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射波刀治疗前庭神经鞘瘤对听力的影响:一项回顾性研究。

Effects of CyberKnife therapy for vestibular schwannoma on hearing: a retrospective study.

作者信息

Çakır O, Berkiten G, Tutar B, Yılmazer A B, Kumral T L, Saltürk Z, Uyar Y

机构信息

Department of ENT,Burdur State Hospital,Istanbul,Turkey.

Department of Otorhinolaryngology - Head and Neck Surgery,Okmeydani Training and Research Hospital,Istanbul,Turkey.

出版信息

J Laryngol Otol. 2018 Sep;132(9):796-801. doi: 10.1017/S0022215118001500. Epub 2018 Sep 5.

Abstract

OBJECTIVES

To evaluate the effects of CyberKnife stereotactic radiotherapy for the treatment of vestibular schwannoma on hearing, as evaluated by audiological tests.

METHODS

Patients with vestibular schwannoma were evaluated before and after CyberKnife radiosurgery. Evaluation included pure tone thresholds, speech discrimination scores, auditory brainstem responses and radiological signs.

RESULTS

The study comprised 26 patients diagnosed with vestibular schwannoma and subsequently treated with CyberKnife radiosurgery. The mean follow-up time was 16.4 months. The mean post-treatment hearing preservation rate was 69.23 per cent. There was no significant relationship between hearing loss after treatment and patient age, radiation dosage during treatment, or size of tumour. With regard to auditory brainstem responses, patients with hearing loss following treatment had a significantly higher inter-peak latency between waves I-III than patients with preserved hearing.

CONCLUSION

Stereotactic CyberKnife radiosurgery is an excellent alternative treatment modality for patients with vestibular schwannoma, and results in acceptable preservation of hearing. Residual hearing following CyberKnife therapy is not significantly affected by factors such as age, size of tumour or dosage of treatment.

摘要

目的

通过听力学测试评估射波刀立体定向放射治疗前庭神经鞘瘤对听力的影响。

方法

对前庭神经鞘瘤患者在射波刀放射外科手术前后进行评估。评估内容包括纯音阈值、言语辨别得分、听觉脑干反应和放射学征象。

结果

该研究纳入了26例诊断为前庭神经鞘瘤并随后接受射波刀放射外科治疗的患者。平均随访时间为16.4个月。治疗后听力保留率平均为69.23%。治疗后听力损失与患者年龄、治疗期间的放射剂量或肿瘤大小之间无显著关系。关于听觉脑干反应,治疗后听力损失的患者I-III波之间的峰间潜伏期明显高于听力保留的患者。

结论

立体定向射波刀放射外科手术是前庭神经鞘瘤患者的一种优秀替代治疗方式,能使听力得到可接受的保留。射波刀治疗后的残余听力不受年龄、肿瘤大小或治疗剂量等因素的显著影响。

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