OTO Open. 2026 Apr 6;10(2):e70222. doi: 10.1002/oto2.70222. eCollection 2026 Apr-Jun.
ABSTRACT
OBJECTIVE: To evaluate the impact of limited English proficiency (LEP) on the presentation, diagnosis, and management of vestibular schwannoma (VS).
STUDY DESIGN: Retrospective matched cohort study.
SETTING: Single tertiary academic center.
METHODS: A retrospective review of patients diagnosed with VS at a tertiary academic center from 2018 to 2023 identified 29 LEP and 1350 non-LEP patients. LEP patients were matched 1:1 to non-LEP patients using propensity scores based on age, sex, insurance, and zip code-based income. Clinical variables included audiometric data, tumor characteristics, time to diagnosis and treatment, and management outcomes.
RESULTS: No significant differences were found in presenting symptoms, tumor characteristics, or treatment recommendations. LEP patients were significantly less likely to undergo word recognition testing (41% vs 97%, P < .001). Among those tested, bilingual LEP patients performed worse than non-LEP counterparts in word recognition testing (44.5% vs 61.9%, P = .1). LEP patients trended toward larger tumor volumes at diagnosis (6072.5 mm³ vs 2114 mm³, P = .059) and longer delays from symptom onset to diagnosis (4949 vs 2609 days), even after outlier removal. LEP patients also had higher loss to follow-up rates (34% vs 14%, P = .123).
CONCLUSION: Though not statistically significant, several trends suggest LEP patients may face potential barriers to timely diagnosis and follow-up for VS. The relative underrepresentation of LEP patients may also reflect underlying disparities. These findings underscore the need for targeted efforts to improve access and outcomes for LEP patients in neurotologic care.
PMID:41948694 | PMC:PMC13052497 | DOI:10.1002/oto2.70222
