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

J Laryngol Otol. 2018 Sep;132(9):796-801. doi: 10.1017/S0022215118001500. Epub 2018 Sep 5.

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.

Keywords: CyberKnife Radiosurgery; Hearing Loss; Stereotactic Radiosurgery; Vestibular Schwannoma.

MeSH terms

  • Adult
  • Evoked Potentials, Auditory, Brain Stem / physiology
  • Female
  • Hearing / physiology*
  • Hearing Loss / complications*
  • Hearing Loss / prevention & control
  • Hearing Tests / instrumentation
  • Humans
  • Male
  • Middle Aged
  • Neuroma, Acoustic / pathology
  • Neuroma, Acoustic / radiotherapy*
  • Radiation Dosage
  • Radiosurgery / adverse effects*
  • Radiosurgery / methods
  • Retrospective Studies