Evidence map›Paper›PMID 41586863›Full record

Observational studyJournal of neuro-oncology2026

Intralabyrinthine MRI FLAIR as a predictive marker for hearing loss in vestibular schwannomas in Neurofibromatosis Type 2.

Robert L Walker, Maxwell T Laws, H Jeffrey Kim, Christopher Zalewski, Ashok Asthagiri, Sruthi Ranganathan, Christina Hayes, John D Heiss, John A Butman, Prashant Chittiboina

2 registry-linked trialsAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00060541 recruitingnot on this map

Evaluation and Treatment of Neurosurgical Disorders

TypeobservationalSponsorNational Institute of Neurological Disorders and Stroke (NINDS)Ran2003Enrolled5,000ConditionsNeurologic DisordersArmsLaboratory tests, Radiological exams
NCT00598351 recruitingnot on this map

A Prospective Natural History Study of Patients With Neurofibromatosis Type 2 (NF2).

TypeobservationalSponsorNational Institute of Neurological Disorders and Stroke (NINDS)Ran2008Enrolled269ConditionsNeurofibromatosis
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Robert L WalkerNeurosurgery Unit for Pituitary and Inheritable Disorders, National Institute for Neurological Diseases and Stroke, Bethesda, MD, USA.
Maxwell T LawsNeurosurgery Unit for Pituitary and Inheritable Disorders, National Institute for Neurological Diseases and Stroke, Bethesda, MD, USA.
H Jeffrey KimNational Institute on Deafness and Other Communication Disorders, Bethesda, MD, USA.
Christopher ZalewskiAudiology Branch, Otolaryngology Branch, National Institute on Deafness and Other Communication Disorders, Bethesda, MD, USA.
Ashok AsthagiriDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA.
Sruthi RanganathanDepartment of Medicine, University of Cambridge, Cambridge, UK.
Christina HayesSurgical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
John D HeissSurgical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
John A ButmanRadiology and Imaging Sciences, Clinical Center at the National Institutes of Health, Bethesda, MD, USA.
Prashant ChittiboinaNeurosurgery Unit for Pituitary and Inheritable Disorders, National Institute for Neurological Diseases and Stroke, Bethesda, MD, USA. prashant.chittiboina@nih.gov.

Funding

Neuro-oncology of Familial Neoplasia SyndromesZIANS003053 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI CHITTIBOINA, PRASHANT · 2009 to 2025
$14.9M
Speech Perception and Spoken Word Recognition by Children with Cochlear ImplantsR01DC000064 · NIDCD · INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS · PI MIYAMOTO, RICHARD T. · 1990 to 2008
$4.4M
Clinical Analysis Of Disorders Of Hearing And BalanceZ01DC000064 · NIDCD · NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS · PI GRIFFITH, ANDREW J · 2001 to 2008
$1.2M
Intramural NIH HHS Z01 DC000064Intramural NIH HHS ZIA NS003053National Institute of Neurological Diseases and Stroke ZIA NS003053-13NIDCD NIH HHS DC000064NIDCD NIH HHS R01 DC000064
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe onset of hearing loss due to vestibular schwannomas (VS) is inevitable but does not correlate with the size of the tumor. In patients with Neurofibromatosis Type 2 (NF2) and VS, we previously found an association between pre-contrast fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) signal in the labyrinth and hearing loss. Here, we asked whether FLAIR hyper-intensity could serve as a predictive biomarker for hearing loss in NF2 patients with VS.

methodsA prospective longitudinal study (NCT00598351) of NF2 enrolled 168 subjects between 2008 and 2013. This study included 34 patients with small VS (total volume ≤ 500mm3). Middle fossa decompression surgery (n = 4 patients) was provided via a standard-of-care trial (NCT00060541).

resultsFrom 34 eligible subjects (mean age 26.8y) with NF2 and small VS, 53 ears met inclusion criteria. Abnormal hearing was recorded in 18 ears at study entry; all 18 ears had FLAIR hyper-intensity. Of the 35 ears with normal hearing, 16 had FLAIR hyper-intensity at study entry, 6 (37.5%) of which developed new hearing loss (median time to hearing loss of 4.45 years). Conversion to FLAIR hyper-intensity occurred in 11 ears, 3 of which proceeded to hearing loss. No hearing loss developed in the eight ears that remained FLAIR negative. FLAIR conversion has high sensitivity (1·00, 95% CI 0·39–1) and negative predictive value (1·00, 95% CI 0·63–1) for new-onset hearing loss. In 4 patients undergoing middle fossa decompression surgery, we found that surgery stabilized hearing but did not reverse FLAIR hyperintensity.

conclusionsOur findings suggest that intralabyrinthine FLAIR hyper-intensity is a sensitive, non-invasive biomarker for hearing loss related to VS. Hearing decline followed FLAIR hyper-intensity by approximately 4 years but was absent in ears with normal FLAIR signal.

trial registrationRegistry: ClinicalTrials.gov, TRN: NCT00060541, Registration date: 4 June 2003.

Indexed as

Ear, InnerHearing LossMagnetic Resonance ImagingNeurofibromatosis 2Neuroma, AcousticAdolescentAdultFemaleFollow-Up StudiesHumansLongitudinal StudiesMaleMiddle AgedPrognosisProspective StudiesYoung AdultAcoustic neuromaHearing lossLabyrinthine proteinMRI FLAIRNeurofibromatosis 2NF2PerilymphTumor growthVestibular schwannoma

Identifiers

PMID41586863
PMCPMC12835039

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.