Predictors of Hearing Loss After Gamma Knife Radiosurgery for Vestibular Schwannomas: Age, Cochlear Dose, and Tumor Coverage

Brown, Melandee; Ruckenstein, Michael J.; Bigelow, Douglas C.; Judy, Kevin; Wilson, Vasthi; Alonso‐Basanta, Michelle; Lee, John Y.K.

doi:10.1227/neu.0b013e31821a42f3

Cited by 45 publications

(66 citation statements)

References 36 publications

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“…Although there is no evidence for a threshold dose below which radiation poses no threat to the cochlea, the risk of hearing loss is statistically significant with cochlea irradiation greater than 8 Gy in three sessions (dose equivalent of 5.4 Gy 3 ). Using different analytical methods, Brown et al (1) reported that, for each percentage of cochlear volume receiving at least 5.3 Gy (the mean dose in their study), there is an increase of approximately 0.168 dB in pure-tone average on follow-up audiograms.…”

Section: Cochlear Radiation and Hearing Lossmentioning

confidence: 97%

Cochlea Radiation Dose Correlates with Hearing Loss After Stereotactic Radiosurgery of Vestibular Schwannoma

et al. 2013

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Section: Cochlear Radiation and Hearing Lossmentioning

confidence: 97%

Cochlea Radiation Dose Correlates with Hearing Loss After Stereotactic Radiosurgery of Vestibular Schwannoma

et al. 2013

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“…A recent study by Brown et al have also highlighted that in addition to age and cochlear dose, treatment plan conformity indices, particularly tumor coverage, are highly predictive of hearing preservation. 19 Our analysis revealed that a significantly greater number of cases were reported properly adhering to the seven of the eight elements pertinent to radiosurgery included in the Guidelines, with the exception of the nature of the tumor. The characteristic most frequently included was the size of the tumor, and the least frequently included characteristic was the nature of the tumor.…”

Section: Discussionmentioning

confidence: 87%

The effect of the 2003 Consensus Reporting Standards on publications describing patients with vestibular schwannoma treated with stereotactic radiosurgery

Han

Sughrue

et al. 2012

Journal of Clinical Neuroscience

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“…1,8,10,13,15 Kano et al 15 reported that a central cochlear dose of < 4.2 Gy was significant in patients with vestibular schwannoma retaining their hearing function. Similarly, Hasegawa et al 8 demonstrated that hearing preservation was significantly better in patients with vestibular schwannoma with a mean cochlear dose of < 6 Gy.…”

Section: Hearing Functionmentioning

confidence: 99%

Gamma Knife surgery for patients with facial nerve schwannomas: a multiinstitutional retrospective study in Japan

Hasegawa

Kato

Kida

et al. 2016

JNS

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obJective The aim of this study was to explore the efficacy and safety of stereotactic radiosurgery for patients with facial nerve schwannomas (FNSs). methods This study was a multiinstitutional retrospective analysis of 42 patients with FNSs treated with Gamma Knife surgery (GKS) at 1 of 10 medical centers of the Japan Leksell Gamma Knife Society (JLGK1301). The median age of the patients was 50 years. Twenty-nine patients underwent GKS as the initial treatment, and 13 patients had previously undergone surgery. At the time of the GKS, 33 (79%) patients had some degree of facial palsy, and 21 (50%) did not retain serviceable hearing. Thirty-five (83%) tumors were solid, and 7 (17%) had cystic components. The median tumor volume was 2.5 cm 3 , and the median prescription dose to the tumor margin was 12 Gy. results The median follow-up period was 48 months. The last follow-up images showed partial remission in 23 patients and stable tumors in 19 patients. Only 1 patient experienced tumor progression at 60 months, but repeat GKS led to tumor shrinkage. The actuarial 3- and 5-year progression-free survival rates were 100% and 92%, respectively. During the follow-up period, 8 patients presented with newly developed or worsened preexisting facial palsy. The condition was transient in 3 of these patients. At the last clinical follow-up, facial nerve function improved in 8 (19%) patients, remained stable in 29 (69%), and worsened in 5 (12%; House-Brackmann Grade III in 4 patients, Grade IV in 1 patient). With respect to hearing function, 18 (90%) of 20 evaluated patients with a pure tone average of ≤ 50 dB before treatment retained serviceable hearing. coNclusioNs GKS is a safe and effective treatment option for patients with either primary or residual FNSs. All patients, including 1 patient who required repeat GKS, achieved good tumor control at the last follow-up. The incidence of newly developed or worsened preexisting facial palsy was 12% at the last clinical follow-up. In addition, the risk of hearing deterioration as an adverse effect of radiation was low. These results suggest that GKS is a safe alternative to resection.

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Predictors of Hearing Loss After Gamma Knife Radiosurgery for Vestibular Schwannomas: Age, Cochlear Dose, and Tumor Coverage

Cited by 45 publications

References 36 publications

Cochlea Radiation Dose Correlates with Hearing Loss After Stereotactic Radiosurgery of Vestibular Schwannoma

Cochlea Radiation Dose Correlates with Hearing Loss After Stereotactic Radiosurgery of Vestibular Schwannoma

The effect of the 2003 Consensus Reporting Standards on publications describing patients with vestibular schwannoma treated with stereotactic radiosurgery

Gamma Knife surgery for patients with facial nerve schwannomas: a multiinstitutional retrospective study in Japan

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