Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-27T09:45:14.460Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of CyberKnife therapy for vestibular schwannoma on hearing: a retrospective study

Published online by Cambridge University Press:  05 September 2018

O Çakır ,
G Berkiten ,
B Tutar ,
A B Yılmazer ,
T L Kumral ,
Z Saltürk  and
Y Uyar
O Çakır
Affiliation:
Department of ENT, Burdur State Hospital, Istanbul, Turkey
G Berkiten
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey
B Tutar*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey
A B Yılmazer
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey
T L Kumral
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey
Z Saltürk
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey
Y Uyar
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey
*
Author for correspondence: Dr Belgin Tutar, Department of Otorhinolaryngology – Head and Neck Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey E-mail: belgintutar@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

To evaluate the effects of CyberKnife stereotactic radiotherapy for the treatment of vestibular schwannoma on hearing, as evaluated by audiological tests.

Methods

Patients with vestibular schwannoma were evaluated before and after CyberKnife radiosurgery. Evaluation included pure tone thresholds, speech discrimination scores, auditory brainstem responses and radiological signs.

Results

The study comprised 26 patients diagnosed with vestibular schwannoma and subsequently treated with CyberKnife radiosurgery. The mean follow-up time was 16.4 months. The mean post-treatment hearing preservation rate was 69.23 per cent. There was no significant relationship between hearing loss after treatment and patient age, radiation dosage during treatment, or size of tumour. With regard to auditory brainstem responses, patients with hearing loss following treatment had a significantly higher inter-peak latency between waves I–III than patients with preserved hearing.

Conclusion

Stereotactic CyberKnife radiosurgery is an excellent alternative treatment modality for patients with vestibular schwannoma, and results in acceptable preservation of hearing. Residual hearing following CyberKnife therapy is not significantly affected by factors such as age, size of tumour or dosage of treatment.

Keywords

Vestibular SchwannomaCyberKnife RadiosurgeryHearing LossStereotactic Radiosurgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 9 , September 2018 , pp. 796 - 801
Copyright
Copyright © JLO (1984) Limited, 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr B Tutar takes responsibility for the integrity of the content of the paper

