{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T11:34:18Z","timestamp":1777721658068,"version":"3.51.4"},"reference-count":51,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2023,5,13]],"date-time":"2023-05-13T00:00:00Z","timestamp":1683936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>(1) To determine tumor control rates for treating growing vestibular schwannoma (VS) with CyberKnife stereotactic radiosurgery (CK SRS); (2) to determine hearing outcomes after CK SRS; (3) to propose a set of variables that could be used to predict hearing outcomes for patients receiving CK SRS for VS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case series review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>127 patients who received CK SRS for radiographically documented growing VS were reviewed. Tumors were monitored for post\u2010procedure growth radiographically with linear measurements and three\u2010dimensional segmental volumetric analysis (3D\u2010SVA). Hearing outcomes were reviewed for 109 patients. Cox proportional hazard modeling was used to identify variables correlated with hearing outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Tumor control rate was 94.5% for treating VS with CK SRS. Hearing outcomes were categorized using the American Academy of Otolaryngology\u2010Head and Neck Surgery (AAO\u2010HNS) classification system. As of their last available audiogram, 33.3% of patients with pre\u2010treatment class A and 26.9% of patients with class B retained their hearing in that class. 15.3% of patients starting with class A or B with extended follow\u2010up (&gt;60\u2009months), maintained hearing within this same grouping. Our final model proposed to predict hearing outcomes included age, fundal cap distance (FCD), tumor volume, and maximum radiation dose to the cochlea; however, FCD was the only statistically significant variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CK SRS is an effective treatment for control of VS. Hearing preservation by class was achieved in a third of patients. Finally, FCD was found to be protective against hearing loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:S1\u2013S12, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30731","type":"journal-article","created":{"date-parts":[[2023,5,13]],"date-time":"2023-05-13T11:15:11Z","timestamp":1683976511000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["CyberKnife Stereotactic Radiosurgery for Growing Vestibular Schwannoma: Longitudinal Tumor Control, Hearing Outcomes, and Predicting Post\u2010Treatment Hearing Status"],"prefix":"10.1002","volume":"134","author":[{"given":"Douglas M.","family":"Hildrew","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2014Head and Neck Surgery, Department of Surgery Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip L.","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology School of Medicine, University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2682-3297","authenticated-orcid":false,"given":"Leila J.","family":"Mady","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Johns Hopkins School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinhong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Public Health, University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5888-668X","authenticated-orcid":false,"given":"Marci L.","family":"Nilsen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology School of Medicine, University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."},{"name":"Department of Acute and Tertiary Care, School of Nursing University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1363-8949","authenticated-orcid":false,"given":"Barry E.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology School of Medicine, University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001169"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-015-1827-9"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.2.216"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002936"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200503000-00011"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2005.103.1.0059"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.1.JNS121370"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27568"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815590105"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27421"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.01.037"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.5.JNS111858"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2015.02.003"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.3171\/2008.3.17473"},{"issue":"8","key":"e_1_2_7_16_1","first-page":"464P","article-title":"The bloody angle: 100\u2009years of acoustic neuroma surgery","volume":"88","author":"Ramsden RT","year":"1995","journal-title":"J R Soc Med"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.3171\/2011.7.JNS11749"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000335783.70079.85"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.6.FOCUS12192"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.11.JNS131552"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000159650.79833.2B"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e31821e192f"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e318222e451"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2013.00121"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.10.010"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3182a435f5"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817695805"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000002090"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(95)70101-X"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx511"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31821a42f3"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2012.04.001"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21908"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002837"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002856"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816638314"},{"issue":"4","key":"e_1_2_7_37_1","first-page":"495","article-title":"Acoustic tumor growth: implications for treatment choices","volume":"20","author":"Fucci MJ","year":"1999","journal-title":"Am J Otol"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000169782.69341.6d"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318180a4c4"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.7.GKS12783"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215109992362"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000316858.25606.8F"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyy407"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812447766"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2019.01.046"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3181cc06cb"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2016.09.019"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818770413"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003039"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003618"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003056"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2015.08.003"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30731","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T11:50:42Z","timestamp":1704801042000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,13]]},"references-count":51,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/lary.30731"],"URL":"https:\/\/doi.org\/10.1002\/lary.30731","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,13]]},"assertion":[{"value":"2022-11-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}