S-Space College of Medicine/School of Medicine (의과대학/대학원) Neurosurgery (신경외과학전공) Journal Papers (저널논문_신경외과학전공)
Hearing preservation after gamma knife stereotactic radiosurgery of vestibular schwannoma
- Paek, Sun Ha; Chung, Hyun-Tai; Jeong, Sang Soon; Park, Chul-Kee; Kim, Chae-Yong; Kim, Jeong Eun; Kim, Dong Gyu; Jung, Hee-Won
- Issue Date
- John Wiley & Sons
- Cancer. 2005 Aug 1;104(3):580-90.
- Adult; Aged; Cochlear Nerve/*pathology; Female; Follow-Up Studies; Hearing Loss/diagnosis/etiology/*prevention & control; Humans; Male; Middle Aged; Neuroma, Acoustic/pathology/*surgery; Postoperative Complications/diagnosis/etiology/*prevention & control; Prospective Studies; *Radiosurgery; Stereotaxic Techniques; Treatment Outcome; Tumor Burden
- BACKGROUND: To evaluate the hearing preservation rate and to determine its prognostic factors after gamma knife (GK) stereotactic radiosurgery (SRS) in patients with vestibular schwannoma, the authors used a prospective study design to analyze these patients. METHODS: Between December 1997 and January 2002, 25 patients with vestibular schwannoma with serviceable hearing were enrolled in the current study. The median tumor volume was 3.0 cc (0.16-9.1 cc). The prescription dose was 12.0 +/- 0.7 gray at an isodose line of 49.8 +/- 1.1%. The tumor control rate and complications were evaluated by focusing on hearing preservation and its prognostic factors. RESULTS: Based on radiologic study, the tumor control rate was 92% during the median follow-up period of 45 months. The trigeminal and facial nerve preservation rates were 95% and 100%, respectively. Thirteen (52%) of the 25 patients preserved serviceable hearing and 9 (36%) patients retained their pre-GK G-R grade levels after GK SRS. However, 16 patients showed hearing deterioration > 20 dB within 3-6 months and this trend continued for 24 months after the treatment. The maximum radiotherapy dose delivered to the cochlear nucleus was the single, significant prognostic factor of hearing deterioration. CONCLUSIONS: The authors concluded that a more sophisticated strategy to prevent hearing deterioration during the first 6 months post-GK SRS is necessary to improve long-term hearing preservation.
- 0008-543X (Print)
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