References

1Evans, DG, Moran, A, King, A, Saeed, S, Gurusinghe, N, Ramsden, R. Incidence of vestibular schwannoma and neurofibromatosis 2 in the North West of England over a 10-year period: higher incidence than previously thought. Otol Neurotol 2005;26:93–7Google Scholar
2Sakamoto, G, Sinclair, J, Gibbs, C, Adler, JR, Chang, SD. Stereotactic radiosurgery for vestibular schwannoma using the CyberKnife. In: Timmerman, R, Xing, L, eds. Image-guided and Adaptive Radiation Therapy. Philadelphia: Lippincott Williams & Wilkins, 2010;125–32Google Scholar
3Gardner, G, Robertson, JH. Hearing preservation in unilateral vestibular schwannoma surgery. Ann Otol Rhinol Laryngol 1988;97:55–66Google Scholar
4Arthurs, BJ, Fairbanks, RK, Demakas, JJ, Lamoreaux, WT, Giddings, NA, Mackay, AR et al. A review of treatment modalities for vestibular schwannoma. Neurosurg Rev 2011;34:265–77Google Scholar
5Fusco, MR, Fisher, WS, McGrew, BM, Walters, BC. Current practices in vestibular schwannoma management: a survey of American and Canadian neurosurgeons. Clin Neurol Neurosurg 2014;127:143–8Google Scholar
6Sakamoto, GT, Blevins, N, Gibbs, IC. Cyberknife radiotherapy for vestibular schwannoma. Otolaryngol Clin North Am 2009;42:665–75Google Scholar
7German, MA, Zardouz, S, Sina, MK, Ziai, K, Djalilian, HR. Stereotactic radiosurgery for vestibular schwannomas: a survey of current practice patterns of neurotologists. Otol Neurotol 2011;32:834–7Google Scholar
8Matthies, C, Samii, M. Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation. Neurosurgery 1997;40:1–9Google Scholar
9Delbrouck, C, Hassid, S, Massager, N, Choufani, G, David, P, Devriendt, D et al. Preservation of hearing in vestibular schwannomas treated by radiosurgery using Leksell Gamma Knife: preliminary report of a prospective Belgian clinical study. Acta Otorhinolaryngol Belg 2003;57:197–204Google Scholar
10Nagel, D, Schäfer, J. Changes in cochlear microphonic response after Y-ray irradiation of the inner ear of the guinea-pig. Arch Otorhinolaryngol 1984;241:17–21Google Scholar
11Couldwell, WT, Mohan, AL. Enlargement of a vestibular schwannoma after stereotactic radiotherapy. Acta Neurochir (Wien) 2002;144:1319–22Google Scholar
12Johnson, EW. Results of auditory tests in vestibular schwannoma patients. In: House, WF, Luetje, CM, eds. Acoustic Tumors, vol. 1. Baltimore: University Park Press, 1979;209–24Google Scholar
13Brown, M, Ruckenstein, M, Bigelow, D, Judy, K, Wilson, V, Alonso-Basanta, M et al. Predictors of hearing loss after gamma knife radiosurgery for vestibular schwannomas: age, cochlear dose, and tumor coverage. Neurosurgery 2011;69:605–13Google Scholar
14Kano, H, Kondziolka, D, Khan, A, Flickinger, JC, Lunsford, LD. Predictors of hearing preservation after stereotactic radiosurgery for vestibular schwannoma: clinical article. J Neurosurg 2013;119:863–73Google Scholar
15Yang, I, Aranda, D, Han, SJ, Chennupati, S, Sughrue, ME, Cheung, SW et al. Hearing preservation after stereotactic radiosurgery for vestibular schwannoma: a systematic review. J Clin Neurosci 2009;16:742–7Google Scholar
16Roos, DE, Potter, AE, Zacest, AC. Hearing preservation after low dose linac radiosurgery for vestibular schwannoma depends on initial hearing and time. Radiother Oncol 2011;101:420–4Google Scholar
17Franzin, A, Spatola, G, Serra, C, Picozzi, P, Medone, M, Milani, D et al. Evaluation of hearing function after Gamma Knife surgery of vestibular schwannomas. Neurosurg Focus 2009;27:E3Google Scholar
18Tamura, M, Carron, R, Yomo, S, Arkha, Y, Muraciolle, X, Porcheron, D et al. Hearing preservation after gamma knife radiosurgery for vestibular schwannomas presenting with high-level hearing. Neurosurgery 2009;64:289–96Google Scholar
19Linskey, ME. Hearing preservation in vestibular schwannoma stereotactic radiosurgery: what really matters? J Neurosurg 2013;119:129–36Google Scholar
20Yamakami, I, Uchino, Y, Kobayashi, E, Yamaura, A. Conservative management, gamma-knife radiosurgery, and microsurgery for acoustic neurinomas: a systematic review of outcome and risk of three therapeutic options. Neurol Res 2003;25:682–90Google Scholar
21Tsai, JT, Lin, JW, Lin, CM, Chen, YH, Ma, HI, Jen, YM et al. Clinical evaluation of CyberKnife in the treatment of vestibular schwannomas. Biomed Res Int 2013;2013:297093Google Scholar
22Thomas, C, Di Maio, S, Ma, R, Vollans, E, Chu, C, Clark, B et al. Hearing preservation following fractionated stereotactic radiotherapy for vestibular schwannomas: prognostic implications of cochlear dose. J Neurosurg 2007;107:917–26Google Scholar
23Kim, CH, Chung, KW, Kong, DS, Nam, DH, Park, K, Kim, JH et al. Prognostic factors of hearing preservation after gamma knife radiosurgery for vestibular schwannoma. J Clin Neurosci 2010;17:214–18Google Scholar
24Smouha, EE, Yoo, M, Mohr, K, Davis, RP. Conservative management of vestibular schwannoma: a meta-analysis and proposed treatment algorithm. Laryngoscope 2005;115:450–4Google Scholar
25Timmer, FC, Hanssens, PE, van Haren, AE, Mulder, JJ, Cremers, CW, Beynon, AJ et al. Gamma knife radiosurgery for vestibular schwannomas: results of hearing preservation in relation to the cochlear radiation dose. Laryngoscope 2009;119:1076–81Google Scholar
26Paek, SH, Chung, HT, Jeong, SS, Park, CK, Kim, CY, Kim, JE et al. Hearing preservation after gamma knife stereotactic radiosurgery of vestibular schwannoma. Cancer 2005;104:580–90Google Scholar
27Hall, JW, Antonelli, PJ. Assessment of peripheral and central auditory function. In: Bailey, BJ, Johnson, JT, Newlands, SD, eds. Head & Neck Surgery: Otolaryngology, 4th edn. Philadelphia: Lippincott Williams & Wilkins, 2006;1933–4Google Scholar
28Flickinger, JC, Lunsford, LD, Linskey, ME, Duma, CM, Kondziolka, D. Gamma knife radiosurgery for acoustic tumors: multivariate analysis of four year results. Radiother Oncol 1993;27:91–8Google Scholar
29Noren, G. Gamma knife radiosurgery of acoustic neurinomas: a historic perspective. Neurochirurgie 2004;50:253–6Google Scholar
30Yang, I, Sughrue, ME, Han, SJ, Aranda, D, Pitts, LH, Cheung, SW et al. A comprehensive analysis of hearing preservation after radiosurgery for vestibular schwannoma: clinical article. J Neurosurg 2013;119:851–9Google Scholar
31Pollock, BE, Driscoll, CL, Foote, RL, Link, MJ, Gorman, DA, Bauch, CD et al. Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery. Neurosurgery 2006;59:77–85Google Scholar