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Hearing Outcomes in Conservatively Managed Vestibular Schwannoma Patients With Serviceable Hearing.
Otol Neurotol ; 39(8): e704-e711, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30036205
ABSTRACT

OBJECTIVE:

To characterize the risk of progression to nonserviceable hearing in patients with sporadic vestibular schwannomas (VS) who elect initial observation. STUDY

DESIGN:

Retrospective case series.

SETTING:

Two tertiary care centers. PATIENTS VS patients with serviceable hearing who underwent at least two audiograms and two MRI studies before intervention or loss to follow-up. MAIN OUTCOME MEASURE(S) Serviceable hearing, defined as the pure tone average ≤ 50 dB HL and word recognition score ≥ 50%.

RESULTS:

Four-hundred sixty-six patients (median age of 57 yr and median tumor diameter of 7.3 mm) had serviceable hearing at presentation and were followed for a median of 2.3 years (IQR 1.0 - 4.0). Kaplan-Meier estimated rates of maintaining serviceable hearing (95% CI; number still at risk) at 1, 3, 5, 7, and 10 years following diagnosis were 94% (91-96; 357), 77% (73-82; 172), 66% (60-73; 81), 56% (49-65; 31), and 44% (33-59; 10), respectively. Each 10-dB increase in pure-tone averages at diagnosis was associated with a 2-fold increased likelihood of developing nonserviceable hearing (hazard ratio 2.07; p < 0.001). Each 10% decrease in word recognition score was associated with a 1.5-fold increased likelihood of developing nonserviceable hearing (hazard ratio 1.48; p < 0.001).

CONCLUSIONS:

Among patients with sporadic VS, good baseline word recognition score and low pure-tone average are jointly associated with maintenance of serviceable hearing. These data may be used to guide patient counseling and optimize management.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Neuroma Acústico / Audição Aspecto clínico: Etiologia / Prognóstico Limite: Idoso / Feminino / Humanos / Masculino / Meia-Idade Idioma: Inglês Revista: Otol Neurotol Assunto da revista: Neurologia / Otorrinolaringologia Ano de publicação: 2018 Tipo de documento: Artigo