The relationship between NF-2 associated vestibular schwannoma tumor size and the degree of hearing impairment: A retrospective chart review
Location
Medical Education Building, LSUHSC-NO
Presentation Date
10-10-2019 10:00 AM
End Date
10-10-2019 12:00 PM
Description
Vestibular schwannomas (also known as acoustic neuromas) are benign tumors that arise from the Schwann cell layer covering the vestibulocochlear nerve. A large percentage of these tumors develop sporadically while a small subset of patients (approximately 5%) develop these tumors as a result of the inherited syndrome neurofibromatosis type II (NF2). Previous studies have shown no correlation between tumor size in non-NF2 acoustic neuroma and the degree of hearing impairment. Hearing preservation is one of the main goals in the management of NF2 acoustic neuromas. Herein, we would like to evaluate the effect of tumor size, if any, on the extent of hearing loss in the NF2 population at multiple local hospitals in New Orleans and Baton Rouge in the past 20 years. NF2 acoustic neuromas are typically treated with surgery. With hearing preservation remaining one of the main challenges in these surgeries, establishing the existence or nonexistence of a correlation between tumor size and hearing loss is critical. If such a correlation exists, it can impact how soon hearing preservation interventions are performed especially given the early age of onset for NF2. So far, we’ve only gained access to the databases at 2 hospitals (Our Lady of the Lake Regional Medical Center and the Culicchia Neurological Clinic) out of 4 target hospitals. The charts of 57 patients were retrieved and reviewed. The size of the tumor and the location (CPA, IAC, or both) was determined based on the imaging results. The longest axis was used to estimate the size of the tumors. The pure tone average (PTA), the speech discrimination threshold, and the speech recognition scores were analyzed. Only 22 (38.6%) patients fit the inclusion criteria. Demographics were the following: 12 (54.5%) women and 10 (45.4%) men. 12 are White and 10 are Black. The mean age was 36.95 (range, 16–68) with a mean BMI of 28.7 (range, 40–88). The mean age at diagnosis was 22.55 (range, 18.56– 43.57). The total number of individual tumors was 37. The collected data was analyzed using SAS® software. A linear regression model was using to analyze the relationship between tumor size and the audiometric variables. The tumors where subdivided into two groups based on location. The first group included tumors located in the cerebellopontine angle (CPA) and extending into the internal auditory canal. The second group only included tumors that were limited inside the internal auditory canal. The data analyzed showed an observed statistically significant relationship between CPA/IAC tumor size and all three studied audiometric results. The results were statistically significant (pr > F = 0.12 – 0.018) with R-squared ranging between 0.16 and 0.32. The tumors limited to the internal auditory canal didn’t show a significant relationship between tumor size and any of the three variables. Further research is needed to expand the sample size to obtain more representative data.
Recommended Citation
Karkoutli, Ahmad I., "The relationship between NF-2 associated vestibular schwannoma tumor size and the degree of hearing impairment: A retrospective chart review" (2019). Medical Student Research Poster Symposium. 22.
https://digitalscholar.lsuhsc.edu/sommrd/2019/posters/22
The relationship between NF-2 associated vestibular schwannoma tumor size and the degree of hearing impairment: A retrospective chart review
Medical Education Building, LSUHSC-NO
Vestibular schwannomas (also known as acoustic neuromas) are benign tumors that arise from the Schwann cell layer covering the vestibulocochlear nerve. A large percentage of these tumors develop sporadically while a small subset of patients (approximately 5%) develop these tumors as a result of the inherited syndrome neurofibromatosis type II (NF2). Previous studies have shown no correlation between tumor size in non-NF2 acoustic neuroma and the degree of hearing impairment. Hearing preservation is one of the main goals in the management of NF2 acoustic neuromas. Herein, we would like to evaluate the effect of tumor size, if any, on the extent of hearing loss in the NF2 population at multiple local hospitals in New Orleans and Baton Rouge in the past 20 years. NF2 acoustic neuromas are typically treated with surgery. With hearing preservation remaining one of the main challenges in these surgeries, establishing the existence or nonexistence of a correlation between tumor size and hearing loss is critical. If such a correlation exists, it can impact how soon hearing preservation interventions are performed especially given the early age of onset for NF2. So far, we’ve only gained access to the databases at 2 hospitals (Our Lady of the Lake Regional Medical Center and the Culicchia Neurological Clinic) out of 4 target hospitals. The charts of 57 patients were retrieved and reviewed. The size of the tumor and the location (CPA, IAC, or both) was determined based on the imaging results. The longest axis was used to estimate the size of the tumors. The pure tone average (PTA), the speech discrimination threshold, and the speech recognition scores were analyzed. Only 22 (38.6%) patients fit the inclusion criteria. Demographics were the following: 12 (54.5%) women and 10 (45.4%) men. 12 are White and 10 are Black. The mean age was 36.95 (range, 16–68) with a mean BMI of 28.7 (range, 40–88). The mean age at diagnosis was 22.55 (range, 18.56– 43.57). The total number of individual tumors was 37. The collected data was analyzed using SAS® software. A linear regression model was using to analyze the relationship between tumor size and the audiometric variables. The tumors where subdivided into two groups based on location. The first group included tumors located in the cerebellopontine angle (CPA) and extending into the internal auditory canal. The second group only included tumors that were limited inside the internal auditory canal. The data analyzed showed an observed statistically significant relationship between CPA/IAC tumor size and all three studied audiometric results. The results were statistically significant (pr > F = 0.12 – 0.018) with R-squared ranging between 0.16 and 0.32. The tumors limited to the internal auditory canal didn’t show a significant relationship between tumor size and any of the three variables. Further research is needed to expand the sample size to obtain more representative data.
Comments
Mentor: Moises Arriaga, MD (Department of Otolaryngology)