Hearing Preservation After Gamma Knife Radiosurgery for Vestibular Schwannomas Presenting With High-Level Hearing

Tamura, Manabu; Carron, Romain; Yomo, Shoji; Arkha, Yasser; Muraciolle, Xavier; Porcheron, D.; Thomassin, J.-M.; Ph, Roche; Régis, Jean

doi:10.1227/01.neu.0000338256.87936.7c

Cited by 150 publications

(125 citation statements)

References 30 publications

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“…Of these, 16 retained serviceable hearing (84.2%), and 10 of the 16 (62.5%) retained GR Class I function. Tamura et al, 50 however, who reported on a larger sample size with a longer follow-up duration, noted that 50% of their patients retained GR Class I three years after radiosurgery and 78.4% retained serviceable hearing. As stated above, we cannot exclude the possibility that further hearing impairment will not occur during the ongoing follow-up.…”

Section: Hearing Function After Gksmentioning

confidence: 94%

“…Our data also appear to be in line with the literature. 50 Crude rates of hearing preservation must be weighted with the time course of hearing in the long term. Hearing impairment usually occurs gradually over 6-24 months.…”

Section: Hearing Function After Gksmentioning

confidence: 99%

“…In a study of 74 patients with GR Class I hearing function at treatment, Tamura et al 50 reported that 5 patients (8.1%) in a subgroup of 58 individuals experienced total hearing loss. Their larger sample size (74 vs 50 patients) and their longer median follow-up (48 vs 36 months) than in ours does not allow us to exclude the possibility that some events may also occur in our patients as follow-up continues.…”

Section: Hearing Function After Gksmentioning

confidence: 99%

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Evaluation of hearing function after Gamma Knife surgery of vestibular schwannomas

Franzin¹,

Spatola²,

Serra³

et al. 2009

FOC

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Object Due to technological advances in neuroradiology in recent years, incidental diagnoses of vestibular schwannomas (VSs) have increased. The aim of this study was to evaluate the hearing function after treatment with Gamma Knife surgery (GKS) for VSs in patients adequately selected with “good” or “useful” hearing before treatment and to assess the possible predictive factors for hearing function preservation. Methods Of all patients treated in the authors' hospital between 2001 and 2007, they retrospectively studied 50 patients with a unilateral VS in whom there was serviceable hearing (Gardner-Robertson [GR] Class I or II). Additional inclusion criteria were: no Type 2 neurofibromatosis, no previous treatment, and at least 6 months' follow-up of neuroradiological and audiological data. The median patient age was 54 years (range 24–78 years). The median tumor volume was 0.73 ml (range 0.03–6.6 ml), and the median radiation dose to the tumor margin was 13 Gy (range 12–16 Gy) with an isodose of 50%. Results Patient age, tumor volume, and presenting symptoms were found to correlate with hearing function. At a median of 36 months after radiosurgery, tumor growth control was 96% and no patient required any other additional treatment. Serviceable hearing was preserved in 34 patients (68%): 21 (62%) with GR Class I hearing and 13 (38%) with GR Class II hearing. The remaining 16 patients had poor hearing function:15 with GR Class III and 1 with GR Class IV hearing function. In 19 (58%) of 33 patients with GR Class I function before GKS the same class was maintained posttreatment; 29 (88%) maintained functional hearing (GR Class I or II). In all patients with an intracanalicular lesion, functional hearing was maintained. Significant prognostic factors for maintaining serviceable hearing were GR Class I function before treatment, symptoms at presentation, patient age younger than 54 years, and Koos Stage T1 disease. Conclusions The results of the study show that the probability of preserving functional hearing in patients undergoing GKS treatment for unilateral VSs is very high. Patients with GR Class I, age younger than 54 years, with presenting symptoms other than hearing loss, and a Koos Stage T1 tumor have better prognosis. The prescribed dose of 13 Gy appears to represent an excellent compromise between controlling the disease and preserving auditory function.

