Materiały źródłowe

• #1 Vestibular schwannoma (acoustic neuroma) – UpToDate

  https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma

  Vestibular schwannomas (also known as acoustic neuromas) are Schwann cell-derived, histologically benign tumors of the eighth cranial nerve, most commonly arising from the vestibular portion of the nerve. They are the third most common nonmalignant primary brain tumor, after meningioma and pituitary tumors, and account for 80 to 90 percent of tumors in the cerebellopontine angle. […] The overall incidence of vestibular schwannoma is approximately 3 to 5 per 100,000 person-years. The incidence rises with advancing age. For patients over 70 years of age, the incidence may be as high as 21 per 100,000 person-years. […] The incidence appears to be increasing, due at least in part to the incidental diagnosis of asymptomatic lesions with the widespread use of magnetic resonance imaging (MRI) and computed tomography (CT). A retrospective analysis of 46,000 MRI scans done for other reasons identified eight unsuspected vestibular schwannomas (0.02 percent), and autopsy studies suggest that the prevalence may be even higher.

• #2 Vestibular schwannoma (acoustic neuroma) – UpToDate

  https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma/print

  Vestibular schwannomas (also known as acoustic neuromas) are Schwann cell-derived, histologically benign tumors of the eighth cranial nerve, most commonly arising from the vestibular portion of the nerve. They are the third most common nonmalignant primary brain tumor, after meningioma and pituitary tumors, and account for 80 to 90 percent of tumors in the cerebellopontine angle. […] The overall incidence of vestibular schwannoma is approximately 3 to 5 per 100,000 person-years. The incidence rises with advancing age. For patients over 70 years of age, the incidence may be as high as 21 per 100,000 person-years. […] The incidence appears to be increasing, due at least in part to the incidental diagnosis of asymptomatic lesions with the widespread use of magnetic resonance imaging (MRI) and computed tomography (CT).

• #3 Vestibular schwannoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/vestibular-schwannoma?embed_domain=hackmd.io%252525252f%2525252540yipuafecsl2jsu8smr5njq%252525252fbnjhjgjghjghjghfavicon.ico&lang=us

  Vestibular schwannomas account for ~8% of all primary intracranial tumors and 75-90% of CPA masses. The vast majority (95%) of solitary lesions are sporadic. Bilateral vestibular schwannomas are highly suggestive of neurofibromatosis type 2 (NF2), although bilateral tumors are encountered in the familial form of vestibular schwannomas in the absence of other stigmata of NF2. […] Although they usually occur between the fourth to sixth decades of life, with a median age of 50 years, individuals with NF2 tend to present earlier, with a peak incidence around the third decade of life. Although rare, vestibular schwannomas may occur in children.

• #4 Vestibular Schwannoma/Acoustic Neuroma | East Bay Brain & Spine Medical Group

  https://www.eastbaybrainandspine.com/conditions/braintumors/vestibular-schwannoma-acoustic-neuroma/

  Vestibular schwannoma, also known as acoustic neuroma, is a benign (noncancerous) tumor that develops on the balance and hearing nerves leading from your inner ear to the brain. […] In most cases, the cause of acoustic neuromas is unknown. However, a small number of cases are linked with a syndrome called neurofibromatosis type II (NF2). NF2 is a hereditary condition characterized by the growth of benign tumors on the balance nerves on both sides of the head (bilateral vestibular schwannomas). […] An MRI can visualize the tumor and may be used to monitor its growth over time. […] According to studies, about 50-60% of acoustic neuromas do not grow during the first few years of observation. However, if the tumor does grow, it may lead to worsening symptoms over time. […] Hearing loss in the affected ear occurs in a significant number of cases. Studies show that it can range anywhere from 30% to over 90%, depending on the tumor size and surgical technique used. […] The prognosis for someone with a vestibular schwannoma is generally very good. Because these tumors are benign, they dont spread (metastasize).

• #5 Vestibular schwannoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/vestibular-schwannoma?embed_domain=hackmd.io%252525252f%2525252540yipuafecsl2jsu8smr5njq%252525252fbnjhjgjghjghjghfavicon.ico&lang=us

  Vestibular schwannomas account for ~8% of all primary intracranial tumors and 75-90% of CPA masses. The vast majority (95%) of solitary lesions are sporadic. Bilateral vestibular schwannomas are highly suggestive of neurofibromatosis type 2 (NF2), although bilateral tumors are encountered in the familial form of vestibular schwannomas in the absence of other stigmata of NF2. […] Although they usually occur between the fourth to sixth decades of life, with a median age of 50 years, individuals with NF2 tend to present earlier, with a peak incidence around the third decade of life. Although rare, vestibular schwannomas may occur in children.

• #6 What is Acoustic Neuroma (Vestibular Schwannoma)? Symptoms, Risk Factors & Treatments | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/acoustic-neuroma.html

  The cause of most cases of acoustic neuroma is not known. Most occur randomly, thus they are called sporadic vestibular schwannomas. These sporadic tumors are considered to be different from genetic tumors. […] Bilateral acoustic neuromas are a sign of a rare inherited disorder called neurofibromatosis type 2 (NF2). We offer complete genetic testing and counseling to help determine your risk.

• #7 Acoustic Neuroma: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/acoustic-neuromas

  Acoustic neuromas represent the third most common intracranial non-malignant tumour after meningiomas and pituitary adenomas. They are the most common extra-axial posterior fossa tumours in adults, comprising over 80% of tumours in the cerebellopontine angle. […] In most cases, the tumours present unilaterally; bilateral are a hallmark of neurofibromatosis type 2. […] Many epidemiological studies have failed to find a link between acoustic neuroma and mobile phone use. […] 7% of patients with acoustic neuroma also have NF2. […] Acoustic neuroma due to NF2 tends to present earlier, typically around 30 years old. […] Current treatment options include observation, surgical resection, fractionated radiotherapy, and radiosurgery. […] For patients with small neuromas and good preserved hearing, the most appropriate course of action may be to watch and wait with serial scans to monitor growth.

• #8 Acoustic Neuroma (Vestibular Schwannoma) | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/ear-nose-throat/acoustic-neuroma

  Acoustic neuromas are typically slow growing over a period of years. […] Each year approximately 2,500-3,000 individuals in the United States are diagnosed with this tumor, which typically affects only one ear. […] NF2, the genetic variant, is a rare cause of these tumors accounting for only 5 percent of acoustic neuromas. […] Publications over the last two decades from the University of Michigan report high rates of success with preservation of hearing when the middle fossa approach was used to remove small to moderate size tumors.

• #9 Acoustic Neuroma: Practice Essentials, History of the Procedure, Epidemiology

  https://emedicine.medscape.com/article/882876-overview

  Acoustic neuromas are the most common tumor of the cerebellopontine angle, accounting for approximately 80% of cerebellopontine angle tumors. […] Traditionally, the estimated incidence of vestibular schwannomas was 1 per 100,000 persons. However, with the increasing usage of MRI technology, there has been an increase in the number of incidentally found vestibular schwannomas. A meta-analysis by Marinelli et al identified six studies regarding national and international incidence rates of vestibular schwannomas, in Denmark, the Netherlands, Taiwan, and the United States. The incidence rate ranged from 3.0-5.2 per 100,000 person-years. Incidence was also found to increase with age, with one study identifying a rate of 20.6 per 100,000 person-years among patients over age 70 years.

• #10 Vestibular schwannoma (acoustic neuroma) – UpToDate

  https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma

  Vestibular schwannomas (also known as acoustic neuromas) are Schwann cell-derived, histologically benign tumors of the eighth cranial nerve, most commonly arising from the vestibular portion of the nerve. They are the third most common nonmalignant primary brain tumor, after meningioma and pituitary tumors, and account for 80 to 90 percent of tumors in the cerebellopontine angle. […] The overall incidence of vestibular schwannoma is approximately 3 to 5 per 100,000 person-years. The incidence rises with advancing age. For patients over 70 years of age, the incidence may be as high as 21 per 100,000 person-years. […] The incidence appears to be increasing, due at least in part to the incidental diagnosis of asymptomatic lesions with the widespread use of magnetic resonance imaging (MRI) and computed tomography (CT). A retrospective analysis of 46,000 MRI scans done for other reasons identified eight unsuspected vestibular schwannomas (0.02 percent), and autopsy studies suggest that the prevalence may be even higher.

