title: Analysis of causes for late presentation of Indian patients with vestibular schwannoma.
abstract: OBJECTIVE
  To determine the causes of delay in diagnosis and treatment of Indian patients with vestibular schwannomas.
  
  
  METHODS
  In a prospective study from 2003 to 2005, 50 patients with a confirmed diagnosis of vestibular schwannoma were interviewed to determine the causes for (1) the delay between the patient noting the initial symptom and the definitive diagnosis, and (2) the reasons for delayed diagnosis.
  
  
  RESULTS
  In 90 per cent of patients, the initial symptom was either hearing loss (62 per cent), vertigo (24 per cent) or tinnitus (4 per cent). However, most patients had been diagnosed and had presented for surgery only after neurological symptoms had became apparent. The delay between the initial medical consultation and the final diagnosis ranged from one month to 204 months (mean +/- standard deviation, 32.2 +/- 38.9 months). After the patient had noted symptoms, the diagnosis of vestibular schwannoma was delayed due to doctor-related causes in 80 per cent of cases, and due to patient-related causes in 20 per cent. Delay following diagnosis was minimal.
  
  
  CONCLUSIONS
  Delay in the diagnosis of vestibular schwannoma in Indian patients is due to both doctor- and patient-related factors.
authors.affiliation: Department of ENT, Christian Medical College, Vellore, India.
authors.forename: R
authors.initials: R
authors.lastname: Ambett
authors.forename: V
authors.initials: V
authors.lastname: Rupa
authors.forename: V
authors.initials: V
authors.lastname: Rajshekhar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000592:standards; D013997:Time Factors; D014012:Tinnitus / Q000209:etiology; D014717:Vertigo / Q000209:etiology; D014724:Vestibular Function Tests; D055815:Young Adult