Ten-Year Follow-up on Tumor Growth and Hearing in Patients Observed With an Intracanalicular Vestibular Schwannoma
| Autor: | Malene Kirchmann, Kirstine Karnov, Søren Hansen, Thomas Dethloff, S.-E. Stangerup, Per Cayé-Thomasen |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Hearing loss Acoustic neuroma Cerebellopontine Angle Schwannoma Cohort Studies 03 medical and health sciences 0302 clinical medicine otorhinolaryngologic diseases medicine Humans Hearing Loss 030223 otorhinolaryngology Aged medicine.diagnostic_test business.industry Hearing Tests Magnetic resonance imaging Neuroma Acoustic Middle Aged Cerebellopontine angle medicine.disease Magnetic Resonance Imaging Surgery Otorhinolaryngology Hearing level Female Neurology (clinical) medicine.symptom Audiometry business 030217 neurology & neurosurgery |
| Zdroj: | Neurosurgery. 80:49-56 |
| ISSN: | 1524-4040 0148-396X |
| DOI: | 10.1227/neu.0000000000001414 |
| Popis: | Background Reports on the natural history of tumor growth and hearing in patients with a vestibular schwannoma (VS) are almost exclusively short-term data. Long-term data are needed for comparison with results of surgery and radiotherapy. Objective To report the long-term occurrence of tumor growth and hearing loss in 156 patients diagnosed with an intracanalicular VS and managed conservatively. Methods In this longitudinal cohort study, diagnostic and follow-up magnetic resonance imaging and audiometry were compared. Results After a follow-up of 9.5 years, tumor growth had occurred in 37% and growth into the cerebellopontine angle had occurred in 23% of patients. Conservative treatment failed in 15%. The pure tone average had increased from 51- to 72-dB hearing level, and the speech discrimination score (SDS) had decreased from 60% to 34%. The number of patients with good hearing (SDS > 70%) was reduced from 52% to 22%, and the number of patients with American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) class A hearing was reduced from 19% to 3%. Hearing was preserved better in patients with 100% SDS at diagnosis than in patients with even a small loss of SDS. Serviceable hearing was preserved in 34% according to AAO-HNS (class A-B) and in 58% according to the word recognition score (class I-II). Rate of hearing loss was higher in patients with growing tumors. Conclusion Tumor growth occurred in only a minority of patients diagnosed with an intracanalicular VS during 10 years of observation. The risk of hearing loss is small in patients with normal discrimination at diagnosis. Serviceable hearing is preserved spontaneously in 34% according to AAO-HNS and in 58% according to the word recognition score. |
| Databáze: | OpenAIRE |
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