• #11 Vestibular schwannoma (acoustic neuroma) – UpToDate

  https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma/print

  Vestibular schwannomas (also known as acoustic neuromas) are Schwann cell-derived, histologically benign tumors of the eighth cranial nerve, most commonly arising from the vestibular portion of the nerve. They are the third most common nonmalignant primary brain tumor, after meningioma and pituitary tumors, and account for 80 to 90 percent of tumors in the cerebellopontine angle. […] The overall incidence of vestibular schwannoma is approximately 3 to 5 per 100,000 person-years. The incidence rises with advancing age. For patients over 70 years of age, the incidence may be as high as 21 per 100,000 person-years. […] The incidence appears to be increasing, due at least in part to the incidental diagnosis of asymptomatic lesions with the widespread use of magnetic resonance imaging (MRI) and computed tomography (CT).

• #12 Incidence and prevalence of vestibular schwannoma – Louis Hofmeyr

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/incidence-and-prevalence-of-vestibular-schwannoma/

  Incidence refers to the number of new cases of a specific disease or condition occurring within a particular time period. It gives us an idea of how frequently new cases are developing within a population. […] Prevalence, however, refers to the total number of existing cases of a disease or condition within a population at a given time. It gives us an idea of how widespread a particular disease or condition is within a population. […] According to the literature, the prevalence likely exceeds 1 out of 500 people. This means that at least 1 out of 500 people will develop a vestibular schwannoma in their lifetime. […] The global traditional quoted incidence of 1 per 100,000 population is wrong. This is an old figure and an underestimation. The incidence of sporadic VS is closer to 5 per 100,000 people. In elderly patients 70 years, the incidence is estimated to rise to over 20 per 100,000 of the population.

• #13 Vestibular schwannoma (acoustic neuroma) – UpToDate

  https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma

  Vestibular schwannomas (also known as acoustic neuromas) are Schwann cell-derived, histologically benign tumors of the eighth cranial nerve, most commonly arising from the vestibular portion of the nerve. They are the third most common nonmalignant primary brain tumor, after meningioma and pituitary tumors, and account for 80 to 90 percent of tumors in the cerebellopontine angle. […] The overall incidence of vestibular schwannoma is approximately 3 to 5 per 100,000 person-years. The incidence rises with advancing age. For patients over 70 years of age, the incidence may be as high as 21 per 100,000 person-years. […] The incidence appears to be increasing, due at least in part to the incidental diagnosis of asymptomatic lesions with the widespread use of magnetic resonance imaging (MRI) and computed tomography (CT). A retrospective analysis of 46,000 MRI scans done for other reasons identified eight unsuspected vestibular schwannomas (0.02 percent), and autopsy studies suggest that the prevalence may be even higher.

• #14 Incidence and prevalence of vestibular schwannoma – Louis Hofmeyr

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/incidence-and-prevalence-of-vestibular-schwannoma/

  Incidence refers to the number of new cases of a specific disease or condition occurring within a particular time period. It gives us an idea of how frequently new cases are developing within a population. […] Prevalence, however, refers to the total number of existing cases of a disease or condition within a population at a given time. It gives us an idea of how widespread a particular disease or condition is within a population. […] According to the literature, the prevalence likely exceeds 1 out of 500 people. This means that at least 1 out of 500 people will develop a vestibular schwannoma in their lifetime. […] The global traditional quoted incidence of 1 per 100,000 population is wrong. This is an old figure and an underestimation. The incidence of sporadic VS is closer to 5 per 100,000 people. In elderly patients 70 years, the incidence is estimated to rise to over 20 per 100,000 of the population.

• #15 Contemporary Management of Vestibular Schwannoma | AAO-HNS Bulletin

  https://bulletin.entnet.org/clinical-patient-care/article/22834080/contemporary-management-of-vestibular-schwannoma

  Vestibular schwannomas (VS), also referred to as acoustic neuromas, are benign neoplastic growths that arise on the vestibular nerve. […] The exact incidence of these growths is not entirely clear. Although historically a rate of 1:100,000 has been described, a recent study suggested the true incidence of VS ranges from 3.0 to 5.2 per 100,000 person-years but is 20.6 per 100,000 person-years in patients aged 70 years and older, which may be attributable to the advent of magnetic. […] Stangerup SE, Caye-Thomasen P. Epidemiology and natural history of vestibular schwannomas. […] In a large multicenter study examining VS volume, 65% of tumors demonstrated growth at a median time to growth of 1 mm/year, and those that continued observation demonstrated persistent growth at a similar rate.

• #16 Epidemiology Of Vestibular Schwannomas – Prospective 40-Year Data From An Unselected National Cohort

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6850685/

  Reports on the epidemiology of vestibular schwannoma (VS) indicate an increase in diagnosed cases, often based on selected materials over a limited period of time. This report presents prospective 40-year epidemiological data from an unselected national cohort of all patients diagnosed with a VS in Denmark since 1976. […] Over the past 40 years, the incidence rate of vestibular schwannomas has increased steadily from 3 VS/million/year to 34 VS/million/year, primarily due to easier access to improved diagnostics and the finding of more tumors in older people. Concurrently, the diagnostic tumor size has decreased from 26mm to 7mm, and the age at diagnosis has increased from 49 to 60 years. […] This prospective study on 40-year epidemiological data from the unselected, unbiased national cohort of all Danish patients diagnosed with a VS since 1976 shows that the incidence rate of diagnosed tumors has been increasing steadily over the years, from 2.8 VS/million/year in 1976 to 33.8 VS/million/year in 2015. Improved diagnostics and increased availability of improved diagnostics are probably the main reasons for this increase, although an increased tumor occurrence cannot entirely be ruled out.

• #17 Incidence and Risk Factors of Vestibular Schwannoma in Korea : A Population-Based Study

  https://www.jkns.or.kr/journal/view.php?number=7576

  Incidence and Risk Factors of Vestibular Schwannoma in Korea: A Population-Based Study […] This study aims to investigate the incidence of vestibular schwannoma (VS) and demographic characteristics in Korea using population-based National Health Insurance Service data. […] The total number of VS patients was 5751. The average incidence rate was 0.71 per 100000 from 2005 to 2020, and the annual incidence rate increased from 0.33 in 2005 to 1.32 in 2019 but decreased to 0.80 in 2020. Incidence was highest in those aged 60-69 years (1.791) and lowest in those younger than 20 years (0.041). Incidence was higher in females, and the number of patients who received radiosurgery (46.64%) was largest compared to the wait and scan group (37.96%), microsurgery group (12.85%), or the group who received both (2.56%). Diabetes, dyslipidemia, and alcohol consumption increased the risk of VS, while cigarette smoking reduced the risk of VS.

• #18 Incidence and Risk Factors of Vestibular Schwannoma in Korea : A Population-Based Study

  https://www.jkns.or.kr/journal/view.php?number=7576

  The incidence of VS exhibited an increasing trend from 2005 to 2019. Radiosurgery (46.64%) was the most common treatment modality. Diabetes, dyslipidemia, and alcohol consumption increased the risk of VS, while cigarette smoking reduced the risk of VS. […] The overall annual incidence from 2005 to 2020 was 0.71 per 100000, ranging from 0.33 to 1.32. This appeared to be lower than the incidences reported previously in Taiwan (incidence range from 1.74 to 3.72 per 100000 from 2001 to 2012), Netherlands (incidence range from 1.03 to 1.55 per 100000 from 2001 to 2012), and Denmark (incidence range from 0.26 to 3.7 per 100000 from 1976 to 2011). The annual incidence rate gradually increased from 0.33/100000 in 2005 to 1.32/100000 in 2019. […] The annual incidence of VS was highest in the age range of 60 to 69 years (1.791/100000 persons) and second highest in the age range of 50 to 59 years (1.497/100000 persons). The annual incidence of VS in female patients (0.900) was higher than in male patients (0.734). The overall female to male incidence ratio was 1.225, and the sex difference was statistically significant (p=0.0098).

• #19

  https://link.springer.com/article/10.1007/s00701-023-05665-9

  Vestibular schwannoma (VS) is the most common benign tumour arising in the lateral skull base. Reported incidence rates of VS vary across geographical locations and over time. There is scarce updated evidence over the past decade on the epidemiology and mode of presentation of VS. […] To describe the epidemiology and mode of presentation of VS in the East of England between 2013 and 2016. […] There were 391 new cases identified resulting in an overall mean incidence of 2.2 VS cases per 100,000 person-year. The incidence rate for all patients in the 40 age group ranged between 0.3 and 0.7 per 100,000 person-year, increasing to a range of 5.7 to 6.1 per 100,000 person-year in the 60-69 age group. […] The incidence of vestibular schwannoma has increased compared to previous studies in the UK and is similar to incidence rates reported in other countries during the past decade.

• #20 Incidence and presentation of vestibular schwannoma: a 3-year cohort registry study.

  https://www.repository.cam.ac.uk/items/3f4eaa6b-8b6d-4a5d-945c-f2ef4bad2307

  BACKGROUND: Vestibular schwannoma (VS) is the most common benign tumour arising in the lateral skull base. Reported incidence rates of VS vary across geographical locations and over time. […] OBJECTIVE: To describe the epidemiology and mode of presentation of VS in the East of England between 2013 and 2016. […] RESULTS: There were 391 new cases identified resulting in an overall mean incidence of 2.2 VS cases per 100,000 person-year. The incidence rate for all patients in the 40 age group ranged between 0.3 and 0.7 per 100,000 person-year, increasing to a range of 5.7 to 6.1 per 100,000 person-year in the 60-69 age group. […] CONCLUSIONS: The incidence of vestibular schwannoma has increased compared to previous studies in the UK and is similar to incidence rates reported in other countries during the past decade.

• #21

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1871924/

  Vestibular schwannomas, commonly termed acoustic neuromas, arise from the vestibular branch of the eighth cranial nerve and are benign, slow-growing brain tumors that negatively impact patient quality of life. They are thought to account for the majority of intracranial nerve sheath tumors. […] The overall incidence of primary nerve sheath tumors of the brain/CNS was 1.1 per 100,000 person-years (CBTRUS, 19951999 and LACCSP, 19951998). The incidence of vestibular schwannomas was similar for both data sets: 0.6 per 100,000 person-years (CBTRUS, 19951999) and 0.8 per 100,000 person-years (LACCSP, 19951998). […] Moreover, the incidence of primary nerve sheath tumors of the brain/CNS overall (CBTRUS, 19851999 and LACCSP, 19751998) and of vestibular schwannomas (CBTRUS, 19921999 and LACCSP, 19921998) increased over time.

• #22

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1871924/

  Increases in the incidence of vestibular schwannomas over the last few decades have also been observed in Denmark and other countries. […] The incidence of vestibular schwannomas was similar among males and females, higher in whites than in nonwhites, lowest among the 0- to 19-year age group, and highest among the 45- to 64-year age group. […] The incidence of vestibular schwannomas increased about 14% per year (95% CI, 8.2%20.8%). […] Statistically significant increasing trends were observed for nerve sheath tumors overall (P 0.0001) and the subgroups of benign schwannomas (P 0.0001) and vestibular schwannomas (P 0.0001). […] This analysis documented an increase in incidence of vestibular schwannomas, as well as primary nerve sheath tumors of the brain and CNS overall, lending (modest) support to the emerging hypothesis regarding an environmental cause of these rare tumors, which requires further elucidation.

• #23 Vestibular schwannoma (acoustic neuroma) – UpToDate

  https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma

  Vestibular schwannomas (also known as acoustic neuromas) are Schwann cell-derived, histologically benign tumors of the eighth cranial nerve, most commonly arising from the vestibular portion of the nerve. They are the third most common nonmalignant primary brain tumor, after meningioma and pituitary tumors, and account for 80 to 90 percent of tumors in the cerebellopontine angle. […] The overall incidence of vestibular schwannoma is approximately 3 to 5 per 100,000 person-years. The incidence rises with advancing age. For patients over 70 years of age, the incidence may be as high as 21 per 100,000 person-years. […] The incidence appears to be increasing, due at least in part to the incidental diagnosis of asymptomatic lesions with the widespread use of magnetic resonance imaging (MRI) and computed tomography (CT). A retrospective analysis of 46,000 MRI scans done for other reasons identified eight unsuspected vestibular schwannomas (0.02 percent), and autopsy studies suggest that the prevalence may be even higher.

• #24 Vestibular schwannoma (acoustic neuroma) – UpToDate

  https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma/print

  Vestibular schwannomas (also known as acoustic neuromas) are Schwann cell-derived, histologically benign tumors of the eighth cranial nerve, most commonly arising from the vestibular portion of the nerve. They are the third most common nonmalignant primary brain tumor, after meningioma and pituitary tumors, and account for 80 to 90 percent of tumors in the cerebellopontine angle. […] The overall incidence of vestibular schwannoma is approximately 3 to 5 per 100,000 person-years. The incidence rises with advancing age. For patients over 70 years of age, the incidence may be as high as 21 per 100,000 person-years. […] The incidence appears to be increasing, due at least in part to the incidental diagnosis of asymptomatic lesions with the widespread use of magnetic resonance imaging (MRI) and computed tomography (CT).

• #25 Vestibular schwannoma (acoustic neuroma) – UpToDate

  https://www.uptodate.com/contents/vestibular-schwannoma-acoustic-neuroma

  Vestibular schwannomas (also known as acoustic neuromas) are Schwann cell-derived, histologically benign tumors of the eighth cranial nerve, most commonly arising from the vestibular portion of the nerve. They are the third most common nonmalignant primary brain tumor, after meningioma and pituitary tumors, and account for 80 to 90 percent of tumors in the cerebellopontine angle. […] The overall incidence of vestibular schwannoma is approximately 3 to 5 per 100,000 person-years. The incidence rises with advancing age. For patients over 70 years of age, the incidence may be as high as 21 per 100,000 person-years. […] The incidence appears to be increasing, due at least in part to the incidental diagnosis of asymptomatic lesions with the widespread use of magnetic resonance imaging (MRI) and computed tomography (CT). A retrospective analysis of 46,000 MRI scans done for other reasons identified eight unsuspected vestibular schwannomas (0.02 percent), and autopsy studies suggest that the prevalence may be even higher.

• #26 Mayo Clinic Q and A: Is surgery best for an acoustic neuroma? – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-is-surgery-best-for-an-acoustic-neuroma/

  An acoustic neuroma, more accurately called a vestibular schwannoma, is a relatively uncommon and benign tumor that grows on the balance, or vestibular, nerve. […] Increasingly, acoustic neuromas are being discovered as incidental findings when people undergo an MRI for unrelated reasons, such as chronic headache, multiple sclerosis or even during surveillance imaging for another unrelated tumor. […] For many years, health care professionals thought surgical removal was the best treatment for everybody. But today, only some patients with acoustic neuroma will require surgery. […] Treatment varies depending on the size and growth of the acoustic neuroma, symptoms, and your personal preferences. […] Monitoring involves regular imaging and hearing tests, usually every six to 12 months at first. The main risk of monitoring is tumor growth and progressive hearing loss. […] Research in peripheral nerve tumors is ongoing in general and to compare the three treatment strategies. But based on long-term data, there appears to be surprisingly little difference in outcome no matter which treatment is chosen for smaller tumors.

• #27 Incidence and prevalence of vestibular schwannoma – Louis Hofmeyr

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/incidence-and-prevalence-of-vestibular-schwannoma/

  The mean age of diagnosis of sporadic vestibular schwannoma is 60 years. It has increased because life expectancy has risen, and magnetic resonance imaging has become readily available. […] The incidence of vestibular schwannoma is equal between men and women. […] The size of vestibular schwannoma at diagnosis has decreased. In 1976, the average size at diagnosis was 30mm. In 2015, the average size decreased to 7mm. This is because more MRIs are performed, and therefore, some vestibular schwannoma are picked up before displaying symptoms.

• #28

  https://journals.lww.com/otology-neurotology/Fulltext/2000/09000/Incidence_of_Vestibular_Schwannoma_in_Denmark,.18.aspx?generateEpub=Article%7Cotology-neurotology:2000:09000:00018%7C%7C

  To establish the incidence rate of vestibular schwannomas (VS) (acoustic neuromas) in Denmark. […] The nationwide and population-based age-specific, sex-specific, and calendar year-specific incidence rates of VS in Denmark between 1977 and 1995 are presented. […] A total of 795 cases were reported during the period of the study. […] The incidence rate increased from 5 cases per million population per year in 1977-1981 to 10 cases in 1992-1995; the increase was from 5 to 11 cases among women and 5 to 9 cases among men. […] The age-specific incidence rates show that VS is rarely diagnosed in persons under 30, but the incidence rate appears to increase among women after menopause. […] The overall incidence rate of VS increased linearly during the study period, probably owing to the introduction of more precise diagnostic procedures, increased awareness among physicians and patients of the symptoms of VS, improved registration of benign tumors in Denmark, and the use of data from two sources.