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Section: Hearing Function After Gksmentioning

confidence: 94%

Section: Hearing Function After Gksmentioning

confidence: 99%

Section: Hearing Function After Gksmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of hearing function after Gamma Knife surgery of vestibular schwannomas

Franzin¹,

Spatola²,

Serra³

et al. 2009

FOC

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“…These authors also mentioned that patients who were not treated using gamma knife radiosurgery lost an average of 9-39 dB compared with an average loss of 2 dB at 3 years following radiosurgery, which corresponds with a preservation of hearing functionality of 60-75%. Tamura et al (Tamura et al, 2009) reported a 78.4% hearing preservation rate in Gardner-Robertson Class 1 patients. The probability of preserving functional hearing was higher in patients who had initial symptoms that were other than a decrease in hearing, in patients who were younger than 50 years, and in those patients whose cochlea received a dose of less than 4 Gy during treatment.…”

Section: Hearing Preservationmentioning

confidence: 96%

“…The probability of preserving functional hearing was higher in patients who had initial symptoms that were other than a decrease in hearing, in patients who were younger than 50 years, and in those patients whose cochlea received a dose of less than 4 Gy during treatment. (Tamura, et al, 2009). …”

Section: Hearing Preservationmentioning

confidence: 99%

Gamma Knife Radiosurgery for the Vestibular Schwannomas, Technical Considerations and Hydrocephalus as a Complication

Hwang¹,

Park²,

Lee³

et al. 2011

Gamma Knife Radiosurgery

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Hearing preservation after stereotactic radiosurgery for sporadic intracanalicular vestibular schwannomas classified as Koos grade 1

Kang,

Ji,

Kim

et al. 2024

Cancer Medicine

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IntroductionThe mechanism of hearing loss following stereotactic radiosurgery (SRS) for vestibular schwannomas (VSs) remains unclear. There is conflicting evidence regarding cochlear nerve damage by transient volume expansion of VSs after radiosurgery and radiation‐induced cochlear damage. This study aimed to investigate whether there is a specific patient population that can achieve definite hearing preservation after SRS for VSs.MethodsA total of 37 consecutive patients with sporadic unilateral intracanalicular VSs and serviceable hearing (Gardner‐Roberson [G‐R] class I or II) were treated with SRS from 2009 to 2023. This is a retrospective study. Survival analysis with Cox regression for hearing deterioration was performed.ResultsThe median age was 55 years old. The median tumor volume was 0.089 cm3, and the median marginal dose was 12.0 Gy. Nonserviceable hearing deterioration occurred in 9 patients (24.3%), with a median onset of 11.9 months after SRS. The actuarial rates of serviceable hearing preservation were 86%, 82%, and 70% at 1, 2, and 3 years after SRS, respectively. In a multivariate analysis, only baseline pure tone average > 30 dB increased the risk of nonserviceable hearing deterioration with significant hazard ratio. There were 13 patients with petit VSs whose tumor volume was smaller than 0.05 cm3, and 11 of them were treated by a 4‐mm single shot with a marginal dose of 12 Gy. None of the 13 patients had nonserviceable hearing deterioration.ConclusionsPetit VSs that can be treated with 4‐mm single or double shots with a marginal dose of 12 Gy may achieve hearing preservation after SRS.

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Hearing Preservation After Gamma Knife Radiosurgery for Vestibular Schwannomas Presenting With High-Level Hearing

Cited by 150 publications

References 30 publications

Evaluation of hearing function after Gamma Knife surgery of vestibular schwannomas

Evaluation of hearing function after Gamma Knife surgery of vestibular schwannomas

Gamma Knife Radiosurgery for the Vestibular Schwannomas, Technical Considerations and Hydrocephalus as a Complication

Hearing preservation after stereotactic radiosurgery for sporadic intracanalicular vestibular schwannomas classified as Koos grade 1

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