Promotion of clinical research to improve the prognosis of vestibular schwannoma

Abstract

Since most of the initial symptoms of solitary vestibular schwannomas (VS) are auditory symptoms such as hearing loss and tinnitus, our principal research theme has been how we can improve the prognosis of VS patients from the standpoint of otologists. As more and more tumors are detected at an early stage as small tumors, our goal is to preserve hearing function and QOLs in VS patients. Specifically, we have promoted surgery by transpetrosal approach with intraoperative continuous nerve monitoring, clarified the indications for hearing conservation surgery considering preoperative OAE and ABR results, and improved the hearing conservation rate. In a multicenter, retrospective observational study, we found that acute sensorineural hearing loss in VS is characterized by recurrence in 25% of the patients by one year. Besides, we standardized the Japanese version of the VS-specific QOL questionnaire, and found that the severity of tinnitus had a significant impact on the decline in QOL in VS patients during follow-up, and established a strategy to deal with post-operative tinnitus. Thereafter, we continue to conduct research to improve the prognosis further.