• #29 Epidemiology Of Vestibular Schwannomas – Prospective 40-Year Data From An Unselected National Cohort

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6850685/

  Reports on the epidemiology of vestibular schwannoma (VS) indicate an increase in diagnosed cases, often based on selected materials over a limited period of time. This report presents prospective 40-year epidemiological data from an unselected national cohort of all patients diagnosed with a VS in Denmark since 1976. […] Over the past 40 years, the incidence rate of vestibular schwannomas has increased steadily from 3 VS/million/year to 34 VS/million/year, primarily due to easier access to improved diagnostics and the finding of more tumors in older people. Concurrently, the diagnostic tumor size has decreased from 26mm to 7mm, and the age at diagnosis has increased from 49 to 60 years. […] This prospective study on 40-year epidemiological data from the unselected, unbiased national cohort of all Danish patients diagnosed with a VS since 1976 shows that the incidence rate of diagnosed tumors has been increasing steadily over the years, from 2.8 VS/million/year in 1976 to 33.8 VS/million/year in 2015. Improved diagnostics and increased availability of improved diagnostics are probably the main reasons for this increase, although an increased tumor occurrence cannot entirely be ruled out.

• #30 Incidence and prevalence of vestibular schwannoma – Louis Hofmeyr

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/incidence-and-prevalence-of-vestibular-schwannoma/

  The mean age of diagnosis of sporadic vestibular schwannoma is 60 years. It has increased because life expectancy has risen, and magnetic resonance imaging has become readily available. […] The incidence of vestibular schwannoma is equal between men and women. […] The size of vestibular schwannoma at diagnosis has decreased. In 1976, the average size at diagnosis was 30mm. In 2015, the average size decreased to 7mm. This is because more MRIs are performed, and therefore, some vestibular schwannoma are picked up before displaying symptoms.

• #31 Epidemiology Of Vestibular Schwannomas – Prospective 40-Year Data From An Unselected National Cohort

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6850685/

  Reports on the epidemiology of vestibular schwannoma (VS) indicate an increase in diagnosed cases, often based on selected materials over a limited period of time. This report presents prospective 40-year epidemiological data from an unselected national cohort of all patients diagnosed with a VS in Denmark since 1976. […] Over the past 40 years, the incidence rate of vestibular schwannomas has increased steadily from 3 VS/million/year to 34 VS/million/year, primarily due to easier access to improved diagnostics and the finding of more tumors in older people. Concurrently, the diagnostic tumor size has decreased from 26mm to 7mm, and the age at diagnosis has increased from 49 to 60 years. […] This prospective study on 40-year epidemiological data from the unselected, unbiased national cohort of all Danish patients diagnosed with a VS since 1976 shows that the incidence rate of diagnosed tumors has been increasing steadily over the years, from 2.8 VS/million/year in 1976 to 33.8 VS/million/year in 2015. Improved diagnostics and increased availability of improved diagnostics are probably the main reasons for this increase, although an increased tumor occurrence cannot entirely be ruled out.

• #32 Vestibular schwannoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/vestibular-schwannoma?embed_domain=hackmd.io%252525252f%2525252540yipuafecsl2jsu8smr5njq%252525252fbnjhjgjghjghjghfavicon.ico&lang=us

  Vestibular schwannomas account for ~8% of all primary intracranial tumors and 75-90% of CPA masses. The vast majority (95%) of solitary lesions are sporadic. Bilateral vestibular schwannomas are highly suggestive of neurofibromatosis type 2 (NF2), although bilateral tumors are encountered in the familial form of vestibular schwannomas in the absence of other stigmata of NF2. […] Although they usually occur between the fourth to sixth decades of life, with a median age of 50 years, individuals with NF2 tend to present earlier, with a peak incidence around the third decade of life. Although rare, vestibular schwannomas may occur in children.

• #33 Incidence and prevalence of vestibular schwannoma – Louis Hofmeyr

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/incidence-and-prevalence-of-vestibular-schwannoma/

  The mean age of diagnosis of sporadic vestibular schwannoma is 60 years. It has increased because life expectancy has risen, and magnetic resonance imaging has become readily available. […] The incidence of vestibular schwannoma is equal between men and women. […] The size of vestibular schwannoma at diagnosis has decreased. In 1976, the average size at diagnosis was 30mm. In 2015, the average size decreased to 7mm. This is because more MRIs are performed, and therefore, some vestibular schwannoma are picked up before displaying symptoms.

• #34

  https://step2.medbullets.com/oncology/120406/vestibular-schwannoma-acoustic-neuroma

  median age is ~50 years […] typically the vestibular portion […] usually unilateral (~90% of cases) […] associated with bilateral acoustic neuromas, cataracts, meningiomas, and ependymomas.

• #35 Incidence and presentation of vestibular schwannoma: a 3-year cohort registry study.

  https://www.repository.cam.ac.uk/items/3f4eaa6b-8b6d-4a5d-945c-f2ef4bad2307

  BACKGROUND: Vestibular schwannoma (VS) is the most common benign tumour arising in the lateral skull base. Reported incidence rates of VS vary across geographical locations and over time. […] OBJECTIVE: To describe the epidemiology and mode of presentation of VS in the East of England between 2013 and 2016. […] RESULTS: There were 391 new cases identified resulting in an overall mean incidence of 2.2 VS cases per 100,000 person-year. The incidence rate for all patients in the 40 age group ranged between 0.3 and 0.7 per 100,000 person-year, increasing to a range of 5.7 to 6.1 per 100,000 person-year in the 60-69 age group. […] CONCLUSIONS: The incidence of vestibular schwannoma has increased compared to previous studies in the UK and is similar to incidence rates reported in other countries during the past decade.

• #36 Incidence and Risk Factors of Vestibular Schwannoma in Korea : A Population-Based Study

  https://www.jkns.or.kr/journal/view.php?number=7576

  The incidence of VS exhibited an increasing trend from 2005 to 2019. Radiosurgery (46.64%) was the most common treatment modality. Diabetes, dyslipidemia, and alcohol consumption increased the risk of VS, while cigarette smoking reduced the risk of VS. […] The overall annual incidence from 2005 to 2020 was 0.71 per 100000, ranging from 0.33 to 1.32. This appeared to be lower than the incidences reported previously in Taiwan (incidence range from 1.74 to 3.72 per 100000 from 2001 to 2012), Netherlands (incidence range from 1.03 to 1.55 per 100000 from 2001 to 2012), and Denmark (incidence range from 0.26 to 3.7 per 100000 from 1976 to 2011). The annual incidence rate gradually increased from 0.33/100000 in 2005 to 1.32/100000 in 2019. […] The annual incidence of VS was highest in the age range of 60 to 69 years (1.791/100000 persons) and second highest in the age range of 50 to 59 years (1.497/100000 persons). The annual incidence of VS in female patients (0.900) was higher than in male patients (0.734). The overall female to male incidence ratio was 1.225, and the sex difference was statistically significant (p=0.0098).

• #37

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1871924/

  Increases in the incidence of vestibular schwannomas over the last few decades have also been observed in Denmark and other countries. […] The incidence of vestibular schwannomas was similar among males and females, higher in whites than in nonwhites, lowest among the 0- to 19-year age group, and highest among the 45- to 64-year age group. […] The incidence of vestibular schwannomas increased about 14% per year (95% CI, 8.2%20.8%). […] Statistically significant increasing trends were observed for nerve sheath tumors overall (P 0.0001) and the subgroups of benign schwannomas (P 0.0001) and vestibular schwannomas (P 0.0001). […] This analysis documented an increase in incidence of vestibular schwannomas, as well as primary nerve sheath tumors of the brain and CNS overall, lending (modest) support to the emerging hypothesis regarding an environmental cause of these rare tumors, which requires further elucidation.

• #38 Incidence and prevalence of vestibular schwannoma – Louis Hofmeyr

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/incidence-and-prevalence-of-vestibular-schwannoma/

  The mean age of diagnosis of sporadic vestibular schwannoma is 60 years. It has increased because life expectancy has risen, and magnetic resonance imaging has become readily available. […] The incidence of vestibular schwannoma is equal between men and women. […] The size of vestibular schwannoma at diagnosis has decreased. In 1976, the average size at diagnosis was 30mm. In 2015, the average size decreased to 7mm. This is because more MRIs are performed, and therefore, some vestibular schwannoma are picked up before displaying symptoms.

• #39 Incidence and Risk Factors of Vestibular Schwannoma in Korea : A Population-Based Study

  https://www.jkns.or.kr/journal/view.php?number=7576

  The incidence of VS exhibited an increasing trend from 2005 to 2019. Radiosurgery (46.64%) was the most common treatment modality. Diabetes, dyslipidemia, and alcohol consumption increased the risk of VS, while cigarette smoking reduced the risk of VS. […] The overall annual incidence from 2005 to 2020 was 0.71 per 100000, ranging from 0.33 to 1.32. This appeared to be lower than the incidences reported previously in Taiwan (incidence range from 1.74 to 3.72 per 100000 from 2001 to 2012), Netherlands (incidence range from 1.03 to 1.55 per 100000 from 2001 to 2012), and Denmark (incidence range from 0.26 to 3.7 per 100000 from 1976 to 2011). The annual incidence rate gradually increased from 0.33/100000 in 2005 to 1.32/100000 in 2019. […] The annual incidence of VS was highest in the age range of 60 to 69 years (1.791/100000 persons) and second highest in the age range of 50 to 59 years (1.497/100000 persons). The annual incidence of VS in female patients (0.900) was higher than in male patients (0.734). The overall female to male incidence ratio was 1.225, and the sex difference was statistically significant (p=0.0098).

