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79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

30.04. - 04.05.2008, Bonn

Radiotherapy of vestibular schwannoma: effect on the hearing

Meeting Abstract

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  • corresponding author Claudius Fauser - ENT-Clinic, Klinikum rechts der Isar of the Technical University, Munich, Germany
  • author Axel Müller - Radiotherapy-Department, Klinikum rechts der Isar of the Technical University, Munich, Germany
  • author Christine Ladar - Radiotherapy-Department, Klinikum rechts der Isar of the Technical University, Munich, Germany
  • author Anca Grosu - Radiotherapy-Department, Klinikum rechts der Isar of the Technical University, Munich, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2008/08hno07.shtml

Published: July 8, 2008

© 2008 Fauser et al.
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Outline

Text

Today, radiotherapy is considered to be a gentle treatment option in vestibular schwannoma therapy. Hearing, in particular, is supposed to be preserved better than in the microsurgical approach. The aim of this study was to evaluate how and when the hearing changed after singular or fractionated radiotherapy.

Method: 72 patients (34 female, 38 male), on average 60 years old (32 to 81), were treated with radiotherapy in a prospective trial. Depending on the tumor size, 50 patients were treated „radiosurgically“ (RS, singular 12 Gy), and 22 patients received a stereotactic, fractionated radiotherapy (SFR, cumulative dose 54 Gy). Therapy was conducted between February 1998 and May 2007, with an average follow-up of 3,4 years.

Results: The average absolute hearing loss on the radiated ear in the pure tone audiogram was 13 dB for RC and 19 dB for SFR. All frequencies were affected to the same extent. This hearing loss was progressing slowly and occurred within the first 2,5 years after RC and within the first 3,5 years after SFR. 8 patients (11%) experienced a lasting hearing improvement after the radiotherapy of 7 dB on average. 4 patients (6%), in contrast, suffered a hearing loss of more than 40 dB. The hearing loss was very variable and did not correlate with tumor size or dose of radiation.

Conclusion: Radiotherapy of vestibular schwannomas results in a slow, over 2.5–3.5 years, progressing average hearing loss of 13 to 19 dB. Hearing loss is very variable, and hearing improvement was observed in 11% of the patients.