Skip to main content
×
×
Home

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

  • O Çakır (a1), G Berkiten (a2), B Tutar (a2), A B Yılmazer (a2), T L Kumral (a2), Z Saltürk (a2) and Y Uyar (a2)...
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.

Copyright
Corresponding author
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
Footnotes
Hide All

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

Footnotes
References
Hide All
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;26:93–7
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;125–32
3Gardner, G, Robertson, JH. Hearing preservation in unilateral vestibular schwannoma surgery. Ann Otol Rhinol Laryngol 1988;97:5566
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;34:265–77
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;127:143–8
6Sakamoto, GT, Blevins, N, Gibbs, IC. Cyberknife radiotherapy for vestibular schwannoma. Otolaryngol Clin North Am 2009;42:665–75
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;32:834–7
8Matthies, C, Samii, M. Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation. Neurosurgery 1997;40:19
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;57:197204
10Nagel, D, Schäfer, J. Changes in cochlear microphonic response after Y-ray irradiation of the inner ear of the guinea-pig. Arch Otorhinolaryngol 1984;241:1721
11Couldwell, WT, Mohan, AL. Enlargement of a vestibular schwannoma after stereotactic radiotherapy. Acta Neurochir (Wien) 2002;144:1319–22
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;209–24
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;69:605–13
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;119:863–73
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;16:742–7
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;101:420–4
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:E3
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;64:289–96
19Linskey, ME. Hearing preservation in vestibular schwannoma stereotactic radiosurgery: what really matters? J Neurosurg 2013;119:129–36
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;25:682–90
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;2013:297093
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;107:917–26
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;17:214–18
24Smouha, EE, Yoo, M, Mohr, K, Davis, RP. Conservative management of vestibular schwannoma: a meta-analysis and proposed treatment algorithm. Laryngoscope 2005;115:450–4
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;119:1076–81
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;104:580–90
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;1933–4
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;27:91–8
29Noren, G. Gamma knife radiosurgery of acoustic neurinomas: a historic perspective. Neurochirurgie 2004;50:253–6
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;119:851–9
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;59:7785
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed