Early Radiosurgery Improves Hearing Preservation in Vestibular Schwannoma Patients With Normal Hearing at the Time of Diagnosis

Akpinar, Berkcan; Mousavi, Seyed H.; McDowell, Michael M.; Niranjan, Ajay; Faraji, Amir H.; Flíckinger, John C.; Lunsford, L. Dade

doi:10.1016/j.ijrobp.2016.01.019

Cited by 50 publications

(31 citation statements)

References 26 publications

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“…The study found that patients in the early treatment group maintained serviceable hearing significantly longer than those patients in the late treatment group; 1-, 3-, 5-, and 10-year rates of serviceable hearing preservation were 96, 93, 88, and 64% for the early treatment group, compared with 87, 73, 55, and 55% for the late treatment group. 50 Limitations to this study include its retrospective nature and the fact that the late treatment group had slightly lower speech discrimination scores and significantly higher PTAs as compared with the early treatment group. Nevertheless, future studies exploring the role of radiation timing should be explored to better characterize this interesting finding.…”

Section: Timing Of Radiationmentioning

confidence: 94%

“…Akpinar and colleagues studied the effect of early treatment ( 2 years) versus late treatment (>2 years) of 88 VS patients with GR Class 1 hearing utilizing SRS. 50 Both cohorts received an average tumor margin dose of 12.5 Gy (range, 11.5-13 Gy) and had a median follow-up of 75 months (range, 12-169 months). The study found that patients in the early treatment group maintained serviceable hearing significantly longer than those patients in the late treatment group; 1-, 3-, 5-, and 10-year rates of serviceable hearing preservation were 96, 93, 88, and 64% for the early treatment group, compared with 87, 73, 55, and 55% for the late treatment group.…”

Section: Timing Of Radiationmentioning

confidence: 99%

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Hearing Preservation in Stereotactic Radiosurgery for Vestibular Schwannoma

Tolisano

Hunter

2019

J Neurol Surg B

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Despite no universally accepted definition of hearing preservation following vestibular schwannoma (VS) treatment, numerous variables have been identified as possible factors that may affect hearing outcomes following radiotherapy. Age, pretreatment hearing, radiation dose, tumor location and size, length of follow-up, fractionation, and timing of radiation have all been explored, among other variables, as factors related to hearing outcomes following radiation. These variables and associated hearing outcomes will be explored in detail, summarizing the literature to date to improve patient counseling for those patients who present with serviceable hearing and are considering their VS management options.

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Section: Timing Of Radiationmentioning

confidence: 94%

Section: Timing Of Radiationmentioning

confidence: 99%

Hearing Preservation in Stereotactic Radiosurgery for Vestibular Schwannoma

Tolisano

Hunter

2019

J Neurol Surg B

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“…is associated with higher rates of hearing deterioration compared to slower growing tumors 31 . If hearing preservation remains a treatment objective, earlier intervention may lead to a better outcome 52 .…”

Section: Observationmentioning

confidence: 99%

The Management and Imaging of Vestibular Schwannomas

Lin¹,

Crane

2017

AJNR Am J Neuroradiol

108

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Vestibular schwannomas are the most common cerebellopontine angle tumor. Over the past century, the management goals of vestibular schwannomas have shifted from total resection to functional preservation. Current treatment options include surgical resection, stereotactic radiosurgery and observation. Imaging has become a crucial part of the initial screening, evaluation and follow up assessment of vestibular schwannomas. Recognizing and understanding the management objectives, various treatment modalities, expected post-treatment findings and complications allows the radiologists to play an essential role in a multidisciplinary team by providing key findings that are relevant to the treatment planning and outcome assessment. The authors provide a comprehensive discussion of the surgical management, role of radiation therapy and observation, imaging differential, and pre- and post-treatment imaging findings of vestibular schwannomas.

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“…This is why important data show better hearing outcomes with earlier management, when hearing is at its highest level. 1 The concept of "watch and wait" for smaller tumors has been followed most commonly by tumor growth and hearing loss. 37 As for the use of low radiation doses, my personal concern is that a dose reduction may lead to a higher failure rate for longer-term tumor control without clear benefit to hearing.…”

Section: Vestibular Schwannomasmentioning

confidence: 99%

Current and novel practice of stereotactic radiosurgery

Kondziolka¹

2019

Journal of Neurosurgery

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Stereotactic radiosurgery emerged as a neurosurgical discipline in order to utilize energy for the manipulation of brain or nerve tissue, with the goal of minimal access and safe and effective care of a spectrum of neurosurgical disorders. Perhaps no other branch of neurosurgery has been so disruptive across the entire discipline of brain tumor care, treatment of vascular disorders, and management of functional problems. Radiosurgery is mainstream, supported by thousands of peer-reviewed outcomes reports. This article reviews current practice with a focus on challenges, emerging trends, and areas of investigation.

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Early Radiosurgery Improves Hearing Preservation in Vestibular Schwannoma Patients With Normal Hearing at the Time of Diagnosis

Cited by 50 publications

References 26 publications

Hearing Preservation in Stereotactic Radiosurgery for Vestibular Schwannoma

Hearing Preservation in Stereotactic Radiosurgery for Vestibular Schwannoma

The Management and Imaging of Vestibular Schwannomas

Current and novel practice of stereotactic radiosurgery

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