Abstract:
OBJECTIVE:This study reviewed our experience in treating patients with vestibular schwannoma (VS) who had acute sensorineural hearing loss (ASHL) early after radiosurgery. PATIENTS AND METHODS:Seventy VS patients underwent cyberknife radiosurgery. Of them, 6 patients had ASHL early (<6 m) after radiosurgery (Group A), accounting for 8.6% prevalence. The remaining 64 patients without ASHL were assigned to Group B. Another 10 VS patients with tiny tumor and serviceable hearing adopted observation policy (Group C). All patients underwent a test battery for inner ear function, and tumor size was measured via MR imaging. RESULTS:The mean hearing level of Group A was 39 ± 16 dB before radiosurgery, which deteriorated to 67 ± 14 dB at the onset of ASHL after radiosurgery. Three months after treatment for ASHL, hearing improvement was noted in only one patient (17%). Mean tumor volumes of Group A before and after ASHL were 1.54 ± 1.48 cc and 1.33 ± 1.04 cc, respectively, showing non-significant difference. Receiver operating characteristic curve analysis revealed that the optimal cutoff value for tumor size was 1.45 cm for predicting absence of ASHL, with a sensitivity of 96% and a specificity of 67%. In contrast, Group C with mean tumor size of 0.64 ± 0.15 cm adopted observation policy, and none of them had ASHL two years after diagnosis. CONCLUSION:Prevalence of ASHL in VS patients early after radiosurgery is 8.6%, likely due to radiation injury to the cochlear nerve. Thus, when tumor size is <1.45 cm, serviceable hearing is the criteria for determining whether observation policy (with serviceable hearing) or radiosurgery (lack of serviceable hearing) is given. For those tumor sizes ranged 1.45-3.0 cm, radiosurgery is indicated regardless of hearing level.
journal_name
J Neurol Scijournal_title
Journal of the neurological sciencesauthors
Wu CH,Chen CM,Cheng PW,Young YHdoi
10.1016/j.jns.2019.02.008subject
Has Abstractpub_date
2019-04-15 00:00:00pages
30-35eissn
0022-510Xissn
1878-5883pii
S0022-510X(19)30069-3journal_volume
399pub_type
杂志文章abstract::A 31/2-year-old girl presented with frequent falls. She had an unsteady gait, delayed behavioural development absent tendon reflexes and in the legs decreased strength tone and equivocal plantar responses. She then developed ataxia, nystagmus, choreoathetosis, cranial nerve palsies, diminished strength and tone in the...
journal_title:Journal of the neurological sciences
pub_type: 杂志文章
doi:10.1016/0022-510x(85)90022-x
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Multiple sclerosis (MS) has been consistently associated with the HLA-DR2 haplotype and particularly with the HLA-DRB1*15 allele. Epistatic interactions between both parental alleles in the DRB1 loci have been shown to modify the MS susceptibility risk. This study investigated the frequencies o...
journal_title:Journal of the neurological sciences
pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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journal_title:Journal of the neurological sciences
pub_type: 杂志文章
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journal_title:Journal of the neurological sciences
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journal_title:Journal of the neurological sciences
pub_type: 临床试验,杂志文章
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journal_title:Journal of the neurological sciences
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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journal_title:Journal of the neurological sciences
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journal_title:Journal of the neurological sciences
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pub_type: 杂志文章
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journal_title:Journal of the neurological sciences
pub_type: 杂志文章
doi:10.1016/j.jns.2006.03.013
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pub_type: 杂志文章,meta分析,评审
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journal_title:Journal of the neurological sciences
pub_type: 杂志文章
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journal_title:Journal of the neurological sciences
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journal_title:Journal of the neurological sciences
pub_type: 杂志文章
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更新日期:1994-12-20 00:00:00
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journal_title:Journal of the neurological sciences
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journal_title:Journal of the neurological sciences
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journal_title:Journal of the neurological sciences
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journal_title:Journal of the neurological sciences
pub_type: 杂志文章
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journal_title:Journal of the neurological sciences
pub_type: 杂志文章
doi:
更新日期:1996-08-01 00:00:00
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