Effects of treatment for vestibular schwannoma on hearing function
Research type
Research Study
Full title
Effects of treatment for vestibular schwannoma on hearing function: a feasibility study
IRAS ID
321428
Contact name
Omar Pathmanaban
Contact email
Sponsor organisation
Northern Care Alliance NHS Foundation Trust
ISRCTN Number
ISRCTN72586805
Duration of Study in the UK
1 years, 9 months, 3 days
Research summary
Research Summary
Vestibular schwannomas (VS) are non-cancerous tumours that grow on the hearing and balance nerve. These tumours can cause problems such as hearing loss, ringing or other noises in the head (tinnitus) and loss of balance.
Treatment options for VS depend on tumour size and how fast it is growing. Small tumours are usually monitored using MRI scans (i.e., ‘watch and wait’). Surgery may be needed to remove a large tumour or treat one that is growing. One type of treatment, stereotactic radiosurgery (SRS), uses a precise beam of radiation to arrest tumour growth.
The ‘watch and wait’ treatment option presents a risk to hearing function as hearing often continues to deteriorate in the affected ear, even without obvious tumour growth. Some research studies suggest that stereotactic radiosurgery used at the time of tumour diagnosis, might delay hearing ability decline but the evidence is unclear.
A research team at the Northern Care Alliance NHS Foundation Trust and the University of Manchester is aiming to conduct a trial of whether SRS is superior to ‘watch and wait’ for preserving hearing function in people with VS. Before we can design the full trial, however, a feasibility study is required to understand how best to monitor hearing function in people undergoing treatment for VS. The aim of this study is to assess the viability of monitoring hearing function in people being managed for VS. We need to understand which hearing function tests are best to evaluate potential benefits of SRS vs. ‘watch and wait’. We also aim to measure the reliability of the hearing tests over time i.e., test-retest reliability in the feasibility study. This information is important because we are planning to ask participants recruited to the full trial to complete the hearing tests at different time points during their treatment for VS.Summary of Results
We want to find out the best way to measure hearing in people with vestibular schwannoma (VS). This is important because we are planning a larger study in the future to compare two treatment approaches: “watch and wait” (regular MRI scans and monitoring) and stereotactic radiosurgery (SRS), a type of focused radiotherapy. Some early research suggests that SRS may help protect hearing if given at diagnosis, but the evidence is not clear. Before we can run the full trial, we first need to test which hearing checks work best and how easy it is for people to take part.
Background: Vestibular schwannomas (VS) are non-cancerous tumours that grow on the hearing and balance nerve. These tumours can cause problems such as hearing loss, ringing or other noises in the head (tinnitus) and loss of balance. Treatment options for VS depend on tumour size and how fast it is growing. Small tumours are usually monitored using MRI scans (i.e., ‘watch and wait’). Surgery may be needed to remove a large tumour or treat one that is growing. One type of treatment, stereotactic radiosurgery (SRS), uses a precise beam of radiation to arrest tumour growth. The ‘watch and wait’ treatment option presents a risk to hearing function as hearing often continues to deteriorate in the affected ear, even without obvious tumour growth. Some research studies suggest that stereotactic radiosurgery used at the time of tumour diagnosis, might delay hearing ability decline but the evidence is unclear. A research team at the Northern Care Alliance NHS Foundation Trust and the University of Manchester is aiming to conduct a trial of whether SRS is superior to ‘watch and wait’ for preserving hearing function in people with VS. Before we can design the full trial, however, a feasibility study is required to understand how best to monitor hearing function in people undergoing treatment for VS.
Methods: We invited 44 people with VS to take part in this study. Of these, 30 were being monitored with “watch and wait” and 14 were scheduled for radiosurgery. Everyone came to the Manchester Centre for Audiology and Deafness, where they completed five different hearing tests and two short questionnaires. The hearing tests looked at things like: ear health (checking for wax or other issues), how the eardrum is working, how well people hear sounds, how clearly they can understand words in quiet, and how well they can hear speech in noisy backgrounds. The questionnaires asked about everyday listening experiences and how much tinnitus affects daily life.
Key findings: We were able to recruit patients quickly, which suggests that running a bigger trial will be possible. The hearing tests and questionnaires took less than two hours to complete, and most people managed to finish them all. A correlation between different hearing tests was seen, and this study alongside our patient and public involvement has helped us choose the most meaningful hearing tests to use for future trials. The results also helped us estimate how many people would need to take part in the future study to properly test whether SRS really protects hearing better than “watch and wait.”
REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
23/NW/0149
Date of REC Opinion
7 Jul 2023
REC opinion
Further Information Favourable Opinion