• #40 Vestibular schwannoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/vestibular-schwannoma?embed_domain=hackmd.io%252525252f%2525252540yipuafecsl2jsu8smr5njq%252525252fbnjhjgjghjghjghfavicon.ico&lang=us

  Vestibular schwannomas account for ~8% of all primary intracranial tumors and 75-90% of CPA masses. The vast majority (95%) of solitary lesions are sporadic. Bilateral vestibular schwannomas are highly suggestive of neurofibromatosis type 2 (NF2), although bilateral tumors are encountered in the familial form of vestibular schwannomas in the absence of other stigmata of NF2. […] Although they usually occur between the fourth to sixth decades of life, with a median age of 50 years, individuals with NF2 tend to present earlier, with a peak incidence around the third decade of life. Although rare, vestibular schwannomas may occur in children.

• #41 Acoustic Neuroma: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/acoustic-neuromas

  Acoustic neuromas represent the third most common intracranial non-malignant tumour after meningiomas and pituitary adenomas. They are the most common extra-axial posterior fossa tumours in adults, comprising over 80% of tumours in the cerebellopontine angle. […] In most cases, the tumours present unilaterally; bilateral are a hallmark of neurofibromatosis type 2. […] Many epidemiological studies have failed to find a link between acoustic neuroma and mobile phone use. […] 7% of patients with acoustic neuroma also have NF2. […] Acoustic neuroma due to NF2 tends to present earlier, typically around 30 years old. […] Current treatment options include observation, surgical resection, fractionated radiotherapy, and radiosurgery. […] For patients with small neuromas and good preserved hearing, the most appropriate course of action may be to watch and wait with serial scans to monitor growth.

• #42 Acoustic Neuroma (Vestibular Schwannoma): Symptoms

  https://my.clevelandclinic.org/health/diseases/16400-acoustic-neuroma

  Acoustic neuromas (vestibular schwannomas) are benign (noncancerous) tumors that can affect the nerves that help you hear and maintain your balance. […] Each year, about 1 in 100,000 people develop an acoustic neuroma. People ages 65 to 74 are more likely to have an acoustic neuroma than younger adults and children. […] Treatments vary depending on factors like: The tumor size and location. How the tumor affects your hearing and balance. Your age and overall health. […] If tests show the tumor isnt growing and you have no symptoms, your provider may recommend observation. Theyll do regular MRIs to look for changes. […] Your care team will discuss possible post-surgical complications and how to treat and manage them. Issues that may arise after surgery include: Hearing loss in one ear. […] Acoustic neuromas are slow-growing, benign (noncancerous) tumors that can affect your hearing and balance.

• #43 Acoustic Neuroma (Vestibular Schwannoma) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/acoustic-neuroma

  Acoustic neuroma, also called vestibular schwannoma, is a type of benign (noncancerous) tumor. It starts in the cells that wrap around the hearing and balance nerve that connects your ear to your brain. […] Each year in the United States, more than 5,000 people are diagnosed with an acoustic neuroma. They are often between the ages of 30 and 60. […] There are no obvious risk factors for developing an acoustic neuroma. Most affect only one ear. […] Some people develop acoustic neuromas in both ears as part of a hereditary disorder called NF2-related schwannomatosis. This is rare. When it does happen, teens and young adults are most often affected. […] If you think you may have an acoustic neuroma, Memorial Sloan Ketterings experts can make or confirm your diagnosis. Once a diagnosis is made, well work with you to determine which treatment is the best. Treatments for acoustic neuroma include wait and see (observation), surgery, radiation therapy, or a combination of surgery and radiation. If your symptoms are not severe, and if the tumor is small and if it is not growing, we may recommend observation of your condition with no other intervention. […] An appointment to see one of our experts for an acoustic neuroma diagnosis or treatment is usually available within days.

• #44 Vestibular schwannoma – Wikipedia

  https://en.wikipedia.org/wiki/Vestibular_schwannoma

  A vestibular schwannoma (VS), also called acoustic neuroma, is a benign tumor that develops on the vestibulocochlear nerve that passes from the inner ear to the brain. […] The only environmental exposure that has been definitely associated with the growth of a VS is therapeutic radiation exposure to the head. […] Both varieties of VS (sporadic and NF2) are very rare, accounting for only about 8% of all primary brain tumors. The incidence of NF2 is approximately 1 per 60,000 people. […] In 2015, researchers at the Cleveland Clinic in Ohio used population-based data of the Central Brain Tumor Registry of the U.S. to calculate an incidence of 10.9 per million of population, or about 3,300 cases of VS per year. A higher incidence up to 29.3 per million of population was found for the 65-74 year-old age group. […] The annual number of diagnosed VS increased significantly worldwide by the early 1990s with the introduction of magnetic resonance imaging (MRI). […] Epidemiologists in Denmark reported 193 cases of VS for 2015—an incidence of 34 per million of population per year.

• #45 Incidence and Risk Factors of Vestibular Schwannoma in Korea : A Population-Based Study

  https://www.jkns.or.kr/journal/view.php?number=7576

  In univariate analysis, VS was associated with all of three metabolic diseases; hypertension (hazard ratio [HR], 1.223; 95% confidence interval [CI], 1.161-1.289), diabetes mellitus (HR, 1.346; 95% CI, 1.274-1.421), dyslipidemia (HR, 1.459; 95% CI, 1.385-1.537). Smoking history decreased the risk of VS (HR, 0.806; 95% CI, 0.755-0.860), and alcohol history increased the risk of VS (HR, 2.069; 95% CI, 1.952-2.194). […] In multivariate Cox regression analysis, hypertension was not a statistically significant risk factor of VS (p=0.3104). VS was associated with diabetes mellitus (HR, 1.123; 95% CI, 1.048-1.203) and dyslipidemia (HR, 1.276; 95% CI, 1.194-1.363). Alcohol consumption increased the risk of VS (HR, 2.631; 95% CI, 2.469-2.803) in highest HR among the risk factors. On the contrary, smoking (current or ex-smoker) was associated with decreased risk of VS (HR, 0.557; 95% CI, 0.519-0.597).

• #46 Incidence and Risk Factors of Vestibular Schwannoma in Korea : A Population-Based Study

  https://www.jkns.or.kr/journal/view.php?number=7576

  In univariate analysis, VS was associated with all of three metabolic diseases; hypertension (hazard ratio [HR], 1.223; 95% confidence interval [CI], 1.161-1.289), diabetes mellitus (HR, 1.346; 95% CI, 1.274-1.421), dyslipidemia (HR, 1.459; 95% CI, 1.385-1.537). Smoking history decreased the risk of VS (HR, 0.806; 95% CI, 0.755-0.860), and alcohol history increased the risk of VS (HR, 2.069; 95% CI, 1.952-2.194). […] In multivariate Cox regression analysis, hypertension was not a statistically significant risk factor of VS (p=0.3104). VS was associated with diabetes mellitus (HR, 1.123; 95% CI, 1.048-1.203) and dyslipidemia (HR, 1.276; 95% CI, 1.194-1.363). Alcohol consumption increased the risk of VS (HR, 2.631; 95% CI, 2.469-2.803) in highest HR among the risk factors. On the contrary, smoking (current or ex-smoker) was associated with decreased risk of VS (HR, 0.557; 95% CI, 0.519-0.597).

• #47 Cancer Epidemiology – Acoustic neuroma risk in relation to mobile telephone use: Results of the INTERPHONE international case–control study – IARC

  https://www.iarc.who.int/news-events/cancer-epidemiology-acoustic-neuroma-risk-in-relation-to-mobile-telephone-use-results-of-the-interphone-international-case-control-study/

  Acoustic neuroma risk in relation to mobile telephone use: Results of the INTERPHONE international casecontrol study doi:10.1016/j.canep.2011.05.012, Available online 23 August 2011. The study included 1105 patients with newly diagnosed acoustic neuroma (vestibular schwannoma) and 2145 controls from 13 countries. There was no increase in risk of acoustic neuroma with ever regular use of a mobile phone or for users who began regular use 10 years or more before diagnosis. Elevated risks observed at the highest level of cumulative call time could be due to chance, reporting bias or a causal effect.

