title: Efficacy of corticosteroids in hearing preservation after radiosurgery for vestibular schwannoma: a prospective study.
abstract: OBJECTIVE
  We prospectively investigated the efficacy of corticosteroid medication in salvaging acute hearing deterioration after radiosurgery for vestibular schwannoma (VS) and analyzed prognostic factors for hearing preservation.
  
  
  METHODS
  Forty-one patients with serviceable hearing treated with gamma knife radiosurgery between 2004 and 2006 were included. Nineteen patients who suffered acute hearing deterioration after radiosurgery were treated with oral corticosteroids. The efficacy of corticosteroids was compared with the results of a historical observation group of 15 patients who had experienced hearing deterioration but who had not taken corticosteroids.
  
  
  RESULTS
  The tumor control rate and serviceable hearing preservation rate at the last follow-up were 97.6 and 61%, respectively. There was no significant difference in the actuarial serviceable hearing preservation rates between the corticosteroid treatment group and the historical observation group (p = 0.519). However, the mean pure-tone averages were significantly different between the 2 groups (51.5 vs. 63.7 dB; p = 0.025). Multivariate analysis revealed that preradiosurgery hearing status and transient volume expansion were prognostic factors for hearing preservation (p = 0.013 and p = 0.029, respectively).
  
  
  CONCLUSIONS
  This study demonstrates the possibility that corticosteroid medication may improve acute hearing deterioration after radiosurgery in VS patients. Further studies on optimal corticosteroid medication for managing acute hearing deterioration after radiosurgery are mandatory.
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Kim
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Paek
authors.forename: Hyun-Tai
authors.initials: HT
authors.lastname: Chung
authors.forename: Yong Hwy
authors.initials: YH
authors.lastname: Kim
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Han
authors.forename: Chul-Kee
authors.initials: CK
authors.lastname: Park
authors.forename: Hee-Won
authors.initials: HW
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D034381:Hearing Loss / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009464:Neuroma, Acoustic / Q000188:drug therapy / Q000601:surgery*; D011446:Prospective Studies; D016634:Radiosurgery; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents