{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:11:01Z","timestamp":1792134661550,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,4]],"date-time":"2024-02-04T00:00:00Z","timestamp":1707004800000},"content-version":"vor","delay-in-days":34,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016275","name":"Seoul National University Bundang Hospital","doi-asserted-by":"publisher","award":["13\u20102023\u20100014"],"award-info":[{"award-number":["13\u20102023\u20100014"]}],"id":[{"id":"10.13039\/100016275","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The mechanism of hearing loss following stereotactic radiosurgery (SRS) for vestibular schwannomas (VSs) remains unclear. There is conflicting evidence regarding cochlear nerve damage by transient volume expansion of VSs after radiosurgery and radiation\u2010induced cochlear damage. This study aimed to investigate whether there is a specific patient population that can achieve definite hearing preservation after SRS for VSs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 37 consecutive patients with sporadic unilateral intracanalicular VSs and serviceable hearing (Gardner\u2010Roberson [G\u2010R] class I or II) were treated with SRS from 2009 to 2023. This is a retrospective study. Survival analysis with Cox regression for hearing deterioration was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age was 55\u2009years old. The median tumor volume was 0.089\u2009cm<jats:sup>3<\/jats:sup>, and the median marginal dose was 12.0\u2009Gy. Nonserviceable hearing deterioration occurred in 9 patients (24.3%), with a median onset of 11.9\u2009months after SRS. The actuarial rates of serviceable hearing preservation were 86%, 82%, and 70% at 1, 2, and 3\u2009years after SRS, respectively. In a multivariate analysis, only baseline pure tone average &gt; 30\u2009dB increased the risk of nonserviceable hearing deterioration with significant hazard ratio. There were 13 patients with petit VSs whose tumor volume was smaller than 0.05\u2009cm<jats:sup>3<\/jats:sup>, and 11 of them were treated by a 4\u2010mm single shot with a marginal dose of 12\u2009Gy. None of the 13 patients had nonserviceable hearing deterioration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Petit VSs that can be treated with 4\u2010mm single or double shots with a marginal dose of 12\u2009Gy may achieve hearing preservation after SRS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6990","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T05:14:01Z","timestamp":1707110041000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Hearing preservation after stereotactic radiosurgery for sporadic intracanalicular vestibular schwannomas classified as Koos grade 1"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2143-410X","authenticated-orcid":false,"given":"Ho","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Seoul National University Bundang Hospital, Seoul National 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