Association Between Diagnostic Time and Functional Hearing Outcomes in Sporadic Vestibular Schwannomas: A Retrospective Cross-Sectional Study from Two Tertiary Care Centers in Mexico

Purpose: To analyze the association between diagnostic time and auditory functional status, as measured by the Gardner–Robertson scale, in patients with sporadic vestibular schwannoma. Methods: A retrospective, observational, cross-sectional study was conducted at two tertiary referral centers in Mexico. Adult patients with unilateral sporadic vestibular schwannoma, radiologic confirmation on magnetic resonance imaging, and baseline audiological assessment were included. Total diagnostic time was defined as the interval from symptom onset to diagnosis and was log-transformed due to its right-skewed distribution. Hearing status was categorized as functional or non-functional. Tumor volume was quantified using semi-automated volumetric magnetic resonance imaging. Univariable analyses and Spearman correlations were performed, followed by multivariable logistic regression adjusting for tumor volume. Results: 58 patients were included, of whom 40 (69%) presented with non-functional hearing at diagnosis. Total diagnostic time was longer in patients with non-functional hearing compared with those with functional hearing (median 403 vs. 192 days, p = 0.039). Tumor volume was significantly higher in the non-functional hearing group (median 8.38 vs. 0.88 cm³, p = 0.002) and demonstrated a moderate association with worse auditory functional status (rₛ = 0.535, p < 0.001). Log-transformed total diagnostic time demonstrated a weak but significant correlation with worse hearing status (rₛ = 0.274, p = 0.038) and was associated with non-functional hearing in multivariable analysis (OR 1.49; 95% CI, 1.03–2.17; p = 0.036). Conclusions: Longer diagnostic time was associated with worse auditory functional status at diagnosis in patients with sporadic vestibular schwannoma