Fundal Fluid Cap Is Associated With Hearing Preservation in the Radiosurgical Treatment of Vestibular Schwannoma.

Authors

Dennis I. Bojrab 2nd, Beaumont Health Resident
Christian G. Fritz, Oakland University William Beaumont School of Medicine Student
Kenny F. Lin
Christopher A. Schutt, Beaumont Health
Robert S. Hong, Beaumont Health
Seilesh C. Babu, Beaumont Health
Peter Chen Y, Beaumont Health
Ann Maitz, Beaumont Health
Dennis I. Bojrab, Beaumont Health

Document Type

Article

Publication Date

1-2021

Publication Title

Otology & Neurotology

Abstract

OBJECTIVE: To evaluate the relationship between fundal fluid and hearing outcomes after treatment of vestibular schwannoma (VS) with Gamma Knife radiosurgery (GKRS).

STUDY DESIGN: Retrospective case series.

SETTING: Tertiary neurotology referral center.

PATIENTS: Patients treated with GKRS for vestibular schwannoma between March 2007 and March 2017 were considered for this study. Exclusion criteria included pretreatment pure-tone average (PTA) >90 dB, neurofibromatosis type II, history of previous surgical resection, and follow-up less than 1 year.

MAIN OUTCOME MEASURE(S): Hearing function was assessed both by preservation of serviceable hearing and by preservation of baseline hearing (≤20 dB change in PTA) after GKRS. Hearing preservation comparisons were made between groups of patients with and without a fundal fluid cap.

RESULTS: Patients with a fundal cap had significantly higher rates of baseline hearing preservation (≤20 dB change in PTA) according to Kaplan-Meier survival analysis of all 106 patients (p = 0.006). By the 3rd year posttreatment, 70.9% of patients with a fundal cap had maintained a ≤20 dB change in PTA, while only 43.6% of patients without a fundal fluid cap achieved this outcome (p = 0.004).

CONCLUSIONS: Fundal fluid present on pretreatment magnetic resonance imaging is predictive of improved baseline hearing preservation rates in patients undergoing GKRS for vestibular schwannoma when considering all patients with PTA ≤90 dB. Fundal fluid cap presence may serve as a favorable prognostic indicator to help set hearing expectations and guide patient selection efforts.

Volume

42

Issue

1

First Page

137

Last Page

144

Recommended Citation

Bojrab DI 2nd, Fritz CG, Lin KF, Schutt CA, Hong RS, Babu SC, Chen PY, Maitz A, Bojrab DI. Fundal Fluid Cap Is Associated With Hearing Preservation in the Radiosurgical Treatment of Vestibular Schwannoma. Otol Neurotol. 2021 Jan;42(1):137-144. doi: 10.1097/MAO.0000000000002837. PMID: 33055496.

DOI

10.1097/MAO.0000000000002837

ISSN

1537-4505

PubMed ID

33055496