title: Conservative management of vestibular schwannoma.
abstract: BACKGROUND
  Vestibular schwannoma (VS) is a benign, slow-growing tumour originating in the 8th cranial nerve. The treatment includes microsurgery, stereotactic radiotherapy and conservative management of tumours with periodic radiological tests.
  
  
  METHODS
  This was a retrospective study of patients with VS following conservative management in a tertiary hospital between 1993 and 2013. A total of 73 patients were enrolled in our protocol. The mean age at diagnosis was 59.7 years. The average size was 11.9mm (4-27mm); 58.9% of the tumours were intracanalicular and 41.1%, extracanalicular. The mean follow-up period was 35.75 months.
  
  
  RESULTS
  In 87.7% of patients there was no evidence of tumour growth. A total of 9 tumours (12.3%) increased in size. The average growth rate was 0.62mm/year. The percentage of extracanalicular tumours that grew (20%) was higher than that of intracanalicular tumours (7%). Seven patients (9.5%) experienced significant changes in their symptoms and 6 of these (8.2%) experienced a loss of useful hearing. Six patients (8.2%) left follow-up and underwent surgery.
  
  
  CONCLUSIONS
  Periodic monitoring of vestibular schwannomas with magnetic resonance imaging represents an option for management, because most small tumours experience little or no growth over time.
authors.affiliation: Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: ricardomorujo@hotmail.com.
authors.forename: Ricardo José
authors.initials: RJ
authors.lastname: González-Orús Álvarez-Morujo
authors.affiliation: Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Itziar
authors.initials: I
authors.lastname: Alvarez-Palacios
authors.affiliation: Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Martin-Oviedo
authors.affiliation: Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Bartolomé
authors.initials: B
authors.lastname: Scola-Yurrita
authors.affiliation: Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Arístegui-Ruiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies
keywords: Acoustic neuroma; Conservative management; Manejo conservador; Neurinoma del acústico; Observación; Observation; Schwannoma vestibular; Vestibular schwannoma