{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:11:06Z","timestamp":1784005866229,"version":"3.55.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10]]},"abstract":"OBJECTIVE<\/jats:title>Optimizing outcomes in the management of patients with vestibular schwannomas (VSs) requires consideration of the patient\u2019s goals. Earlier recognition of VS by imaging has led to an evolution in management. Stereotactic radiosurgery (SRS) has emerged as a frequently used strategy designed to reduce management risks, obtain long-term tumor control, and preserve current neurological function. The authors analyzed features that impact hearing preservation rates in patients with serviceable hearing prior to SRS.<\/jats:p><\/jats:sec>METHODS<\/jats:title>The study included 307 patients who had serviceable hearing (Gardner-Robertson hearing scale [GR] grade 1 or 2, speech discrimination score \u2265 50%, pure tone average \u2264 50 dB) at the time of SRS. The authors evaluated parameters that included age, tumor volume, hearing status, disequilibrium, tinnitus, Koos class, sex, and tumor margin dose. The Pittsburgh Hearing Prediction Score (PHPS) was evaluated as a method to predict long-term hearing outcomes in these cases.<\/jats:p><\/jats:sec>RESULTS<\/jats:title>At a median of 7.6 years after SRS (range 1\u201323 years), tumor control was achieved in 95% of patients. The overall serviceable hearing preservation rate was 77.8% at 3 years, 68.8% at 5 years, and 51.8% at 10 years. The PHPS assigns a total of 5 points based on patient age (1 point if < 45 years, 2 points if 45\u201359 years, and 3 points if \u2265 60 years), tumor volume (0 points if < 1.2 cm3<\/jats:sup>, 1 point if \u2265 1.2 cm3<\/jats:sup>), and GR grade (0 points if grade 1 hearing, 1 point if grade 2 hearing) The serviceable hearing preservation rate was 92.3% at 10 years in patients whose score total was 1. In contrast, none of the patients whose PHPS was 5 maintained serviceable hearing at 10 years (p < 0.001).<\/jats:p><\/jats:sec>CONCLUSIONS<\/jats:title>SRS resulted in a high rate of long-term tumor control and cranial nerve preservation. The PHPS helped to predict long-term hearing preservation rates in patients who underwent SRS when they still had serviceable hearing. The best long-term hearing preservation rates were found in younger patients with smaller tumor volumes.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.5.jns182765","type":"journal-article","created":{"date-parts":[[2019,9,7]],"date-time":"2019-09-07T00:07:11Z","timestamp":1567814831000},"page":"1235-1241","source":"Crossref","is-referenced-by-count":18,"title":["Predicting hearing outcomes before primary radiosurgery for vestibular schwannomas"],"prefix":"10.3171","volume":"133","author":[{"given":"Stephen","family":"Johnson","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Kano","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Faramand","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Niranjan","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Flickinger","sequence":"additional","affiliation":[{"name":"Radiation Oncology, and"},{"name":"Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Dade","family":"Lunsford","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Int J Radiat Oncol Biol Phys","first-page":"729","article-title":"Early radiosurgery improves hearing preservation in vestibular schwannoma patients with normal hearing at the time of diagnosis","volume":"95","author":"Akpinar B","year":"2016","unstructured":"Akpinar B, Mousavi SH, McDowell MM, Niranjan A, Faraji AH, Flickinger JC, : Early radiosurgery improves hearing preservation in vestibular schwannoma patients with normal hearing at the time of diagnosis. 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