[Audiological findings and analysis in 93 cases of unilateral vestibular schwannoma].
Objective:To investigate the audiological characteristics of unilateral vestibular schwannoma（VS） and their correlations with disease duration and tumor size, and to evaluate the clinical value of pure-tone audiometry（PTA）, speech discrimination score（SDS）, and auditory brainstem response（ABR） in screening and prognostic assessment. Methods:A retrospective analysis was performed on 93 patients with unilateral VS confirmed by surgery and pathology in our hospital from May 2008 to March 2025. PTA, SDS, ABR, and tumor size were analyzed. Correlation analysis and group comparisons were conducted to explore the relationships between audiological parameters, disease duration, and tumor size. Results:The mean age was（47.1±11.3） years. Hearing loss occurred in 97.8% of patients, tinnitus in 63.4%, and vertigo in 37.6%. PTA showed normal hearing in 2 cases and varying degrees of loss in 91 cases, with descending（33.3%） and flat（29.0%） curves being most common. Hearing loss duration was positively correlated with PTA average（r=0.52, P<0.001）, and flat curves were more frequent in longer disease courses. SDS was significantly negatively correlated with PTA average（P=-0.81） and tumor size（P=-0.61）, with a faster decline than PTA. ABR abnormalities were detected in 82.0%-89.5% of cases, with prolonged wave Ⅲ latency, wave Ⅴ latency, Ⅰ-Ⅴ interpeak interval, and interaural Ⅴ wave interval difference being most frequent. The mean tumor size was （20.5±10.6） mm, with stage Ⅲ being most common（46.2%）. Tumor diameter was positively correlated with hearing loss severity（r=0.37, P=0.001）, and Ⅲ-Ⅴ interpeak interval abnormalities were significantly more frequent in tumors>15 mm（P=0.042）. Conclusion:Hearing curve patterns in VS patients are closely related to hearing loss severity, disease duration, and tumor size. ABR demonstrates high diagnostic sensitivity for VS, particularly when tumor diameter exceeds 15 mm, as indicated by increased Ⅲ-Ⅴ interpeak interval abnormalities. Multidimensional audiological assessment can assist in early detection and prognostic evaluation. ABR screening combined with MRI is recommended for patients with unilateral hearing loss.