• #48 Vestibular schwannoma – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/731

  Vestibular schwannoma is a histologically benign, generally slow-growing tumor that may remain stable for long periods on follow-up magnetic resonance imaging scans after initial detection. […] Diagnosis is confirmed by gadolinium-enhanced magnetic resonance imaging of the head. […] Management includes observation (active surveillance), focused radiation (stereotactic radiosurgery or radiation therapy), or surgery. […] Decision-making regarding tumor management is mainly based on the presenting tumor size, detection of growth during active surveillance, provider bias, baseline patient function (e.g., hearing status), and patient preference. […] Although most tumors are now diagnosed at a smaller size in people with less severe symptoms compared to the pre-magnetic resonance imaging era, some tumors are still only detected after growing quite large and may result in brainstem compression and hydrocephalus.

• #49 Vestibular schwannoma (VS) | CUH

  https://www.cuh.nhs.uk/patient-information/vestibular-schwannoma-vs/

  Vestibular schwannomas are very rare. There is one new vestibular schwannoma diagnosed each year for every 100,000 people in the population. They can occur at any age but are most common in people in their 50s and 60s. They affect men and women equally. […] Approximately 40% of vestibular schwannomas grow after diagnosis but the growth rate is usually very slow with an average growth rate of 1-2mm a year. They can occasionally grow faster and the pattern of growth is very variable. However, the rate of growth means that it is generally safe to plan treatment ahead of time. […] If the scan shows there is growth of the tumour, then we will arrange for you to come to Addenbrookes so that we can show you the scan and discuss what should be done. If there is a small amount of growth and the tumour is not touching the brain, then it may be possible for us to continue observing the tumour. However, if the tumour is starting to compress the brain, then we would probably recommend either radiotherapy or surgery in order to treat the tumour. These forms of treatment will be fully discussed with you so that you can make an informed decision about which type of treatment you would like.

• #50 Wait and scan management of vestibular schwannoma

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/wait-and-scan-management-of-vestibular-schwannoma/

  Wait and scan management of vestibular schwannoma is the observation of the tumour without active intervention. It forms with microsurgery, and radiation are the three options for the management of vestibular schwannomas. Wait and scan management is viable, as 20% to 50% of tumours do not grow over five years from diagnosis. Vestibular schwannomas are benign tumours of the nerves of the inner ear. The incidence is 4-5/100 000 of the population and has increased slightly since the implementation of magnetic resonance imaging (MRI). The trend is that tumours are discovered earlier when they are smaller. These factors make observation, referred to as wait and scan, a management strategy. […] It is crucial that patients are compliant and adhere to the follow-up appointments, so the wait and scan management of vestibular schwannoma protocol should only be considered in motivated patients.

• #51 Wait and scan management of vestibular schwannoma

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/wait-and-scan-management-of-vestibular-schwannoma/

  Vestibular schwannomas are likely to grow within the first five years, with 50%-80% showing growth. Regardless of age at diagnosis, it is probable that sporadic vestibular schwannomas will grow at some point in a patients life, with most tumours showing growth post-diagnosis. Monitoring tumour size is crucial for timely intervention and management. […] Wait and scan may be considered in a known stable (not growing) tumour, a slow-growing tumour with no symptoms, elderly patients over 65 years, especially those with small tumours, vestibular schwannoma in the only or significantly better hearing ear, those with risks for anaesthesia or surgery, those who cannot tolerate radiation, small tumours with good hearing, and those who refuse treatment. […] The ultimate aim of wait and scan management of vestibular schwannoma is maintaining a good quality of life (QOL) for the patient. The QOL is better for the wait and scan management strategy than those who received upfront surgical or radiation treatment. Some of the advantages include the following: 20%- 50% of vestibular schwannomas will not grow in 5 years, 50% of patients with good hearing and 55% of patients with serviceable hearing will preserve it at five years, facial nerve outcomes are better with observation, avoidance of surgical complications (usually early) and radiotherapy complications (usually late), no time off from work, and cost saving compared to surgery and radiation in the early and medium follow-up period.

• #52

  https://link.springer.com/article/10.1007/s12105-020-01155-x

  Vestibular schwannoma (VS) accounts for approximately 8% of all intracranial tumours with an incidence of 10.4 per million per year. […] The documented incidence of VS is rising, but there is a general consensus that this is a reflection of increased reporting. […] The now common use of magnetic resonance imaging (MRI) for symptoms of tinnitus and earlier care seeking patient behaviours are contributing factors to these higher numbers. […] A systematic review of 41 papers showed a mean tumour growth rate of 12 mm/year with up to 75% of tumours showing no further growth. […] An observational study of 436 patients showed similar findings where 68% of tumours did not grow during the follow-up period (mean 3.6 years). […] The evidence presented is inconclusive regarding the best treatment options for all categories of VS.

• #53 The behavior of residual tumors following incomplete surgical resection for vestibular schwannomas | Scientific Reports

  https://www.nature.com/articles/s41598-021-84319-1

  The management of vestibular schwannoma (VS) with residual tumor following incomplete resection remains controversial and little is known regarding postoperative tumor volume changes. […] Fifty-three patients underwent imaging surveillance following incomplete resection. There was no residual tumor growth in 44 patients (83%). […] Significant predictors of regrowth were immediate postoperative tumor volume0.7 cm3 (HR 10.5, p=0.020) and residual tumor location other than the internal auditory canal (IAC) (HR 6.2, p=0.026). […] In conclusion, significant residual tumor regression could occur within 2 years for a VS with an immediate postoperative tumor volume less than 0.7 cm3 or residual tumor in IAC. […] The question of when and under what circumstances should GKRS be performed following incomplete resection will depend on the incidence and the rate of tumor regrowth, and the benefit on neurological outcome.

• #54 How many growing vestibular schwannomas tend to stop growing without any treatment? | The Journal of Laryngology & Otology | Cambridge Core

  https://www.cambridge.org/core/journals/journal-of-laryngology-and-otology/article/how-many-growing-vestibular-schwannomas-tend-to-stop-growing-without-any-treatment/EE65C1C1F594F192FDE6E7636124AD63

  To determine the long-term, spontaneous growth arrest rates in a large cohort of vestibular schwannoma patients. […] A total of 288 patients (39.2 per cent) had growing vestibular schwannomas. […] Approximately 20 per cent of growing vestibular schwannomas spontaneously stop growing, predominantly within the first five years; this is important for long-term management. […] In the UK, the prevalence is 2 per 100 000, and the tumours usually occur between the fourth and sixth decades of life. […] 82 per cent of vestibular schwannomas stopped growing within five years. […] Our study findings indicate that 20 per cent of all growing vestibular schwannomas spontaneously stop growing. […] Additionally, we showed that 82 per cent of vestibular schwannomas stopped growing within the first five years of diagnosis; hence, tumours that continue to grow after this point are less likely to stop.

• #55 How many growing vestibular schwannomas tend to stop growing without any treatment? | The Journal of Laryngology & Otology | Cambridge Core

  https://www.cambridge.org/core/journals/journal-of-laryngology-and-otology/article/how-many-growing-vestibular-schwannomas-tend-to-stop-growing-without-any-treatment/EE65C1C1F594F192FDE6E7636124AD63

  Based on our data, should a small vestibular schwannoma continue growing after a five-year period, treatment might be considered at that point, as the chances that it will spontaneously stop growing are low. […] This retrospective series of 735 sporadic vestibular schwannomas showed that 20 per cent of tumours spontaneously stop growing, usually within five years of diagnosis. […] As tumour growth is likely to stop without any active treatment, extended surveillance is justified, unless there are clinical or radiological contraindications.

• #56 Wait and scan management of vestibular schwannoma

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/wait-and-scan-management-of-vestibular-schwannoma/

  Vestibular schwannomas are likely to grow within the first five years, with 50%-80% showing growth. Regardless of age at diagnosis, it is probable that sporadic vestibular schwannomas will grow at some point in a patients life, with most tumours showing growth post-diagnosis. Monitoring tumour size is crucial for timely intervention and management. […] Wait and scan may be considered in a known stable (not growing) tumour, a slow-growing tumour with no symptoms, elderly patients over 65 years, especially those with small tumours, vestibular schwannoma in the only or significantly better hearing ear, those with risks for anaesthesia or surgery, those who cannot tolerate radiation, small tumours with good hearing, and those who refuse treatment. […] The ultimate aim of wait and scan management of vestibular schwannoma is maintaining a good quality of life (QOL) for the patient. The QOL is better for the wait and scan management strategy than those who received upfront surgical or radiation treatment. Some of the advantages include the following: 20%- 50% of vestibular schwannomas will not grow in 5 years, 50% of patients with good hearing and 55% of patients with serviceable hearing will preserve it at five years, facial nerve outcomes are better with observation, avoidance of surgical complications (usually early) and radiotherapy complications (usually late), no time off from work, and cost saving compared to surgery and radiation in the early and medium follow-up period.

