Conservative management of vestibular schwannoma

Acta Otorrinolaringol Esp. 2014 Sep-Oct;65(5):275-82. doi: 10.1016/j.otorri.2014.01.002. Epub 2014 Jun 13.
[Article in English, Spanish]

Abstract

Introduction: 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.

Keywords: Acoustic neuroma; Conservative management; Manejo conservador; Neurinoma del acústico; Observación; Observation; Schwannoma vestibular; Vestibular schwannoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuroma, Acoustic / diagnosis
  • Neuroma, Acoustic / therapy*
  • Retrospective Studies