss in the contralateral ear at the moment of diagnosis of 46dB. Moreover, 3 patients developed tinnitus in the contralateral ear and 2 of them developed also episodic vertigo.
AbstractContralateral sensorineural hearing loss after vestibular schwannoma (VS) resection has been described, resulting in a severe complication, especially if hearing preservation in the operated side was not a reachable outcome. There exist several theories that would explain this complication, without any guideline of treatment established. We report four patients treated in our institution who developed a severe contralateral SNHL after surgery. After medical treatment only one patient recovered hearing (moderate SNHL) and the other 3 presented a severe SNHL. Cochlear implant was the only treatment of choice in two of them.
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