{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:09:02Z","timestamp":1791374942013,"version":"4.3.1"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,12]]},"abstract":"\nObject<\/jats:title>\nGamma Knife surgery (GKS) has been a safe and effective treatment for small- to medium-sized vestibular schwannomas (VSs) over relatively long-term outcomes. However, even with recent radiosurgical techniques, hearing results following GKS remain unsatisfactory. The purpose of this study was to evaluate the hearing preservation rate as well as factors related to hearing preservation in patients with VSs and serviceable hearing who were treated with GKS.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nAmong patients with Gardner-Robertson (GR) Class I or II serviceable hearing and VSs treated with GKS between 1991 and 2009, 117 were evaluable via periodic MR imaging and audiometry.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nThe median age at the time of GKS was 52 years. Four patients (3%) had undergone prior surgery. Fifty-six patients (48%) had GR Class I hearing and 61 (52%) had GR Class II hearing at the time of GKS. The median tumor volume was 1.9 cm3<\/jats:sup>. The median maximum and tumor margin radiation doses were 24 and 12 Gy, respectively. The median follow-up periods for MR imaging and audiometry were 74 and 38 months, respectively. The overall tumor control rate was 97.5%. Actuarial 3-, 5-, and 8-year hearing preservation rates were 55%, 43%, and 34%, respectively. On multivariate analysis, GR hearing class at the time of GKS and the mean cochlear dose affected hearing preservation significantly. In a limited number of patients who were treated using the most recent dose planning techniques and who had GR Class I hearing before treatment, the 3- and 5-year hearing preservation rates increased to 80% and 70%, respectively.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nFor the majority of patients with small- to medium-sized VSs, GKS was an effective and reasonable alternative to resection with satisfactory long-term tumor control. Factors related to hearing preservation included a GR Class I hearing pre-GKS and a lower mean cochlear radiation dose. To retain serviceable hearing, it is important to apply GKS treatment while patients retain GR Class I hearing.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.7.jns11749","type":"journal-article","created":{"date-parts":[[2011,8,26]],"date-time":"2011-08-26T14:12:22Z","timestamp":1314367942000},"page":"1078-1086","source":"Crossref","is-referenced-by-count":105,"title":["Factors associated with hearing preservation after Gamma Knife surgery for vestibular schwannomas in patients who retain serviceable hearing"],"prefix":"10.3171","volume":"115","author":[{"given":"Toshinori","family":"Hasegawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihisa","family":"Kida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takenori","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Iizuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns11749","series-title":"Neurosurg Rev","first-page":"265","article-title":"A review of treatment modalities for vestibular schwannoma","volume":"34","author":"Arthurs","year":"2011"},{"key":"b2-jns11749","series-title":"Otol Neurotol","first-page":"705","article-title":"Comparison of growth patterns of acoustic neuromas with and without radiosurgery","volume":"27","author":"Battaglia","year":"2006"},{"issue":"3 Suppl","key":"b3-jns11749","series-title":"Int J Radiat Oncol Biol Phys","first-page":"S50","article-title":"Radiation therapy and hearing loss","volume":"76","author":"Bhandare","year":"2010"},{"key":"b4-jns11749","series-title":"J Neurooncol","first-page":"281","article-title":"Factors associated with preservation of facial nerve function after surgical resection of vestibular schwannoma","volume":"102","author":"Bloch","year":"2011"},{"key":"b5-jns11749","series-title":"Int J Radiat Oncol Biol Phys","first-page":"845","article-title":"Long-term follow-up of acoustic schwannoma radiosurgery with marginal tumor doses of 12 to 13 Gy","volume":"68","author":"Chopra","year":"2007"},{"key":"b6-jns11749","series-title":"Int J Radiat Oncol Biol Phys","first-page":"109","article-title":"Tolerance of normal tissue to therapeutic irradiation","volume":"21","author":"Emami","year":"1991"},{"key":"b7-jns11749","series-title":"Int J Radiat Oncol Biol Phys","first-page":"225","article-title":"Acoustic neuroma radiosurgery with marginal tumor doses of 12 to 13 Gy","volume":"60","author":"Flickinger","year":"2004"},{"key":"b8-jns11749","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1153","article-title":"Stereotactic radiosurgery using the gamma knife for acoustic neuromas","volume":"32","author":"Foote","year":"1995"},{"issue":"6","key":"b9-jns11749","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Evaluation of hearing function after Gamma Knife surgery of vestibular schwannomas","volume":"27","author":"Franzin","year":"2009"},{"key":"b10-jns11749","series-title":"Ann Otol Rhinol Laryngol","first-page":"55","article-title":"Hearing preservation in unilateral acoustic neuroma surgery","volume":"97","author":"Gardner","year":"1988"},{"issue":"Suppl","key":"b11-jns11749","series-title":"J Neurosurg","first-page":"128","article-title":"Gamma Knife surgery in vestibular schwannomas: impact on the anterior and posterior labyrinth","volume":"113","author":"Gerosa","year":"2010"},{"key":"b12-jns11749","series-title":"Neurosurgery","first-page":"257","article-title":"Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years","volume":"57","author":"Hasegawa","year":"2005"},{"key":"b13-jns11749","series-title":"J Neurosurg","first-page":"10","article-title":"Long-term outcomes in patients with vestibular schwannomas treated using gamma knife surgery: 10-year follow up","volume":"102","author":"Hasegawa","year":"2005"},{"key":"b14-jns11749","series-title":"J Neurosurg","first-page":"863","article-title":"Predictors of hearing preservation after stereotactic radiosurgery for acoustic neuroma. 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