{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T05:06:03Z","timestamp":1764047163189,"version":"build-2065373602"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T00:00:00Z","timestamp":1675555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study evaluates the natural course of hearing loss (HL) prior to treatment in patients with progressive tumors and an indication for active intervention. Evaluating this patient group specifically can put hearing outcomes after vestibular schwannoma therapy into an adequate context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Inclusion criteria comprised unilateral vestibular schwannomas prior to active treatment, with \u22652\u2009mm extracanalicular (EC) tumor growth and \u22652 audiograms. We performed a comprehensive assessment of hearing using multiple outcome parameters including (the annual decrease in) pure\u2010tone averages (PTAs; an average of 0.5, 1, 2, and 3\u2009kHz). Predictors for HL were evaluated (patient age, tumor size\/progression, follow\u2010up duration, baseline hearing).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At presentation, 86% of patients suffered from sensorineural HL on the affected side (\u226520\u2009dB PTA) with a median of 39\u2009dB (interquartile rate [IQR]: 27\u201051\u2009dB). The median follow\u2010up duration was 21 months (IQR: 13\u201034 months), after which 58% (187\/322) of patients experienced progressive HL (\u226510\u2009dB), with a median increase of 6.4\u2009dB\/year. At the last follow\u2010up, the median PTA was 56\u2009dB (IQR: 37\u201073). Median speech discrimination scores deteriorated from 90% (IQR: 70%\u2010100%) to 65% (IQR: 35%\u2010100%). Tumor progression (maximal EC diameter) was significantly correlated to the progression of sensorineural HL, corrected for follow\u2010up (<jats:italic>F<\/jats:italic>(2,228)\u2009=\u200910.4, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20098%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The majority of patients (58%) with radiologically confirmed progressive vestibular schwannomas experience progressive sensorineural HL during observation. Tumor progression rate, EC\u00a0tumor extension, and longer follow\u2010up are factors associated with more sensorineural HL.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.277","type":"journal-article","created":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T21:28:11Z","timestamp":1675632491000},"page":"622-632","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Course of Hearing Loss in Patients With a Progressive Vestibular Schwannoma"],"prefix":"10.1002","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2918-4750","authenticated-orcid":false,"given":"Kimberley S.","family":"Koetsier","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4174-0270","authenticated-orcid":false,"given":"Heiko","family":"Locher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radboud W.","family":"Koot","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andel G.L.","family":"van der Mey","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7946-1912","authenticated-orcid":false,"given":"Peter\u2010Paul G.","family":"van Benthem","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3955-0152","authenticated-orcid":false,"given":"Jeroen C.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4393-7421","authenticated-orcid":false,"given":"Erik F.","family":"Hensen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"The Leiden Skull Base Centre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002917"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002334"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000002089"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3181c34bda"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001914"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003563"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001190"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1676371"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003313"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(95)70101-X"},{"volume-title":"Comprehensive Management of Vestibular Schwannoma","year":"2019","author":"Carlson ML","key":"e_1_2_9_12_1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.11.JNS091752"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812458401"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812437156"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.19.230367"},{"key":"e_1_2_9_17_1","unstructured":"World Health Organization. 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