Natural History of Hearing Deterioration in Intracanalicular Vestibular Schwannoma
- 1 January 2011
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurosurgery
- Vol. 68 (1), 68-77
- https://doi.org/10.1227/neu.0b013e3181fc60cb
Abstract
Intracanalicular vestibular schwannomas have a range of treatment options that can preserve hearing: microsurgery, stereotactic radiotherapy, and conservative observation. To evaluate the natural course of hearing deterioration during a period of conservative observation. A retrospective case review was performed on 47 patients with a unilateral intracanalicular vestibular schwannoma. Evaluation of growth was monitored by repeat MRI scanning. Repeated pure-tone and speech audiometry results were evaluated for subgroups of patients showing growth or no growth and by subsite location of tumor in the internal auditory canal. Patients had a mean follow-up of 3.6 years. Over the entire population, the pure-tone average thresholds at 0.5, 1, 2, and 3 kHz and the word recognition scores both significantly deteriorated from 38 to 51 dB HL, and from 66% to 55%, respectively. Overall, 74% of subjects with good hearing, according to the 50/50 rule, maintained hearing above this rule. There were no significant differences in hearing loss by subsite in the internal auditory canal (porus, fundus, central) or by growth status (stable, growing, shrinking). Only 6 patients showed a large hearing change. This happened early during follow-up, with relatively stable hearing after this. Hearing will deteriorate in some intracanalicular vestibular schwannomas, regardless of tumor growth. Hearing deterioration, if on a large scale, most likely occurs early in follow-up. The present results using conservative management in these tumors appear similar to those reported for stereotactic radiotherapy or microsurgery.Keywords
This publication has 23 references indexed in Scilit:
- Long-Term Hearing Preservation in Vestibular SchwannomaOtology & Neurotology, 2010
- Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: comparison of middle fossa and restrosigmoid approachesActa Neurochirurgica, 2009
- HEARING PRESERVATION AFTER INTRACANALICULAR VESTIBULAR SCHWANNOMA RADIOSURGERYNeurosurgery, 2008
- Vestibular SchwannomaOtology & Neurotology, 2008
- Long-Term Follow-up of Acoustic Schwannoma Radiosurgery With Marginal Tumor Doses of 12 to 13 GyInternational Journal of Radiation Oncology*Biology*Physics, 2007
- Hearing in Patients with Intracanalicular Vestibular SchwannomasAudiology and Neurotology, 2006
- Tumor Growth and Audiometric Change in Vestibular Schwannomas Managed ConservativelyThe Laryngoscope, 2000
- Management of 1000 Vestibular Schwannomas (Acoustic Neuromas): Hearing Function in 1000 Tumor ResectionsNeurosurgery, 1997
- Measurement of Endocochlear DC Potentials in Ears with Acoustic Neuromas: A Preliminary ReportActa Oto-Laryngologica, 1996
- Mechanisms of Hearing Loss in Acoustic Neuroma: An Otoacoustic Emission StudyActa Oto-Laryngologica, 1995