Hearing preservation after Gamma knife in vestibular schwannomas
Reviewed by Gauri Mankekar

This retrospective study reports the outcomes of hearing preservation up to three years after Gamma knife radiosurgery for Gardner-Robertson Class I (SDS>70% and PTA <30dB) patients with vestibular schwannomas. The authors report that patients with no subjective or objective hearing loss at diagnosis had better hearing outcomes at the end of a follow up period of 2.5 to three years after treatment. The authors conclude that radiosurgery offers the best chance of hearing preservation when carried out in vestibular schwannoma patients before they develop any subjective hearing loss. They recommend that the Gardner-Robertson classification should be modified to include class IA (patients with no subjective hearing loss and a pure tone average 15dB) and class IB (patients with subjective hearing loss and a pure tone average >15dB). The follow-up period in this study is too short and the study does not provide any data on long-term hearing preservation or tumour control, especially considering that the median age of patients in this series was 49 years. 

Hearing preservation up to 3 years after Gamma knife radiosurgery for Gardner-Robertson Class I patients with vestibular schwannomas.
Mousavi SH, Kano H, Faraji AH, Gande A, Flickinger JC, Niranjan A, Monaco E III, Lunsford LD.
NEUROSURGERY
2015;76:584–91.