Radiation exposure and the risk of acoutic neuroma

L. Dade Lunsford, MD1, Yueh-Ying Han, PhD2

1Department of Neurological Surgery, University of Pittsburgh 2Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh

Keywords: vestibular schwannoma, risk factor, radiation-associated tumor, brain tumor, schwannoma

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     Conflicting data exists related to radiation exposure and the risk of development of an acoustic neuroma. 
     We matched patients with acoustic neuroma on a 1:1 protocol to patients with chronic spinal disorders as a hospital based control group in order to see if common exposure factors were more prevalent in patients with acoustic tumors.
     In the interval of 1997-2007, 822 patients underwent Gamma Knife® radiosurgery for an acoustic neuroma at our center. We age and gender matched 343 (42%) acoustic tumor patients to patients who had degenerative spine disorders.
      Both groups completed a self-administered questionnaire that identified exposure to medical radiation, use of cell phones and other electrical appliances, as well as other potential risk factors for tumor development. Conditional logistic regression was used to estimate an odds ratio (OR) for exposures and their 95% confidence intervals (CI).
     We controlled for race, education, smoking, alcohol use, occupational exposure to noise, and a family history of cancer. We found an elevated OR for tumor development in individuals who reported exposure to dental x-rays at least once every two to four years compared to those x-rayed less than once every four years (adjusted OR=2.28, 95% CI=1.16-4.48). A history of other imaging exposures (oral Panorex x-ray, computed tomography of the head and neck, other x-ray examinations, or radiation treatment of the head and neck region) were not associated with acoustic neuroma. Use of cell phones for more than ten years was not associated with the development of acoustic neuroma compared to non-users (adjusted OR=1.38, 95% CI=0.75-2.56). Reported use of electrical appliances (hairdryers, electric shavers, electric blankets) was not associated with acoustic neuroma.
     This was a cohort comparison study and the data obtained was based on recall.
     Increased exposure to dental x-rays was the only ionizing or non-ionizing radiation exposure associated with a higher risk of development of acoustic neuroma. 
     The risk benefit ratio of increased exposure to dental x-rays and other diagnostic radiation should be further evaluated.


Project Roles:

L. Lunsford (), Y. Han ()