Early surgical intervention for vestibular schwannomas in NF2 patients when the cochlear nerve can be spared is an important consideration to allow for possible cochlear implantation. A 6- to 8-week recovery period for the anatomically intact cochlear nerve may be necessary to obtain a positive promontory stimulation response following tumor resection and should be performed prior to cochlear implantation.

Our cDNA microarray analysis of schwannomas suggested several interesting and potentially important tumorigenesis pathways associated with vestibular schwannoma formation. Further in vivo study is necessary to define the roles of these identified genes and their potential relationships with the neurofibromatosis type 2 tumor suppressor gene.

The pRb-CDK pathway was altered in all vestibular schwannoma tumors examined, with CDK2 significantly downregulated in seven of the eight tumors. Further investigation into the regulatory mechanisms governing CDK2 expression may lead to a better understanding of vestibular schwannoma tumorigenesis.

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The goal of this study was to assess the effects ofimmun osupp ressiv e therapy on hearing in patients with presumed autoimmune sensorin eural hearin g loss (AISNHL) and a Western blot assay positivefor a 68 kD inner ear antig en. To achieve this objective, we conducted a retrosp ective review of39 such patients who were treated with either a steroid alone or with a steroid followed by a cytotoxic agent. Pure-tone avera ge (PTA) at 500 Hz, 1 kHz, 2 kHz, and 3 kHz and speecli discrimination scores (SDS) were used as objective tneasu res of outcome. At the compl etion of treatm ent, 23 of the 39 patients (59.0%) exhibited a positive respo nse to therapy. The steroid-only responders (n = 6) tend ed to demonstrat e a greater impro vement in PTA (14.8 vs 4.5 dB), while the cytotoxic-agent responders (n = 17) had a significantly greater impro vement in SDS (26.2 vs 6.9 %; p