Hearing Loss in Acoustic Neuromas Following Stereotactic Radiotherapy
Bibliographic record
Abstract
BACKGROUND: Hearing preservation is a major concern in the management of acoustic neuroma (AN), whether treated by surgery or radiation or followed conservatively. OBJECTIVE: To assess the change in hearing in patients who underwent radiotherapy for ANs and to compare it with data from conservatively managed patients. DESIGN: Prospective case series. SETTING: Neuro-otology, neurosurgery, and radiation oncology practices in tertiary care hospitals of the University Health Network, University of Toronto. PATIENTS AND METHODS: Between 1991 and 1999, 32 patients who underwent radiotherapy were followed prospectively. Seventeen patients had pretreatment measurable hearing and a minimum 1-year follow-up. Twelve of these patients underwent Gamma Knife radiation and five had fractionated radiation therapy with a linear accelerator. Pre- and post-treatment hearing was classified according to the Gardner-Robertson (GR) classificatiom and according to the 1995 guidelines of the American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium (AAO-HNS CHE). OUTCOME MEASURE: Change in hearing post-treatment. RESULTS: Mean follow-up was 48 months. Deterioration in the level of hearing was observed in 8 and 11 of the patients using the AAO-HNS CHE and the GR classifications, respectively. Forty-four to 70% of the patients had lost their pretreatment serviceable hearing, depending on the classification of hearing used and how serviceable hearing was defined. Compared with series of patients followed conservatively in our institution and in other studies, patients who receive stereotactic radiation appear to lose hearing at least at the same rate. CONCLUSION: Our data suggest that hearing loss continues to occur despite radiotherapy, and patients should be advised accordingly.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".