[Grade I and II vestibular schwannomas: hearing, clinical course. Pre- and postoperative aspects].
We propose a point by point response to the questions raised at this round table concerning the spontaneous and postoperative course of grade I and II vestibular schwannomas, focusing on hearing function. The questions concerning non-operated schwannomas are: For operated schwannomas, the questions are: Spontaneously, 75-80% of these schwannomas progress significantly with a degradation of hearing function in more than half of the cases. We monitor clinical disorders and order routine audiometry and MRI. For us, Gardner and Roberson class A or 1 is truly useful hearing function. Preservation of truly useful hearing function after microsurgery is no better than 10%; satisfactory facial motor function is preserved in 70-80% of the cases with grade I, II, or III schwannomas and in more than 50% for grade IV schwannomas. Incomplete excision to preserve hearing function is compromised by recurrence. We preferably treat the smaller grade I schwannomas by radiosurgery to halt tumor progression and attempt to preserve hearing function.
Pellet
W
W
Service de Neurochirurgie, Hôpital Sainte-Marguerite, Assistance Publique-Hôpitaux de Marseille, 270 boulevard Sainte-Marguerite, 13247 Marseille Cedex 9, France.
Roche
Ph
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry; D018450:Disease Progression; D005158:Facial Paralysis / Q000209:etiology / Q000517:prevention & control; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D009464:Neuroma, Acoustic / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011184:Postoperative Period; D012720:Severity of Illness Index; D016896:Treatment Outcome