Current Understanding of Hearing Loss in Sporadic Vestibular Schwannomas: A Systematic Review

Gan, Jinlu; Zhang, Yanling; Wu, Jiada; Lei, Deqiang; Zhang, Fangcheng; Zhao, Hongyang; Wang, Lei

doi:10.3389/fonc.2021.687201

Cited by 19 publications

(24 citation statements)

References 86 publications

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“…If left untreated, some VSs could grow more than 4 cm in one dimension (GVS) and compress adjacent cranial nerves, vessels, and the brainstem ( 3 ). Typical clinical presentations include hearing loss, tinnitus, vertigo, and facial numbness ( 12 ). In extremely rare cases, the GVS invades the petrous apex and extends to the middle cranial fossa.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Extensive Temporal Bone Invasion in a Giant Vestibular Schwannoma

et al. 2022

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BackgroundRare giant vestibular schwannomas (GVSs) invade the temporal bone extensively, which carries unique risks for surgery owing to their complicated relationship with adjacent structures, difficult dissection of the temporal bone, and high risk of complications. The underlying mechanism of this invasive behavior remains unknown.Case descriptionWe report on a 28-year-old woman who presented with typical hearing loss and facial paralysis (House-Brackmann II). Magnetic resonance imaging exhibited a giant mass (∼5.0 cm) in the right cerebellopontine angle (CPA), petrous apex, and middle cranial fossa. Her primary diagnosis was GVS with petrous apex invasion. With the aid of presurgical imaging reconstruction and intraoperative facial nerve monitoring, we adopted a sequential therapeutic strategy, which included microsurgery for the CPA lesion followed by gamma knife radiosurgery (GKRS) for the petrous mass. During follow-up, stable tumor control was achieved with functional preservation of the facial nerve and no other complications. The postoperative immunohistochemical examination demonstrated dramatic intratumoral inflammation, which suggested its potential role in bony erosion. We reviewed the literature of large vestibular schwannoma with a petrous invasion and further discussed its treatment.ConclusionMicrosurgery remains the top therapeutic strategy for GVS. However, gross total resection with functional preservation of cranial nerves is challenging to achieve once the temporal bone is involved. In this case, we applied a planned and sequential approach of microsurgery and GKRS with a promising outcome, which highlighted this combinational strategy in this rare situation. In addition, pathological examination suggested that intratumoral inflammation might play a role in the bony erosion of GVS. Longer observation and more cases are needed to further investigate its molecular mechanism and treatment plan.

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Section: Discussionmentioning

confidence: 99%

Case Report: Extensive Temporal Bone Invasion in a Giant Vestibular Schwannoma

et al. 2022

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“…This contrasts with patients who developed SSD as a result of resection of a vestibular schwannoma (8.3%) or after temporal bone fracture (5.6%). Hearing loss of these etiologies may occur in combination with neural or central hearing loss in addition to cochlear hearing loss [ 28 , 29 ]. This, in turn, may negatively affect the prognosis of hearing gain with CI or the results of the present collective.…”

Section: Discussionmentioning

confidence: 99%

Hearing rehabilitation for unilateral deafness using a cochlear implant: the influence of the subjective duration of deafness on speech intelligibility

