title: [Clinical and radiological evolution of a group of untreated acoustic neuromas].
abstract: BACKGROUND
  The acoustic neuroma is a benign tumour that originates in the vestibular branch of the eighth cranial nerve. The main treatment is surgery, but many authors suggest that with elderly patients or in small neuromas we can opt for watchful waiting.
  
  
  METHODS
  This was a retrospective study from 2007 to 2013 that included 27 patients diagnosed of acoustic neuroma that had not been treated due to the size of the tumour, age and comorbidities, or by patient choice. We evaluated overall condition, hearing thresholds, degree of canal paresis and central disorders.
  
  
  RESULTS
  After 6 years of follow up, clinical manifestations of 18 patients remained unchanged, 5 patients underwent hearing loss and developed tinnitus, 2 cases had more intense tinnitus and 2 cases had dizziness. The radiological controls by magnetic resonance imaging showed that the initial maximum diameters (5-16mm) increased by 1.7mm on average, with annual growth rates below 0.5mm.
  
  
  CONCLUSIONS
  In selected cases, such as for small neuromas and in elderly patients, the conservative option of close monitoring with magnetic resonance imaging is an important alternative given that, in our cases, clinical features and radiological image did not suffer major changes. If there were any such changes, therapeutic options could be proposed.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España. Electronic address: zingaro85@hotmail.com.
authors.forename: Vicente
authors.initials: V
authors.lastname: Escorihuela-García
authors.affiliation: Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Llópez-Carratalá
authors.affiliation: Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Orts-Alborch
authors.affiliation: Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España.
authors.forename: Jaime
authors.initials: J
authors.lastname: Marco-Algarra
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D013997:Time Factors; D057832:Watchful Waiting
keywords: Acoustic neuroma; Acúfeno; Hipoacusia neurosensorial; Hipoacusia unilateral; Neurinoma del acústico; Schwannoma vestibular; Sensorineural hearing loss; Tinnitus; Unilateral hearing loss; Vestibular schwannoma