Acoustic neuromas in the elderly.
OBJECTIVE
To determine if an "observation" protocol with serial scanning is a safe and effective management paradigm for acoustic neuromas in the elderly.


METHODS
A retrospective case review was performed.


METHODS
This study was performed in an academic, tertiary care center.


METHODS
Forty-one patients over the age of 65 years were identified with the primary diagnosis of unilateral acoustic neuroma, without prior treatment or observation.


METHODS
The patients were followed with serial, gadolinium-enhanced magnetic resonance imaging (MRI) scans performed at 6 months and then yearly, if no significant growth occurred.


METHODS
The patients were monitored for tumor growth, cranial nerve deficits, and hydrocephalus.


RESULTS
The patients were followed for an average of 3.5 years (range, 6 months to 9 years). The average tumor size at presentation was 1.14 cm, with a range of growth rates from 0 to 1.2 cm per year. Twenty-one patients demonstrated tumor growth at an average rate of 0.322 cm per year. Only five patients (12%) required further intervention. Three patients underwent translabyrinthine excision, and two patients were treated with radiation. No patients developed significant complications during the observation period.


CONCLUSIONS
Acoustic neuromas in the older population can be managed safely using serial MRI scanning. No correlation could be made between initial tumor size and subsequent growth rate.
Perry
B P
BP
The Otology Group of Texas, San Antonio 78240, USA.
Gantz
B J
BJ
Rubinstein
J T
JT
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009464:Neuroma, Acoustic / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies