Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T22:40:24.441Z Has data issue: false hasContentIssue false

Hearing outcomes of vestibular schwannoma patients managed with ‘wait and scan’: predictive value of hearing level at diagnosis

Published online by Cambridge University Press:  19 January 2010

S-E Stangerup*
Affiliation:
ENT Department, Gentofte University Hospital, Copenhagen, Denmark
M Tos
Affiliation:
ENT Department, Gentofte University Hospital, Copenhagen, Denmark
J Thomsen
Affiliation:
ENT Department, Gentofte University Hospital, Copenhagen, Denmark
P Caye-Thomasen
Affiliation:
ENT Department, Gentofte University Hospital, Copenhagen, Denmark
*
Address for correspondence: Associate Professor Sven-Eric Stangerup, ENT Department, Gentofte University Hospital, Niels Andersens vej 65, 2900 Hellerup, Copenhagen, Denmark. Fax: +45 48 24 76 13 E-mail: stangerup@pc.dk

Abstract

Aims:

This study aimed to evaluate the predictive value of both hearing level (at various frequencies) and speech discrimination for forecasting hearing outcome after a period of observation, in patients with vestibular schwannoma.

Subjects:

Over a 33-year period, 1144 patients with vestibular schwannoma were allocated to ‘wait and scan’ management, with annual magnetic resonance imaging and audiological examination. Two complete pure tone and speech discrimination audiograms were available for 932 patients.

Results:

The predictive value of initial hearing level better than 10 dB for forecasting hearing outcome after observation increased from 59 per cent at 250 Hz to 94 percent at 4000 Hz. At diagnosis, hearing level of 10 dB or better at 4000 Hz was found in only 18 of the 932 VS ears, while good speech discrimination was found in 159 patients (17 per cent). Of the latter patients, 138 maintained good hearing after observation.

Conclusion:

In vestibular schwannoma patients, good high frequency hearing and good speech discrimination at diagnosis are useful tools in predicting good hearing after observation.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

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.)

References

1Kaylie, DM, Gilbert, E, Horgan, MA, Delashaw, JB, McMenomey, SO. Acoustic neuroma surgery outcomes. Otol Neurotol 2001;22:686–9CrossRefGoogle ScholarPubMed
2Gormley, WB, Sekhar, LN, Wright, DC, Kamerer, D, Schessel, D. Acoustic neuromas: results of current surgical management. Neurosurgery 1997;41:50–8CrossRefGoogle ScholarPubMed
3Martin, TP, Tzifa, K, Kowalski, C, Holder, RL, Walsh, R, Irving, RM. Conservative versus primary surgical treatment of acoustic neuromas: a comparison of rates of facial nerve and hearing preservation. Clin Otolaryngol 2008;33:228–35CrossRefGoogle ScholarPubMed
4Smouha, EE, Yoo, M, Mohr, K, Davis, RP. Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm. Laryngoscope 2005;115:450–4CrossRefGoogle ScholarPubMed
5Meyer, TA, Canty, PA, Wilkinson, EP, Hansen, MR, Rubinstein, JT, Gantz, BJ. Small acoustic neuromas: surgical outcomes versus observation or radiation. Otol Neurotol 2006;27:380–92CrossRefGoogle ScholarPubMed
6Evans, DG, Birch, JM, Ramsden, RT, Sharif, S, Baser, ME. Malignant transformation and new primary tumours after therapeutic radiation for benign disease: substantial risks in certain tumour prone syndromes. J Med Genet 2006;43:289–94CrossRefGoogle ScholarPubMed
7Shin, M, Ueki, K, Kurita, H, Kirino, T. Malignant transformation of a vestibular schwannoma after gamma knife radiosurgery. Lancet 2002;360:309–10CrossRefGoogle ScholarPubMed
8Stangerup, SE, Caye-Thomasen, P, Tos, M, Thomsen, J. Change in hearing during ‘wait and scan’ management of patients with vestibular schwannoma. J Laryngol Otol 2008;122:673–81CrossRefGoogle ScholarPubMed
9Kanzaki, J, Tos, M, Sanna, M, Moffat, DA, Monsell, EM, Berliner, KI. New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma. Otol Neurotol 2003;24:642–8CrossRefGoogle ScholarPubMed
10Rosenberg, SI. Natural history of acoustic neuromas. Laryngoscope 2000;110:497508CrossRefGoogle ScholarPubMed