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Combined Otolaryngology Spring Meetings a Forum for Otolaryngologists to Listen, Debate, Network

by Thomas R. Collins •

“He [Dr. Regis] points out that [patients] in the wait-and-see category had poorer hearing preservation than those who received gamma knife and, based upon that, he says you ought to treat them at diagnosis—and neurosurgeons worldwide feel that the minute a tumor is diagnosed you should treat them,” Dr. Brackmann said. “I disagree with that.”

Part of the problem is the strict definition of failure in the study, he said. Additionally, other results show that there is reason to use a more conservative approach. “There’s a lot of inconsistency,” Dr. Brackmann said.

A study out of the Mayo Clinic reviewed long-term hearing preservation, with 44 patients followed up to nine years after undergoing radiosurgery—82% of the patients lost hearing over the follow-up period. “It’s becoming more and more apparent,” Dr. Brackmann said, “that radiosurgery is not a hearing conservation procedure.”

Thomas Collins is a freelance medical writer based in Florida.

Take-Home Points

  • Technology and diagnostics have improved management of vestibular schwannomas.
  • The first course of action with the tumor is no longer to immediately remove it, but rather to observe it.
  • The majority of patients who have normal hearing at tumor diagnosis had hearing preservation over the long term.

Fast Facts

9
 Societies held meetings at COSM 2015
3,200
Participants attended this year’s conference
40
Countries represented among COSM attendees
38
New fellows were inducted into the Triological Society