Efficacy of Corticosteroids in Hearing Preservation after Radiosurgery for Vestibular Schwannoma: A Prospective Study

Objectives: We prospectively investigated the efficacy of corticosteroid medication in salvaging acute hearing deterioration after radiosurgery for vestibular schwannoma (VS) and analyzed prognostic factors for hearing preservation. Methods: Forty-one patients with serviceable hearing treated with gamma knife radiosurgery between 2004 and 2006 were included. Nineteen patients who suffered acute hearing deterioration after radiosurgery were treated with oral corticosteroids. The efficacy of corticosteroids was compared with the results of a historical observation group of 15 patients who had experienced hearing deterioration but who had not taken corticosteroids. Results: The tumor control rate and serviceable hearing preservation rate at the last follow-up were 97.6 and 61%, respectively. There was no significant difference in the actuarial serviceable hearing preservation rates between the corticosteroid treatment group and the historical observation group (p = 0.519). However, the mean pure-tone averages were significantly different between the 2 groups (51.5 vs. 63.7 dB; p = 0.025). Multivariate analysis revealed that preradiosurgery hearing status and transient volume expansion were prognostic factors for hearing preservation (p = 0.013 and p = 0.029, respectively). Conclusions: This study demonstrates the possibility that corticosteroid medication may improve acute hearing deterioration after radiosurgery in VS patients. Further studies on optimal corticosteroid medication for managing acute hearing deterioration after radiosurgery are mandatory. Copyright (c) 2010 S. Karger AG, Basel