• #57 Tinnitus as the sole symptom of vestibular schwannoma …

  https://otorhinolaryngologypl.com/seo/article/01.3001.0009.5290/en

  The question, when a patient should be directed for magnetic resonance imaging, recognised as the gold standard in the diagnostics of vestibular schwannoma with sensitivity of up to 00%, remains open. […] According to Dawes et al., the application of MRI to patients with unilateral tinnitus as the sole symptom allows detection of vestibular schwannoma in 0.5% of cases. According to those authors it is the argument for performing MRI in all patients reporting unilateral tinnitus. […] Non-typical clinical presentations of vestibular schwannoma, with normal results of audiological tests, may pose a diagnostic challenge resulting in delayed diagnosis and treatment.

• #58 Guidelines on the Management of Patients with Vestibular Schwannoma

  https://www.cns.org/guidelines/management-patients-vestibular-schwannoma/5-role-of-imaging-in-diagnosis-management-of-patie

  Level 3: Imaging used to detect vestibular schwannomas should use high-resolution T2-weighted and contrast-enhanced T1-weighted MRI. […] Level 3: Preoperative surveillance for growth of a vestibular schwannoma should be followed with either contrast-enhanced 3D T1 MPRAGE or high-resolution T2 (including CISS or FIESTA sequences) MR imaging. […] Level 3: MRIs should be obtained annually for 5 years, with interval lengthening thereafter with tumor stability. […] Level 3: Adults with cystic vestibular schwannomas should be counseled that their tumors may more often be associated with rapid growth, lower rates of complete resection, and facial nerve outcomes that may be inferior in the immediate postoperative period but similar to non-cystic schwannomas over time. […] Level 3: The degree of lateral IAC involvement by tumor adversely affects facial nerve and hearing outcomes and should be emphasized when interpreting imaging for preoperative planning.

• #59 High-Resolution T2-Weighted Imaging for Surveillance in Postoperative Vestibular Schwannoma: Equivalence with Contrast-Enhanced T1WI for Measurement and Surveillance of Residual Tumor | American Journal of Neuroradiology

  https://www.ajnr.org/content/43/12/1792

  Patients with surgically resected vestibular schwannoma will undergo multiple postoperative surveillance examinations, typically including postcontrast sequences. […] In the postoperative setting, imaging surveillance is necessary for at least 10 years postprocedure, because reported recurrence/residual rates range from 0.17% to 7.7%, depending, in large part, on the completeness of the initial resection. […] On the basis of these results, high-resolution T2WI alone may be sufficient for early postoperative imaging surveillance in this patient population. […] The current recommendations of the American College of Radiology for screening in patients with asymmetric sensorineural hearing loss include both MR imaging of the head and internal auditory canal without and with IV contrast and MR imaging of the head and internal auditory canal without IV contrast, with the latter being an acceptable route when there is a contraindication to contrast administration.

• #60 High-Resolution T2-Weighted Imaging for Surveillance in Postoperative Vestibular Schwannoma: Equivalence with Contrast-Enhanced T1WI for Measurement and Surveillance of Residual Tumor | American Journal of Neuroradiology

  https://www.ajnr.org/content/43/12/1792

  There are no existing American College of Radiology recommendations regarding imaging surveillance in the postoperative setting in patients with vestibular schwannoma; however, contrast-enhanced sequences are typically included. […] This study demonstrates that HR-T2WI is equivalent to Gd-T1WI in the evaluation of residual vestibular schwannoma in patients with prior tumor resection. […] On the basis of these results, HR-T2WI alone may be sufficient for early imaging surveillance in this patient population, thereby reducing examination time and obviating need for multiple contrast doses with time.

• #61 Evidence-based surveillance protocol for vestibular schwannomas: a long-term analysis of tumor growth using conditional probability in: Journal of Neurosurgery Volume 137 Issue 4 (2022) Journals

  https://thejns.org/view/journals/j-neurosurg/137/4/article-p1026.xml

  Conditional probability, we believe, represents a more clinically relevant statistical methodology for approximating growth risks in patients with VS, as it uses information about prior tumor behavior and therefore lends itself to answering questions about the optimum surveillance protocol. […] We posited a surveillance protocol based on conditional probabilities. This protocol should allow the identification of patients whose VS might exhibit growth within the early years of follow-up (when growth risk is greatest), while progressively increasing scanning intervals in line with the reduction in the growth risk observed over time. […] The decision to stop surveillance is more nuanced, and it is ultimately a value judgment to set this at 10.5 years. […] The results presented here allow insights into the long-term growth behavior of VS, which can be used to better inform patients of their risk of growth at particular time points along their surveillance timelinewith the residual lifetime risk of growth at 1% after 7 years 7 months, 0.5% after 8 years 11 months, and 0.25% after 10 years 4 months. […] Thus, we propose a 10.5-year growth riskbased surveillance protocol for VSs under observation, in which interval imaging is undertaken once at 6 months, annually for 3 years, twice at 2-year intervals, and a final scan after 3 years.

• #62 Evidence-based surveillance protocol for vestibular schwannomas: a long-term analysis of tumor growth using conditional probability in: Journal of Neurosurgery Volume 137 Issue 4 (2022) Journals

  https://thejns.org/view/journals/j-neurosurg/137/4/article-p1026.xml

  Conditional probability, we believe, represents a more clinically relevant statistical methodology for approximating growth risks in patients with VS, as it uses information about prior tumor behavior and therefore lends itself to answering questions about the optimum surveillance protocol. […] We posited a surveillance protocol based on conditional probabilities. This protocol should allow the identification of patients whose VS might exhibit growth within the early years of follow-up (when growth risk is greatest), while progressively increasing scanning intervals in line with the reduction in the growth risk observed over time. […] The decision to stop surveillance is more nuanced, and it is ultimately a value judgment to set this at 10.5 years. […] The results presented here allow insights into the long-term growth behavior of VS, which can be used to better inform patients of their risk of growth at particular time points along their surveillance timelinewith the residual lifetime risk of growth at 1% after 7 years 7 months, 0.5% after 8 years 11 months, and 0.25% after 10 years 4 months. […] Thus, we propose a 10.5-year growth riskbased surveillance protocol for VSs under observation, in which interval imaging is undertaken once at 6 months, annually for 3 years, twice at 2-year intervals, and a final scan after 3 years.

• #63 Guidelines on the Management of Patients with Vestibular Schwannoma

  https://www.cns.org/guidelines/management-patients-vestibular-schwannoma/5-role-of-imaging-in-diagnosis-management-of-patie

  Level 3: Imaging used to detect vestibular schwannomas should use high-resolution T2-weighted and contrast-enhanced T1-weighted MRI. […] Level 3: Preoperative surveillance for growth of a vestibular schwannoma should be followed with either contrast-enhanced 3D T1 MPRAGE or high-resolution T2 (including CISS or FIESTA sequences) MR imaging. […] Level 3: MRIs should be obtained annually for 5 years, with interval lengthening thereafter with tumor stability. […] Level 3: Adults with cystic vestibular schwannomas should be counseled that their tumors may more often be associated with rapid growth, lower rates of complete resection, and facial nerve outcomes that may be inferior in the immediate postoperative period but similar to non-cystic schwannomas over time. […] Level 3: The degree of lateral IAC involvement by tumor adversely affects facial nerve and hearing outcomes and should be emphasized when interpreting imaging for preoperative planning.

• #64 Guidelines on the Management of Patients with Vestibular Schwannoma

  https://www.cns.org/guidelines/management-patients-vestibular-schwannoma/5-role-of-imaging-in-diagnosis-management-of-patie

  Level 3: In general, vestibular schwannomas associated with NF2 should be imaged (similar to sporadic schwannomas) with the following caveats: More frequent imaging may be adopted in NF2 patients because of a more variable growth rate for vestibular schwannomas, and annual imaging may ensue once the growth rate is established. […] Level 3: For patients receiving gross total resection, a postoperative MRI may be considered to document the surgical impression and may occur as late as 1 year after surgery. For patients not receiving gross total resection, more frequent surveillance scans are suggested; annual MRI scans may be reasonable for 5 years. Imaging follow-up should be adjusted accordingly for continued surveillance if any change in nodular enhancement is demonstrated.

