Audiological Characteristics in Vestibular Schwannoma Patients

Vestibular schwannoma (VS) is a benign tumor that originates from the Schwann cells of the vestibular nerve sheath in the internal auditory canal. This retrospective study collected data from patients with VS who underwent surgical treatment to identify their demographic characteristics and audiometric features.

This retrospective study included 330 VS patients who underwent surgical treatment at the ENT Hospital of Fudan University between April 2017 and December 2019. The demographic information, audiograms, and tumor details of these patients were collected. Demographic and audiometric characteristics were summarized. Correlation analysis was performed to compare the basic characteristics of patients with tumor size, pure-tone threshold average (PTA), and tumor grades.

Among the patients, 38.8% (128/330) exhibited predominant high-frequency hearing loss on pure-tone audiometry. Approximately 74.5% (246/330) of patients exhibited moderately severe or worse hearing loss. Of the 211 patients who underwent speech testing, 65.4% (138/211) did not have practical hearing function (American Academy of Otolaryngology-Head and Neck Surgery Class C&D) at the time of surgery. Correlation analysis revealed that symptom duration was the most influential variable. No correlation was found between tumor size and PTA or speech discrimination score (SDS). Multivariate ordered regression analysis identified age over 45 years, symptom duration over 12 months, symmetric threshold difference greater than 15 dB, and SDS lower than 75% as high-risk factors for higher Koos grading.

Considering the preservation of postoperative hearing, for patients with lower Koos grades (I + II)-especially for younger patients (age below 45 years) with functional hearing-if PTA increases or if SDS decreases or falls below 75% in their follow-ups, surgery or radiation intervention may be considered after a thorough evaluation, regardless of tumor growth.