Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Otol Neurotol. 2023 Sep 1;44(8):817-821. doi: 10.1097/MAO.0000000000003947. Epub 2023 Jul 7.
We reviewed a cohort of patients with untreated sporadic vestibular schwannoma (VS) and examined the relationship between high-frequency hearing loss (HFHL) in the non-VS ear and long-term hearing outcomes in the VS-affected ear. We hypothesized that the progression of HFHL is associated with accelerated hearing decline in sporadic VS.
Retrospective cohort study.
Tertiary center.
We studied 102 patients with sporadic VS diagnosed from 1999 to 2015 with ≥5 years of observation (median, 6.92; interquartile range, 5.85-9.29). Sixty-six patients had AAO-HNS class A/B hearing at presentation and were included in analysis.
Audiometry, serial magnetic resonance imaging for observation of VS.
Four-frequency pure tone average (PTA) and word recognition scores (WRS) in the VS-affected ear. Decline in high-frequency PTA (average of thresholds at 4000, 6000, and 8,000 Hz) was defined as ≥10 dB during the study period. Decline in WRS was defined as ≥10%.
Compared with those without, patients with progressive HFHL in the non-VS ear were more likely to experience a decline in WRS in the VS ear (80% vs. 54%, p = 0.031). However, the same group showed no difference (52% vs. 41%, p = 0.40) in decline in PTA of the VS ear.
Patients with observed VS who experience progressive HFHL in the non-VS ear are more likely to experience significant declines in speech understanding in the VS-affected ear over time. Patients with a history of presbycusis may have an increased risk of losing serviceable hearing because of sporadic VS.
我们回顾了一组未经治疗的散发性前庭神经鞘瘤（VS）患者，并研究了非 VS 耳高频听力损失（HFHL）与 VS 受累耳长期听力结果之间的关系。我们假设 HFHL 的进展与散发性 VS 的听力下降加速有关。
回顾性队列研究。
三级中心。
我们研究了 1999 年至 2015 年间诊断为散发性 VS 的 102 例患者，随访时间≥5 年（中位数为 6.92；四分位距为 5.85-9.29）。66 例患者在就诊时具有 AAO-HNS 分级 A/B 听力，纳入分析。
听力测试，连续磁共振成像观察 VS。
受影响耳的纯音平均听阈（4 个频率）（PTA）和言语识别率（WRS）。研究期间高频 PTA 下降定义为≥10dB（4000、6000 和 8000Hz 的阈值平均值）。WRS 下降定义为≥10%。
与无进展性 HFHL 的患者相比，非 VS 耳有进展性 HFHL 的患者在 VS 耳的 WRS 下降更常见（80%比 54%，p=0.031）。然而，同一组在 VS 耳 PTA 下降方面没有差异（52%比 41%，p=0.40）。
患有观察性 VS 的患者，其非 VS 耳出现进行性 HFHL，随着时间的推移，更有可能出现 VS 受累耳言语理解能力的显著下降。有听力老化病史的患者可能因散发性 VS 而失去可利用听力的风险增加。