• #65 Guidelines on the Management of Patients with Vestibular Schwannoma

  https://www.cns.org/guidelines/management-patients-vestibular-schwannoma/5-role-of-imaging-in-diagnosis-management-of-patie

  Level 3: In general, vestibular schwannomas associated with NF2 should be imaged (similar to sporadic schwannomas) with the following caveats: More frequent imaging may be adopted in NF2 patients because of a more variable growth rate for vestibular schwannomas, and annual imaging may ensue once the growth rate is established. […] Level 3: For patients receiving gross total resection, a postoperative MRI may be considered to document the surgical impression and may occur as late as 1 year after surgery. For patients not receiving gross total resection, more frequent surveillance scans are suggested; annual MRI scans may be reasonable for 5 years. Imaging follow-up should be adjusted accordingly for continued surveillance if any change in nodular enhancement is demonstrated.

• #66 Guidelines on the Management of Patients with Vestibular Schwannoma

  https://www.cns.org/guidelines/management-patients-vestibular-schwannoma/5-role-of-imaging-in-diagnosis-management-of-patie

  Level 3: In general, vestibular schwannomas associated with NF2 should be imaged (similar to sporadic schwannomas) with the following caveats: More frequent imaging may be adopted in NF2 patients because of a more variable growth rate for vestibular schwannomas, and annual imaging may ensue once the growth rate is established. […] Level 3: For patients receiving gross total resection, a postoperative MRI may be considered to document the surgical impression and may occur as late as 1 year after surgery. For patients not receiving gross total resection, more frequent surveillance scans are suggested; annual MRI scans may be reasonable for 5 years. Imaging follow-up should be adjusted accordingly for continued surveillance if any change in nodular enhancement is demonstrated.

• #67 Vestibular schwannoma (VS) | CUH

  https://www.cuh.nhs.uk/patient-information/vestibular-schwannoma-vs/

  Because the radiotherapy will not remove the tumour, we would recommend a follow-up schedule that includes MRI scans in order to check that the vestibular schwannoma does not show evidence of further growth. It is common in the 1st couple of years after radiotherapy to actually see a slight increase in the size of the lesion as a response to treatment. Normally this will have settled and we would expect the tumour size to be stable from year three onwards.

• #68 Wait and scan management of vestibular schwannoma

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/wait-and-scan-management-of-vestibular-schwannoma/

  Vestibular schwannomas are likely to grow within the first five years, with 50%-80% showing growth. Regardless of age at diagnosis, it is probable that sporadic vestibular schwannomas will grow at some point in a patients life, with most tumours showing growth post-diagnosis. Monitoring tumour size is crucial for timely intervention and management. […] Wait and scan may be considered in a known stable (not growing) tumour, a slow-growing tumour with no symptoms, elderly patients over 65 years, especially those with small tumours, vestibular schwannoma in the only or significantly better hearing ear, those with risks for anaesthesia or surgery, those who cannot tolerate radiation, small tumours with good hearing, and those who refuse treatment. […] The ultimate aim of wait and scan management of vestibular schwannoma is maintaining a good quality of life (QOL) for the patient. The QOL is better for the wait and scan management strategy than those who received upfront surgical or radiation treatment. Some of the advantages include the following: 20%- 50% of vestibular schwannomas will not grow in 5 years, 50% of patients with good hearing and 55% of patients with serviceable hearing will preserve it at five years, facial nerve outcomes are better with observation, avoidance of surgical complications (usually early) and radiotherapy complications (usually late), no time off from work, and cost saving compared to surgery and radiation in the early and medium follow-up period.

• #69 Wait and scan management of vestibular schwannoma

  https://lmhofmeyr.co.za/conditions/conditions-we-specialise-in/acoustic-neuroma/wait-and-scan-management-of-vestibular-schwannoma/

  The following are considered as possible disadvantages: The further and rapid growth of the tumour may make treatment more difficult at a later stage, increase in hearing loss if the tumour is not removed or prevented from growing, in younger patients where complications of microsurgery are related to the size of the tumour, allowing tumour growth with observation may be problematic later, in cases of intracannalicular (smaller) vestibular schwannomas where growth is allowed to maintain hearing, cochlear implantation may not be possible later, a 15% risk of sudden hearing loss, there is a 20% risk of vertigo that may be sudden and incapacitating, anxiety and poor QOL in some patients, knowing that they have an untreated tumour, and the necessity for lifelong MRI and the potentially toxic accumulation of the gadolinium contrast medium in the body.

• #70 Vestibular Schwannoma (acoustic neuroma) | Dr Sean Flanagan

  https://sydneyentclinic.com/sean-flanagan/patient-resources-2/vestibular-schwannoma-acoustic-neuroma/

  Vestibular schwannomas are benign tumours arising from the vestibulo-cochlear nerve. They are the commonest tumour of the cerebello-pontine angle at 80% and represent about 9% of all intracranial tumours. […] A renowned pathologist Schuckneckt estimated an incidence of 0.57% on review of 1400 temporal bones. The National Institutes of Health Consensus Statement estimated an incidence of around 1 per 100,000 per year. The inference is that a significant number of tumours never become clinically apparent. […] The St Vincents Otology and Skull Base Unit has been conducting a prospective study on the management of vestibular schwannomas for over 10 years. […] The failure rate of conservative therapy is now 15-20%, which means that interventional treatment is required after an initial period of observation.

• #71 Quality of life outcomes in acoustic neuroma: systematic review (2000–2021) | The Egyptian Journal of Otolaryngology | Full Text

  https://ejo.springeropen.com/articles/10.1186/s43163-022-00285-z

  In a systematic review on QOL outcomes of AN, Gauden et al. concluded, based upon 47 studies published until 2010, that (1) patients with AN experience reduced QOL compared to population norms, (2) those with larger tumours may experience lower QOL than those with smaller tumours, (3) surgery may improve QOL in patients with large tumours after a temporary decline in physical dimensions of QOL and, (4) conservative treatment and radiosurgery have no effect on QOL. […] Surgical teams should prepare patients for this possibility and ensure adequate community follow-up with specialist physical therapies, audiology, ophthalmology, and psychology to mitigate these effects should they occur. […] This study demonstrates continued interest in AN outcomes beyond physical symptoms but also QOL and provides an update to previous systematic reviews. Study quality was generally good despite expected limitations due to the nature of the population, which does not allow randomisation or blinding of participants. To summarise the present findings: (1) when compared to normative controls, QOL of those with AN is similar if they are under active surveillance. This group typically produced significantly better QOL scores than those who underwent surgery, and there was some indication of improvements in QOL from diagnosis to follow-up. (2) Whilst the greatest proportion of studies comparing QOL between treatment modalities found no significant differences, across study types, those who underwent surgery tended to produce worse QOL than normative data, or those undergoing SRT/SRS or active surveillance, and also show reductions in QOL pre- to post- surgery which were not present in those undergoing SRT/SRS or active surveillance. Evidence for changes in QOL following SRT/SRS was mixed. (3) There was consistency across study types that presence of vertigo and dizziness negatively impacts on QOL regardless of treatment received and that pain (whilst uncommon) also reduces QOL post-surgery; however, the findings for demographic factors such as age, gender, and tumour characteristics were variable across studies. (5) Those who belong to local AN associations may not be representative of AN as a whole, being less likely to remain in active surveillance and more likely to report symptoms and have poorer QOL.

• #72 Quality of life outcomes in acoustic neuroma: systematic review (2000–2021) | The Egyptian Journal of Otolaryngology | Full Text

  https://ejo.springeropen.com/articles/10.1186/s43163-022-00285-z

  Active AN treatments, whilst necessarily to preserve health, can leave some patients with long-term physical deficits. These can have a significant impact across a wide range of QOL domains beyond the physical impairment and into social and emotional wellbeing and participation in society. Surgical teams should adequately prepare patients for this prior to treatment and ensure patients receive adequately community follow-up in terms of specialist physical therapies, audiology, ophthalmology, and psychological follow-up as well as encouraging patients to join support groups and AN associations to learn from and engage the support of peers. Quality-of-life should be a consideration in treatment decisions in view of the differences across modalities.

• #73 Vestibular Schwannoma: Epidemiology, Risk Factors, and Quality of Life – D-Scholarship@Pitt

  http://d-scholarship.pitt.edu/10555/

  INTRODUCTION:The goal of this study has been to describe the epidemiology of vestibular schwannoma and explore potential risk factors for this tumor. […] The epidemiology and risk factors of vestibular schwannoma are poorly understood. Continued research in this area will help to develop an understanding of brain tumor etiology and the role of potential carcinogens in the environment.

Zobacz więcej