Long-Term Hearing Outcomes in Vestibular Schwannoma Patients Treated with Stereotactic Radiosurgery

Monday, October 13, 2025

9:30 AM - 9:36 AM EDT

Location: 244

Introduction: Vestibular schwannomas (VS) can be treated with stereotactic radiosurgery (SRS) to control growth. However, the long-term impact of radiation on hearing outcomes remains poorly characterized. This study adds to the limited long-term hearing outcomes in VS patients post-SRS.

Methods: A single-institution retrospective chart review was conducted for patients with VS treated with SRS between 2001 and 2023. Data on demographics, SRS modality, and hearing outcomes were collected. Serviceable hearing was defined as PTA ≤50 dB, SRT ≤50 dB, and WRS ≥50%. Kaplan-Meier (KM) analysis was used to assess serviceable hearing over time.

Results: A total of 135 patients with serviceable hearing at time of treatment were identified, with a median follow-up of 3.1 years (IQR 1.5-7.7 years). KM-estimated rates of maintaining serviceable hearing (95% CI) were 89.5% at 1 year, 76.2% at 3 years, 65.4% at 5 years, 54.9% at 7 years, and 42.0% at 10 years. For fractionated patients (n=84), KM-estimated rates of serviceable hearing were 65.9% (58.0%-74.9%) at 5 years, 53.1% (43.9-64.4%) at 7 years, and 37.7% (27.3%-52.0%) at 10 years. Rates of serviceable hearing in single-dose SRS patients (n=38) were slightly higher, 67.5.5% (53.8%-84.8%) at 5 years, 64% (49.7%- 82.2% at 7 years), and 58.1% (42.5-79.5%) at 10 years, though not reaching statistical significance, (p=0.25). No differences in hearing outcomes were noted between radiated patients above or below 65 years of age.

Conclusions: Most patients will lose serviceable hearing within 10 years of SRS for VS, with no statistically significant advantage of single-dose over fractionated therapy. Further research is needed to explore the relationship between SRS and hearing outcomes.

Presenting Author(s)

KL

Kalena H. Liu, BS

Medical Student
Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.

Co-Author(s)

PB

Pranav Bingi, BS

Medical Student
Thomas Jefferson University
Austin, TX, United States

Disclosure information not submitted.
KN

Khoa D. Nguyen, BS

Medical Student
Thomas Jefferson University
San Jose, CA, United States

Disclosure information not submitted.
RC

Rebecca C. Chiffer, MD

Assistant Professor
Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.
TW

Thomas O. Willcox, Jr., MD

Associate Professor
TJUH Dept of OTO
Philadelphia, PA, United States

Disclosure information not submitted.
CF

Christopher Farrell, MD

Thomas Jefferson University, United States

Disclosure information not submitted.
Wenyin Shi, MD

Professor, Department of Radiation Oncology
Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.

Senior Author(s)

Jacob B. Hunter, MD

Associate Professor
Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.