Stereotactic radiosurgery (SRS) is currently considered a valid and approved primary treatment for small to medium-size vestibular schwannoma (VS). Despite the high rate of tumor control and the high accuracy of this procedure, hearing deterioration still remain a crucial and disabling side effect. The audiological impact of deafness has significant negative effect on the quality of life in these patients and the role of hearing rehabilitation is an underestimated problems. Among available technologies, Cochlear implantation (CI) should represent a valid alternative in sporadic VS with single side deafness (SSD) and NF2 patients (with bilateral profound hearing loss). METHODS A literature review of the current clinical data was performed searching on scientific literature database such as Medline on Pubmed and Scopus. RESULTS Sixteen (16) case reports or case series were included. Forty-four patients (18 male, 19 female and in 7 cases sex were not specified; 43 NF2 and 1 sporadic VS) affected by VS underwent CI after radiosurgical treatment, were included. Post-implant audiological assessment showed an improvement related to PTA dB value in 6 papers (20 patients), a no response in quite in 13 patients and no response in noise in 16 cases. WRS was recorded in 18 patients ranging from 0-100% (average 52.1%). Eight patients recorded good or excellent recognition. No sound perception was defined in 2 patients. Only environment sound or lip reading was recorded in 7 patients. One patient was unable to performer the test. Clinical outcome al last follow-up showed an audiological improvement in 25 of the 44 patients. The audiological outcome was unchanged in 16 cases. Audiological deterioration was recorded in 3 cases. CONCLUSIONS Radiosurgery followed by CI may represent a potential emerging option in the management of patients affected by VS especially for NF2. An improvement of speech perception in noise, in sound localization with tinnitus suppression was observed
Abstract 2: The emerging role of hearing loss rehabilitation in patients with vestibular schwannoma treated with Gamma Knife Radiosurgery. Literature review / Morselli, Carlotta. - (2021). (Intervento presentato al convegno 107 Congresso Nazionale SIO e Ch-Cf tenutosi a in diretta streaming).
Abstract 2: The emerging role of hearing loss rehabilitation in patients with vestibular schwannoma treated with Gamma Knife Radiosurgery. Literature review.
Carlotta Morselli
2021
Abstract
Stereotactic radiosurgery (SRS) is currently considered a valid and approved primary treatment for small to medium-size vestibular schwannoma (VS). Despite the high rate of tumor control and the high accuracy of this procedure, hearing deterioration still remain a crucial and disabling side effect. The audiological impact of deafness has significant negative effect on the quality of life in these patients and the role of hearing rehabilitation is an underestimated problems. Among available technologies, Cochlear implantation (CI) should represent a valid alternative in sporadic VS with single side deafness (SSD) and NF2 patients (with bilateral profound hearing loss). METHODS A literature review of the current clinical data was performed searching on scientific literature database such as Medline on Pubmed and Scopus. RESULTS Sixteen (16) case reports or case series were included. Forty-four patients (18 male, 19 female and in 7 cases sex were not specified; 43 NF2 and 1 sporadic VS) affected by VS underwent CI after radiosurgical treatment, were included. Post-implant audiological assessment showed an improvement related to PTA dB value in 6 papers (20 patients), a no response in quite in 13 patients and no response in noise in 16 cases. WRS was recorded in 18 patients ranging from 0-100% (average 52.1%). Eight patients recorded good or excellent recognition. No sound perception was defined in 2 patients. Only environment sound or lip reading was recorded in 7 patients. One patient was unable to performer the test. Clinical outcome al last follow-up showed an audiological improvement in 25 of the 44 patients. The audiological outcome was unchanged in 16 cases. Audiological deterioration was recorded in 3 cases. CONCLUSIONS Radiosurgery followed by CI may represent a potential emerging option in the management of patients affected by VS especially for NF2. An improvement of speech perception in noise, in sound localization with tinnitus suppression was observedI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
