Hearing loss and volumetric growth rate in untreated vestibular schwannoma.

Autor:	Gurewitz J; Departments of1Neurosurgery and., Schnurman Z; Departments of1Neurosurgery and., Nakamura A; Departments of1Neurosurgery and., Navarro RE; Departments of1Neurosurgery and., Patel DN; Departments of1Neurosurgery and., McMenomey SO; 2Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York., Roland JT; 2Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York., Golfinos JG; Departments of1Neurosurgery and., Kondziolka D; Departments of1Neurosurgery and.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery [J Neurosurg] 2021 Aug 20; Vol. 136 (3), pp. 768-775. Date of Electronic Publication: 2021 Aug 20 (Print Publication: 2022).
DOI:	10.3171/2021.2.JNS203609
Abstrakt:	Objective: In this study, the authors aimed to clarify the relationship between hearing loss and tumor volumetric growth rates in patients with untreated vestibular schwannoma (VS). Methods: Records of 128 treatment-naive patients diagnosed with unilateral VS between 2012 and 2018 with serial audiometric assessment and MRI were reviewed. Tumor growth rates were determined from initial and final tumor volumes, with a median follow-up of 24.3 months (IQR 8.5-48.8 months). Hearing changes were based on pure tone averages, speech discrimination scores, and American Academy of Otolaryngology-Head and Neck Surgery hearing class. Primary outcomes were the loss of class A hearing and loss of serviceable hearing, estimated using the Kaplan-Meier method and with associations estimated from Cox proportional hazards models and reported as hazard ratios. Results: Larger initial tumor size was associated with an increased risk of losing class A (HR 1.5 for a 1-cm3 increase; p = 0.047) and serviceable (HR 1.3; p < 0.001) hearing. Additionally, increasing volumetric tumor growth rate was associated with elevated risk of loss of class A hearing (HR 1.2 for increase of 100% per year; p = 0.031) and serviceable hearing (HR 1.2; p = 0.014). Hazard ratios increased linearly with increasing growth rates, without any evident threshold growth rate that resulted in a large, sudden increased risk of hearing loss. Conclusions: Larger initial tumor size and faster tumor growth rates were associated with an elevated risk of loss of class A and serviceable hearing.
Databáze:	MEDLINE
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