{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:40:49Z","timestamp":1760956849419,"version":"build-2065373602"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Stereotactic radiosurgery (SRS) is increasingly used for small\u2010to\u2010medium\u2010sized sporadic vestibular schwannoma (VS) and is associated with good tumor control and low\u2010risk of adverse radiation\u2010associated events. The exact mechanism of VS tumor control is unknown but may relate to microvascular hyalinization and resultant tumoral ischemia. This study examined associations of microvascular risk factors with outcomes following SRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Historical cohort of patients who underwent SRS for sporadic VS from 2000 to 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Associations of microvascular risk factors with tumor control and complications were evaluated using Cox proportional hazards regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total 749 patients were studied, 31% with a history of smoking, 38% obesity, 19% hypertension, 8% diabetes, 3% peripheral vascular disease, and 2% history of coronary bypass. Regarding tumor control, no factor was associated with salvage treatment following SRS (n\u2009=\u200942). Hypertension (hazard ratio [HR] 2.81; <jats:italic>P<\/jats:italic>\u2009=\u2009.02) and coronary bypass (HR 6.91; <jats:italic>P<\/jats:italic>\u2009=\u2009.002) were significantly associated with developing facial nerve paresis (n\u2009=\u200922). No significant associations with new facial spasms (n\u2009=\u200953) were identified. Lastly, 191 of 294 patients with serviceable hearing at SRS progressed to nonserviceable hearing at a median 2.0 years (interquartile range: 1.0\u20105.0). After multivariable adjustment for age and ipsilateral hearing status, the HR for the association of smoking history with time to nonserviceable hearing was 1.46 (95% confidence interval 1.04\u20102.04; <jats:italic>P<\/jats:italic>\u2009=\u2009.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We demonstrate that hypertension and history of coronary bypass may be associated with development of facial nerve weakness, while smoking may be associated with accelerated hearing loss in patients undergoing SRS for sporadic VS. These data may help guide patient counseling and inform decision\u2010making regarding treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1038","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T03:35:17Z","timestamp":1730950517000},"page":"967-973","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Microvascular Risk Factors with Sporadic Vestibular Schwannoma Outcomes Following Stereotactic Radiosurgery"],"prefix":"10.1002","volume":"172","author":[{"given":"James R.","family":"Dornhoffer","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric E.","family":"Babajanian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl R.","family":"Khandalavala","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"Marinelli","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghazal S.","family":"Daher","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine M.","family":"Lohse","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew L.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic Rochester Minnesota USA"},{"name":"Department of Neurosurgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815590105"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.8.JNS171281"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13184575"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40139-020-00205-x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2174\/1570161111311040016"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(95)70101-X"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988509300202"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.05.015"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trecan.2022.06.002"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/5975903"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011295"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1351-4"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2015.09.005"},{"issue":"4","key":"e_1_2_8_15_1","first-page":"285","article-title":"Impact of diabetes mellitus on outcomes in patients with brain metastasis treated with stereotactic radiosurgery","volume":"5","author":"LeCompte MC","year":"2018","journal-title":"J Radiosurg SBRT"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29040186"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3171\/20145.FOCUS14121"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.1038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:01:07Z","timestamp":1760954467000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.1038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,7]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/ohn.1038"],"URL":"https:\/\/doi.org\/10.1002\/ohn.1038","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"type":"print","value":"0194-5998"},{"type":"electronic","value":"1097-6817"}],"subject":[],"published":{"date-parts":[[2024,11,7]]},"assertion":[{"value":"2024-08-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}