Pre-existing Vestibular Symptoms Are Associated With Acute Vestibular Symptoms After Gamma Knife Therapy for Vestibular Schwannoma. Issue 6 (July 2021)

• Record Type: Journal Article
• Authors: Bojrab, Dennis I.; Fritz, Christian G.; Lin, Kenny F.; Schutt, Christopher A.; Hong, Robert S.; Babu, Seilesh C.; Chen, Peter Y.; Maitz, Ann; Bojrab, Dennis I.
• Is Part Of: Otology & neurotology. Volume 42:Issue 6(2021)
• Publication Date: 2021-07
• Subjects: Adverse radiation effects -- Stereotactic radiosurgery -- Vertigo -- Vestibular disturbance -- Vestibular schwannoma; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000003064
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : Objective: To identify pretreatment variables associated with the development of acute vestibular symptoms after Gamma Knife (GK) treatment for Vestibular Schwannoma (VS). Study Design: Retrospective case series. Setting: Tertiary neurotology referral center. Patients: Patients treated with GK radiosurgery for VS between March 2007 and March 2017 were considered for this study. Patients with neurofibromatosis type II, previous VS surgery, follow-up less than 6 months, or the lack of T2 magnetic resonance imaging (MRI) sequences from the day of treatment were excluded. Main Outcome Measure(s): The presence of acute vestibular symptoms arising within 6 months after GK was the main outcome variable. Tumor, patient, and treatment characteristics were gathered from the medical record. Results: In total, 98 patients met inclusion criteria. The incidence of acute vestibular symptoms occurring within 6 months after GK treatment was 46.9%. Post-GK vestibular symptoms were reported at a significantly higher frequency among subjects who had reported vestibular symptoms before their treatment ( p = 0.001). Tumor size was not associated with a propensity to develop acute vestibular symptoms ( p = 0.397). The likelihood of receiving a referral to vestibular rehabilitation services was not significantly different among patients with larger versus smaller tumor size, as defined by 1.6 cm and 1.4 cm thresholds ( p = 0.896, p = 0.654). Conclusions: Inquiries aimed at revealing a history of vestibular complaints may prove useful in counseling patients on the likelihood of experiencing acute vestibular symptoms after treatment of Vestibular Schwannoma with Gamma Knife therapy.