Cochlea radiation dose correlates with hearing loss after stereotactic radiosurgery of vestibular schwannoma

Melanie G. Hayden Gephart, Ake Hansasuta, Raymond R. Balise, Clara Choi, Gordon T. Sakamoto, Andrew S. Venteicher, Scott G. Soltys, Iris C. Gibbs, Griffith R. Harsh, John R. Adler, Steven D. Chang

Research output: Contribution to journalReview article

20 Scopus citations

Abstract

Objective: For multisession radiosurgery, no published data relate the volume and dose of cochlear irradiation to quantified risk of hearing loss. We conducted a retrospective, dosimetric study to evaluate the relationship between hearing loss after stereotactic radiosurgery (SRS) and the dose-volume of irradiated cochlea. Methods: Cochlear dose data were retrospectively collected on consecutive patients who underwent SRS (18 Gy in 3 sessions) for vestibular schwanoma between 1999 and 2005 at Stanford University Hospital. Inclusion criteria included Gardner-Robertson (GR) grade I or II hearing prior to radiosurgical treatment, complete audiograms, and magnetic resonance imaging (MRI) follow-up. A cochlea dose-volume histogram was generated for each of the 94 patients who qualified for this study. Results: GR grade I-II hearing posttreatment was maintained in 74% of patients (70/94). Median time to last follow-up audiogram was 2.4 years (range 0.4-8.9) and to last MRI was 3.6 years (range 0.5-9.4). Each higher level of cochlear irradiation was associated with increased risk of hearing loss. Larger cochlear volume was associated with lower risk of hearing loss. Controlling for differences in cochlear volume among subjects, each additional mm3 of cochlea receiving 10 to 16 Gy (single session equivalent doses of 6.6-10.1 Gy3) significantly increased the odds of hearing loss by approximately 5%. Conclusions: Larger cochlear volume is associated with lower risk of hearing loss following trisession SRS for vestibular schwannoma. Controlling for this phenomenon, higher radiation dose and larger irradiated cochlear volume are significantly associated with higher risk of hearing loss. This study confirms and quantifies the risk of hearing loss following trisession SRS for vestibular schwannoma.

Original languageEnglish (US)
Pages (from-to)359-363
Number of pages5
JournalWorld neurosurgery
Volume80
Issue number3-4
DOIs
StatePublished - Sep 2013

Keywords

  • Cochlea
  • Hearing preservation
  • Radiation
  • Stereotactic radiosurgery
  • Vestibular schwannoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Cochlea radiation dose correlates with hearing loss after stereotactic radiosurgery of vestibular schwannoma'. Together they form a unique fingerprint.

  • Cite this

    Hayden Gephart, M. G., Hansasuta, A., Balise, R. R., Choi, C., Sakamoto, G. T., Venteicher, A. S., Soltys, S. G., Gibbs, I. C., Harsh, G. R., Adler, J. R., & Chang, S. D. (2013). Cochlea radiation dose correlates with hearing loss after stereotactic radiosurgery of vestibular schwannoma. World neurosurgery, 80(3-4), 359-363. https://doi.org/10.1016/j.wneu.2012.04.001