Waleka

Strieth

Eichhorn³

et al. 2022

Eur Arch Otorhinolaryngol

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Background For patients with single sided deafness (SSD) or severe asymmetric sensorineural hearing loss (ASHL), cochlear implantation remains the only solution to restore bilateral hearing capacity. Prognostically, the duration of hearing loss in terms of audiological outcome is not yet clear. Therefore, the aim of this study was to retrospectively investigate the influence of subjective deafness duration on postoperative speech perception after cochlear implantation for SSD as well as its impact on quality of life. Materials and methods The present study included a total of 36 adults aged 50.2 ± 15.5 years who underwent CI for SSD/ASHL at our clinic between 2010 and 2015. Patients were audiometrically assessed at 3 and 12–36 months postoperatively. Test results were correlated with self-reported duration of deafness. Quality of life was assessed by questionnaire. Results Mean duration of deafness was 193.9 ± 185.7 months. The side-separated hearing threshold showed an averaged target range between 30 and 40 dB HL. Freiburg monosyllable test increased from 0% pre-operatively to 20% after 3 months (p = 0.001) and to 50% after 12–36 months (p = 0.002). There was a significant correlation between audiometric outcome and subjective deafness duration at 12–36 months postoperatively (r = − 0.564; p = 0.02) with a cutoff for open-set monosyllable recognition at a duration of deafness of greater than 408 months. Quality of life was significantly improved by CI. Conclusions CI implantation in unilaterally deafened patients provides objective and subjective benefits. Duration of deafness is unlikely to be an independent negative predictive factor and thus should not generally be considered as contraindication.

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“…Hearing loss in VS patients is likely caused through a multifactorial process, including compression of the tumor on the vestibulocochlear nerves and labyrinthine artery (which is a terminal artery) and vein ( 17 ). However, patients with large VSs do not always have (severe) hearing loss and vice versa, indicating that tumor compression is likely not the only cause of hearing loss ( 18 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…All of the included patients had an indication for VS treatment (with proton therapy), with the most common indication being tumor progression. This may introduce a selection bias as growing tumors have been reported to be associated with more severe hearing loss ( 17 ). Last, MRI scans from different centers, MRI scanners, and MRI manufacturers were included, which is known to hamper comparability.…”

Section: Discussionmentioning

confidence: 99%

Labyrinthine Fluid Signal Intensity on T2-Weighted MR Imaging in Patients With Vestibular Schwannomas Undergoing Proton Radiotherapy: A Longitudinal Assessment

Koetsier¹,

Mehan

Buch³

et al. 2022

Otol Neurotol

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Objective: In vestibular schwannoma patients, a loss of signal intensity (SI) on T2-weighted magnetic resonance imaging (MRI) has been reported within the ipsilateral labyrinth. The purpose of this study was to quantitatively evaluate the occurrence and course of this intensity loss in relation to proton radiotherapy and its possible association with hearing loss. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: Patients who received proton therapy for a vestibular schwannoma and underwent at least two high-resolution T2-weighted cisternographic sequence (constructive interference in steady state/ fast imaging employing steady-state acquisition/DRIVE) MRIs and audiometry assessments. Main Outcome Measures: Relative T2 SIs from the vestibules and basal/apical cochlear turns of the labyrinth, bilaterally. Results: Ninety-five MRI scans from 34 patients were included. The apical turn of the ipsilateral cochlea showed a lower mean co-chlear SI than on the contralateral side (±3.5 versus 5.0). The mean relative cochlear SI did not significantly change after proton radiotherapy. The ipsilateral vestibule showed a higher SI than the cochlea. The relative mean cochlear SI was not directly correlated to (the degree of ) hearing loss before or after proton radiotherapy, nor did it predict future hearing loss. Conclusion:The relative mean cochlear SI on cisternographic T2-MRI in vestibular schwannoma patients is diminished on the treated side, when compared with the ipsilateral vestibule and the contralateral cochlea/vestibule. The SI of the ipsilateral cochlea does not further decrease after proton radiotherapy and seems to be related to the tumor rather than the therapy. The diminished cochlear SI does not correlate with subsequent loss of hearing.

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Current Understanding of Hearing Loss in Sporadic Vestibular Schwannomas: A Systematic Review

Cited by 19 publications

References 86 publications

Case Report: Extensive Temporal Bone Invasion in a Giant Vestibular Schwannoma

Case Report: Extensive Temporal Bone Invasion in a Giant Vestibular Schwannoma

Hearing rehabilitation for unilateral deafness using a cochlear implant: the influence of the subjective duration of deafness on speech intelligibility

Labyrinthine Fluid Signal Intensity on T2-Weighted MR Imaging in Patients With Vestibular Schwannomas Undergoing Proton Radiotherapy: A Longitudinal Assessment

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