Acoustic neuroma (vestibular schwannoma): growth and surgical and nonsurgical consequences of the wait-and-see policy.
A prospective study of the consequences of the wait-and-see policy in in patients with neuroradiologic diagnostic evidence of having vestibular schwannoma was conducted in a series of 123 patients (127 tumors) over a 20-year period, from 1973 to 1993. The mean follow-up period was 3.4 years, mean annual growth rate was 3.2 mm/year, mean annual volume growth rate was 0.72 ml/year, and mean annual relative growth rate was 41%. Tumor growth was observed in 90 (74%) patients (94 tumors), no growth was seen in 23 (18%) patients (23 tumors), and negative tumor growth was seen in 10 (8%) patients (10 tumors). Surgery due to tumor growth was performed in 35 (28%) patients (35 tumors), 7 (6%) patients (7 tumors) were treated with gamma-radiation and/or shunt insertion, 7 (6%) patients died of brain stem herniation induced by tumor compression, 9 (7%) patients died of non-tumor-related causes, 28 patients were classified as candidates for hearing preservation surgery, and 21 (75%) patients lost their candidacy during the observation period due to tumor growth and/or deterioration of hearing. The results may limit indications for allocation of patients with vestibular schwannoma to the wait-and-see group.
Charabi
S
S
Department of Otorhinolaryngology, Head and Neck Surgery, Gentofte University Hospital, Hellerup, Denmark.
Thomsen
J
J
Mantoni
M
M
Charabi
B
B
Jørgensen
B
B
Børgesen
S E
SE
Gyldensted
C
C
Tos
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome