Journal article
Stereotactic Radiosurgery Versus Observation in Small- and Medium-Sized Vestibular Schwannoma Patients With Normal Hearing: A Retrospective International Multicenter Study
Neurosurgery
16 Sep 2025
PMID: 40956102
Abstract
The therapeutic approach for small- and medium-sized vestibular schwannoma (VS) with normal hearing function remains controversial, with limited comparative data regarding hearing outcomes after stereotactic radiosurgery (SRS) or observation (OBS). We evaluated the serviceable hearing preservation, loss of American Academy of Otolaryngology-Head and Neck Surgery class A hearing, and tumor control (TC) across individuals with Koos grade I and II VSs and normal hearing at presentation who underwent SRS or OBS.
In this multicenter international study, we retrospectively analyzed the hearing, radiological, and neurological outcomes of patients who underwent SRS (SRS group) or OBS (OBS group). The cohorts were matched using propensity scores based on age, sex, tumor volume, pure-tone average, and speech discrimination score at a 1:1 ratio without replacement.
After matching, each group comprised 57 patients. The median follow-up was 49 and 37 months for the SRS and the OBS groups, respectively (P = .3). The 5- and 9-year serviceable hearing preservation rates in the SRS group were 76.2% and 42.4% vs 56.1% and 16.8% in the OBS group (P = .17). Class A preservation occurred in 57.9% (33/57) of the SRS and 52.6% (30/57) of the OBS cohorts (P = .70). Regarding the TC rates, SRS was associated with significantly higher TC rates (P < .0001).
We found that SRS is significantly superior regarding TC and provided noninferior hearing outcomes compared with OBS in VS patients with American Academy of Otolaryngology-Head and Neck Surgery class A hearing at presentation. Therefore, we suggest performing SRS in individuals with VS and normal hearing function.
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Details
- Title
- Stereotactic Radiosurgery Versus Observation in Small- and Medium-Sized Vestibular Schwannoma Patients With Normal Hearing: A Retrospective International Multicenter Study
- Creators
- Bardia Hajikarimloo - University of VirginiaOthman Bin-Alamer - Loma Linda UniversitySalem M Tos - University of VirginiaGeorgios Mantziaris - University of VirginiaMariam Ishaque - University of VirginiaHussam Abou-Al-Shaar - University of Pittsburgh Medical CenterSelcuk Peker - Koç UniversityYavuz Samanci - Koç UniversityIsabelle Pelcher - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellSabrina Begley - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellAnuj Goenka - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellMichael Schulder - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellJean-Nicolas Tourigny - Université de SherbrookeDavid Mathieu - Université de SherbrookeAndréanne Hamel - Université de SherbrookeRobert G Briggs - University of Southern CaliforniaCheng Yu - University of Southern CaliforniaGabriel Zada - University of Southern CaliforniaSteven L Giannotta - University of Southern CaliforniaHerwin Speckter - Instituto Tecnológico de Santo DomingoSarai Palque - Instituto Tecnológico de Santo DomingoManjul Tripathi - Post Graduate Institute of Medical Education and ResearchSaurabh Kumar - Post Graduate Institute of Medical Education and ResearchRupinder Kaur - Post Graduate Institute of Medical Education and ResearchNarendra Kumar - Post Graduate Institute of Medical Education and ResearchBrandon Rogowski - Drexel UniversityMatthew J Shepard - Allegheny Health NetworkBryan A Johnson - Mayo Clinic in FloridaDaniel M Trifiletti - Mayo Clinic in FloridaRonald E Warnick - Jewish HospitalElad Mashiach - Manhattan Institute for Policy ResearchFernando De Nigris Vasconcellos - Manhattan Institute for Policy ResearchKenneth Bernstein - Department of Radiation Oncology, NYU Langone, Manhattan, New York, USAZane Schnurman - Manhattan Institute for Policy ResearchJuan Alzate - Manhattan Institute for Policy ResearchDouglas Kondziolka - Manhattan Institute for Policy ResearchJason P Sheehan - University of Virginia
- Publication Details
- Neurosurgery
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Other Identifier
- 991022155293404721