Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Otolaryngol Head Neck Surg. 2020 Apr;162(4):530-537. doi: 10.1177/0194599819900396. Epub 2020 Jan 28.
To ascertain the relationship among vestibular schwannoma (VS) tumor volume, growth, and hearing loss.
Retrospective cohort study.
Single tertiary center.
Adults with observed VS and serviceable hearing at diagnosis were included. The primary outcome was the development of nonserviceable hearing as estimated using the Kaplan-Meier method. Associations of tumor volume with baseline hearing were assessed using Spearman rank correlation coefficients. Associations of volume and growth with the development of nonserviceable hearing over time were assessed using Cox proportional hazards models and summarized with hazard ratios (HRs).
Of 230 patients with VS and serviceable hearing at diagnosis, 213 had serial volumetric tumor data for analysis. Larger tumor volume at diagnosis was associated with increased pure-tone average (PTA) ( < .001) and decreased word recognition score (WRS) ( = .014). Estimated rates of maintaining serviceable hearing at 6 and 10 years following diagnosis were 67% and 49%, respectively. Larger initial tumor volume was associated with development of nonserviceable hearing in a univariable setting (HR for 1-cm increase: 1.36, = .040) but not after adjusting for PTA and WRS. Tumor growth was not significantly associated with time to nonserviceable hearing (HR, 1.57; = .14), although estimated rates of maintaining serviceable hearing during observation were poorer in the group that experienced growth.
Larger initial VS tumor volume was associated with poorer hearing at baseline. Larger initial tumor volume was also associated with the development of nonserviceable hearing during observation in a univariable setting; however, this association was not statistically significant after adjusting for baseline hearing status.
确定听神经鞘瘤（VS）肿瘤体积、生长与听力损失之间的关系。
回顾性队列研究。
单一体位三级中心。
纳入诊断时存在可观察到的 VS 和可利用听力的成年人。主要结局是使用 Kaplan-Meier 方法估计不可用听力的发展。使用 Spearman 秩相关系数评估肿瘤体积与基线听力的相关性。使用 Cox 比例风险模型评估体积和生长与随时间发展不可用听力的相关性，并使用风险比（HR）进行总结。
在 230 例诊断时具有 VS 和可利用听力的患者中，213 例具有连续的肿瘤体积数据进行分析。诊断时更大的肿瘤体积与纯音平均听力（PTA）升高（ <.001）和言语识别率（WRS）降低（ =.014）相关。诊断后 6 年和 10 年保持可利用听力的估计率分别为 67%和 49%。在单变量设置中，更大的初始肿瘤体积与不可用听力的发展相关（每增加 1cm 的 HR：1.36， <.001），但在调整 PTA 和 WRS 后则不相关。肿瘤生长与不可用听力的时间无显著相关性（HR，1.57； <.001），尽管在经历生长的组中观察期间保持可利用听力的估计率更差。
更大的初始 VS 肿瘤体积与基线时听力较差相关。更大的初始肿瘤体积也与观察期间不可用听力的发展相关，但在调整基线听力状态后，这种相关性无统计学意义。
