Reported hearing outcome measures following stereotactic radiosurgery for vestibular schwannoma: A scoping review

Background: Evidence on hearing outcome measures when assessing hearing preservation following stereotactic radiosurgery (SRS) for adults with vestibular schwannoma (VS) has not previously been collated in a structured review. Objective: The objective of the present study was to perform a scoping review of the evidence regarding the choice of hearing outcomes and other methodological characteristics following SRS for adults with VS. Methods: The protocol was registered in INPLASY and reported according to the PRISMA-Extension guidelines for scoping reviews. A systematic search of 5 online databases revealed 1591 studies, 247 of which met the inclusion criteria. Results: The majority of studies (n = 213, 86%) were retrospective cohort or case series with the remainder (n = 34, 14%) prospective cohort. Pure tone audiometry and speech intelligibility were included in 222 (90%) and 158 (64%) studies, respectively, often summarized within a classification scheme and lacking procedural details. 59 (24%) studies included self-report measures. The median duration of follow-up, when reported, was 43 months (IQR 29, 4-150). Conclusions: Evidence on hearing disability after SRS for VS is based on low quality studies which are inherently susceptible to bias. This review has highlighted an urgent need for a RCT assessing hearing outcomes in patients with VS managed with radiosurgery or radiological observation. Similarly, consensus and co-production of a core outcome set (COS) to determine relevant hearing and communication outcome domains is required. This will ensure that patient priorities, including communication abilities in the presence of background noise and reduced participation restrictions, are addressed.