{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:42:41Z","timestamp":1789785761377,"version":"4.0.1"},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2013,3]]},"abstract":"\nObject<\/jats:title>\nHearing loss after Gamma Knife surgery (GKS) in patients with vestibular schwannoma has been associated with radiation dose to the cochlea. The purpose of this study was to evaluate serviceable hearing preservation in patients with VS who were treated with GKS and to determine if serviceable hearing loss can be correlated with the dose to the cochlea.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nForty patients with vestibular schwannoma with serviceable hearing were treated using GKS with a median marginal dose of 12.5 Gy (range 12.5\u201313 Gy) to the 50% isodose volume. Audiometry was performed prospectively before and after GKS at 1, 3, and 6 months, and then every 6 months thereafter. Hearing preservation was based on pure tone average (PTA) and speech discrimination (SD). Serviceable hearing was defined as PTA less than 50 dB and SD greater than 50%.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nThe median cochlear maximum and mean doses were 6.9 Gy (range 1.6\u201316 Gy) and 2.7 Gy (range 0.7\u20135.0 Gy), respectively. With a median audiological follow-up of 35 months (range 6\u201358 months), the 1-, 2-, and 3-year actuarial rates of maintaining serviceable hearing were 93%, 77%, and 74%, respectively. No patient who received a mean cochlear dose less than 2 Gy experienced serviceable hearing loss (p = 0.035). Patients who received a mean cochlear dose less than 3 Gy had a 2-year hearing preservation rate of 91% compared with 59% in those who received a mean cochlear dose of 3 Gy or greater (p = 0.029). Those who had more than 25% of their cochlea receiving 3 Gy or greater had a higher rate of hearing loss (p = 0.030). There was no statistically significant correlation between serviceable hearing loss and age, tumor size, pre-GKS PTA, pre-GKS SD, pre-GKS Gardner-Robertson class, maximum cochlear dose, or the percentage of cochlear volume receiving 5 Gy. On multivariate analysis there was a trend toward significance for serviceable hearing loss with a mean cochlear dose of 3 Gy or greater (p = 0.074). Local control was 100% at 24 months. No patient developed facial or trigeminal nerve dysfunction.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nWith a median mean cochlear dose of 2.7 Gy, the majority of patients with serviceable hearing retained serviceable hearing 3 years after GKS. A mean cochlear dose less than 3 Gy was associated with higher serviceable hearing preservation.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.10.jns12880","type":"journal-article","created":{"date-parts":[[2012,12,7]],"date-time":"2012-12-07T15:09:09Z","timestamp":1354892949000},"page":"571-578","source":"Crossref","is-referenced-by-count":69,"title":["Hearing preservation in patients with vestibular schwannoma treated with Gamma Knife surgery"],"prefix":"10.3171","volume":"118","author":[{"given":"Andrew M.","family":"Baschnagel","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, William Beaumont Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, William Beaumont Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Bojrab","sequence":"additional","affiliation":[{"name":"Michigan Ear Institute; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pieper","sequence":"additional","affiliation":[{"name":"Michigan Head and Spine Institute, Royal Oak, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Kartush","sequence":"additional","affiliation":[{"name":"Michigan Ear Institute; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oksana","family":"Didyuk","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, William Beaumont Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilka C.","family":"Naumann","sequence":"additional","affiliation":[{"name":"Michigan Ear Institute; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Maitz","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, William Beaumont Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga S.","family":"Grills","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, William Beaumont Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns12880","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1227\/NEU.0b013e31821a42f3","article-title":"Predictors of hearing loss after gamma knife radiosurgery for vestibular schwannomas: age, cochlear dose, and tumor coverage","volume":"69","author":"Brown","year":"2011"},{"key":"b2-jns12880","series-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1016\/j.ijrobp.2007.01.001","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":"b3-jns12880","series-title":"Ann Otol Rhinol Laryngol","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1177\/000348948809700110","article-title":"Hearing preservation in unilateral acoustic neuroma surgery","volume":"97","author":"Gardner","year":"1988"},{"key":"b4-jns12880","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1227\/01.NEU.0000166542.00512.84","article-title":"Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years","volume":"57","author":"Hasegawa","year":"2005"},{"key":"b5-jns12880","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1177\/019459988509300202","article-title":"Facial nerve grading system","volume":"93","author":"House","year":"1985"},{"key":"b6-jns12880","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"863","DOI":"10.3171\/2008.12.JNS08611","article-title":"Predictors of hearing preservation after stereotactic radiosurgery for acoustic neuroma. 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