Stereotactic radiosurgery for vestibular schwannoma reduces tumor size over prolonged follow-up periods, but it alters audiometric and tinnitus classifications without significantly shifting overall quality of life or perceived hearing handicap, Cureus reported. The prospective study tracked 30 patients treated between January 2017 and June 2020 at the Hospital de Câncer Araújo Jorge in Goiânia, Brazil.
Audiometric Shifts and Tinnitus Reductions After Treatment
Patients underwent pure-tone and speech audiometry evaluations before radiosurgery and at a mean follow-up of 21 months, ranging from three to 48 months. Audiometric classifications showed a significant redistribution across the cohort following the procedure. Fewer patients remained in American Academy of Otolaryngology – Head and Neck Surgery category B, dropping with a p-value of 0.031, while more patients shifted into category C, rising with a p-value of 0.044.
Tinnitus symptoms showed distinct changes according to the Tinnitus Handicap Inventory assessments. The proportion of patients classified as having mild tinnitus increased, while those classified as having severe tinnitus decreased, with respective p-values of 0.020 and 0.031. However, self-perceived hearing handicap measured by the Hearing Handicap Inventory for Adults and overall quality of life measured by the WHOQOL-BREF instrument showed no statistically significant category changes.
Tumor Size Reduction and Intracochlear Radiation Dosimetry
Investigators observed significant tumor size reduction specifically in patients who completed at least 24 months of follow-up, recording a p-value of 0.02.
Researchers analyzed intracochlear radiation doses by categorizing patients into three distinct ranges: 5 Gy or less, greater than 5 Gy and up to 10 Gy, and greater than 10 Gy. Despite evaluating these dosimetric ranges against auditory outcomes, the analysis detected no significant association between the intracochlear radiation dose received and the evaluated audiological results. Study authors noted that these findings require cautious interpretation due to the small sample size of 30 evaluated participants.
Frequently Asked Questions About Vestibular Schwannoma Radiosurgery
What is a vestibular schwannoma?
Vestibular schwannoma is the most common benign tumor of the posterior fossa, accounting for approximately 80 percent of cerebellopontine angle tumors. It frequently causes hearing loss, ipsilateral tinnitus, and balance disorders.
What equipment was used to deliver the radiation treatment?
Patients underwent stereotactic radiosurgery using a Novalis TX linear accelerator system from Varian Medical Systems integrated with a Brainlab stereotactic system, utilizing a mean single-fraction dose of 12.5 Gy.
Who was eligible to participate in the study?
Eligible participants were adults aged 18 years or older diagnosed with vestibular schwannoma measuring 3.5 cm or less in diameter who were scheduled to undergo stereotactic radiosurgery between January 2017 and June 2020 at Hospital de Câncer Araújo Jorge.
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