• Maria Peris-Celda, Christopher S Graffeo, Avital Perry, Geffen Kleinstern, Panagiotis Kerezoudis, Driscoll Colin L W CLW Department Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN., Matthew L Carlson, and Michael J Link.
• Department of Neurosurgery, Albany Medical Center, Albany, NY; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN.
• Mayo Clin. Proc. 2020 Nov 1; 95 (11): 2420-2428.

ObjectiveTo assess the impact of differential hearing loss on QOL in sporadic unilateral vestibular schwannoma.Patients And MethodsCross-sectional observational multicenter study including 422 patients with vestibular schwannoma and formal audiometry within 1 year of survey administration, analyzed using multivariable regression.ResultsAmong 422 patients included, the median age was 57 (range, 18-81) years; 223 (53%) were women. Among 390 patients with complete audiometric data, American Academy of Otolaryngology-Head and Neck Surgery class was A in 134 (34%), B in 69 (18%), C in 26 (7%), and D in 161 (41%). A total of 335 of 390 (86%) reported subjective ipsilateral hearing loss (median severity, 6/10 [1 = normal, 10 = deaf]), 166 (43%) reported ipsilateral inability to use the telephone, 155 (37%) reported that hearing loss had affected personal relationships, and 213 (51%) reported difficulty with conversations. After adjusting for age and sex, the odds ratio (OR) for hearing loss adversely affecting relationships was 4.4 for class B hearing vs class A (95% CI, 2.1-9.4; P<.0001). The OR for difficulty with conversations was 2.7 for class B vs class A (95% CI, 1.4-5.3; P=.003). The OR for lost ipsilateral telephone use was 6.3 for class B vs class A (95% CI, 3.2-13.0; P<.0001). Differences between class B and class C were not significant. WRS outperformed PTA as a predictor of hearing-related QOL. The optimal threshold for predicting a significant adverse impact on QOL was WRS less than 72% to 76%.ConclusionHearing loss adversely affects QOL after only modest audiometric disability. The WRS alone appears to be a much more reliable predictor of hearing-related QOL than PTA or American Academy of Otolaryngology-Head and Neck Surgery class.Copyright © 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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