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Purpose <p>Evaluate whether vestibular schwannoma (VS) size, volume, and fundal involvement of the internal auditory canal (IAC) are independent predictors of hearing outcomes at diagnosis.</p> Methods <p>Retrospective, single-center observational study (2001–2020) in a Tertiary academic French medical center for adult patients with sporadic unilateral VS who underwent clinicoradiological monitoring. Tumor size and volume were measured with Horos/ITK-SNAP. Fundus involvement was defined by the presence/absence of a T2 hyperintensity on MRI. Hearing was evaluated by interaural PTA differences and by serviceable/non-serviceable hearing according to WRS.</p> Results <p>One hundred and seventy patients were included. Unlike tumor volume, fundus involvement and tumor size were independent risk factors for hearing loss, increasing the PTA interaural threshold by + 9.07dBHL (<i>p</i> = 0.022) and + 1.35dBHL (<i>p</i> = 0.005), respectively. Fundus involvement affected mid-to-high frequencies, whereas tumor size impacted all frequencies.</p> <p>Based on WRS classification, fundus involvement was associated with increased risk of non-serviceable hearing (OR = 2.82, 95% CI [1.12–7.50]). In sensitivity analyses with multiple imputation, the association remained in the same direction but was not significant. Tumor size showed a non-linear association with non-serviceable hearing (classes C/D): a 13 mm tumor carried a 7.16-fold higher risk versus 5 mm (OR = 7.16, 95% CI [1.73–29.63]). No significant association was observed for tumors &gt; 13 mm.</p> Conclusion <p>Tumor size and IAC fundus involvement are each independent risk factors associated with increased interaural PTA difference at diagnosis. Tumor size showed a non-linear association with WRS-defined non-serviceable hearing, while fundus involvement was significant in complete-case analysis but not after multiple imputation. Tumor volume was not predictive.</p>

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Effect of the position and volume of vestibular schwannoma on hearing threshold at diagnosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月29日

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  • Alexandre Krief,
  • Claire Coutureau,
  • Quentin Gouget,
  • Esteban Brenet,
  • Marc Labrousse,
  • Jean-Charles Kleiber,
  • Ines Bouscatel,
  • Xavier Dubernard

摘要

Purpose

Evaluate whether vestibular schwannoma (VS) size, volume, and fundal involvement of the internal auditory canal (IAC) are independent predictors of hearing outcomes at diagnosis.

Methods

Retrospective, single-center observational study (2001–2020) in a Tertiary academic French medical center for adult patients with sporadic unilateral VS who underwent clinicoradiological monitoring. Tumor size and volume were measured with Horos/ITK-SNAP. Fundus involvement was defined by the presence/absence of a T2 hyperintensity on MRI. Hearing was evaluated by interaural PTA differences and by serviceable/non-serviceable hearing according to WRS.

Results

One hundred and seventy patients were included. Unlike tumor volume, fundus involvement and tumor size were independent risk factors for hearing loss, increasing the PTA interaural threshold by + 9.07dBHL (p = 0.022) and + 1.35dBHL (p = 0.005), respectively. Fundus involvement affected mid-to-high frequencies, whereas tumor size impacted all frequencies.

Based on WRS classification, fundus involvement was associated with increased risk of non-serviceable hearing (OR = 2.82, 95% CI [1.12–7.50]). In sensitivity analyses with multiple imputation, the association remained in the same direction but was not significant. Tumor size showed a non-linear association with non-serviceable hearing (classes C/D): a 13 mm tumor carried a 7.16-fold higher risk versus 5 mm (OR = 7.16, 95% CI [1.73–29.63]). No significant association was observed for tumors > 13 mm.

Conclusion

Tumor size and IAC fundus involvement are each independent risk factors associated with increased interaural PTA difference at diagnosis. Tumor size showed a non-linear association with WRS-defined non-serviceable hearing, while fundus involvement was significant in complete-case analysis but not after multiple imputation. Tumor volume was not predictive.