title: Medication for hearing loss after fractionated stereotactic radiotherapy (SRT) for vestibular schwannoma.
abstract: OBJECTIVE
  To investigate the effectiveness of corticosteroid treatments for patients showing decreases in hearing levels after stereotactic radiotherapy for vestibular schwannoma.
  
  
  METHODS
  Twenty-one patients experienced a hearing loss in pure-tone average at greater than 20 dB or less than 10 dB within 1 year after irradiation administration of 44 Gy/22 fractions followed by a 4 Gy boost. Eight received oral prednisone at a daily dose of 30 mg, which was gradually decreased (medicated group), and 13 received none (nonmedicated group). The average observation period was 26.7 +/- 16.6 (range: 6--69) months.
  
  
  RESULTS
  Hearing recovery was seen after initial onset of the hearing loss in all 8 patients in the medicated group and in 2 of 13 patients in the nonmedicated group (p = 0.001). The hearing recovery, that is, the change in pure-tone average (dB) at the last follow-up from the onset of hearing loss, was 9.8 +/- 6.9 dB (recovery) in the medicated group and -9.4 +/- 12.8 dB (further loss) in the nonmedicated group (p = 0.0013). The hearing recovery rate, normalizing to the degree of the hearing loss before medication, was also significantly higher in the medicated group than in the nonmedicated group (p = 0.0014).
  
  
  CONCLUSIONS
  Corticosteroidal intake is suggested to be effective in improving hearing loss after stereotactic radiotherapy, at least in young patients having a useful pretreatment hearing level, if the treatment for hearing loss is administered immediately after the hearing loss is first detected.
authors.affiliation: Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Sakamoto
authors.forename: H
authors.initials: H
authors.lastname: Shirato
authors.forename: N
authors.initials: N
authors.lastname: Takeichi
authors.forename: H
authors.initials: H
authors.lastname: Aoyama
authors.forename: K
authors.initials: K
authors.lastname: Kagei
authors.forename: T
authors.initials: T
authors.lastname: Nishioka
authors.forename: S
authors.initials: S
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone; D019583:Dose Fractionation, Radiation; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications / Q000601:surgery*; D011241:Prednisone / Q000627:therapeutic use*; D011832:Radiation Injuries / Q000188:drug therapy* / Q000209:etiology; D016634:Radiosurgery / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014725:Vestibular Nerve / Q000528:radiation effects* / Q000601:surgery
chemical_list: D000893:Anti-Inflammatory Agents; D011241:Prednisone