Acoustic Neuroma: Outcome Study

Nader, Remi; Al-Abdulhadi, Khalid; Leblanc, Ree; Zeitouni, Anthony

doi:10.2310/7070.2002.21080

Cited by 8 publications

(4 citation statements)

References 0 publications

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“…Tumor growth was evaluated on serial MR imaging in 12 studies, 8,15,17,20,23,24,26,32,35,37,38,40 on CT or MR imaging in the other 14. 1,2,4,5,7,9,14,16,18,19,22,25,30,33 The mean age of patients was 62 years (range 52-75 years). Information regarding initial tumor size was available in 22 studies (1163 patients).…”

Section: Characteristics Of Studies Patients and Tumorsmentioning

confidence: 99%

Systematic review of the natural history of vestibular schwannoma

Yoshimoto¹

2005

Journal of Neurosurgery

169

120

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Section: Characteristics Of Studies Patients and Tumorsmentioning

confidence: 99%

Systematic review of the natural history of vestibular schwannoma

Yoshimoto¹

2005

Journal of Neurosurgery

169

120

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“…Nader et al 56 . have recently made an attempt to compare the three management modalities but, unfortunately, their radiation group consisted of only three patients and their outcome measures were limited to tumour control and facial nerve function.…”

mentioning

confidence: 99%

Quality of life following microsurgery, radiosurgery and conservative management for unilateral vestibular schwannoma

et al. 2004

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The best way to manage small and medium-sized vestibular schwannomas is currently a matter of heated debate. As these tumours are not immediately life-threatening, patients are invariably concerned about how management would affect their quality of life. Until now, no study has compared the three treatment modalities in terms of physical, psychological and social wellbeing. This study is based on a retrospective database analysis and postal questionnaire survey of unilateral vestibular schwannoma patients who had either been managed conservatively, or treated with microsurgery or radiosurgery. The results showed that: quality of life (measured by the Glasgow Benefit Inventory) deteriorated after microsurgery, particularly for small tumours; conservative management did not lead to a change in quality of life, and there was a trend towards poorer quality of life following radiosurgery. The findings suggest that a conservative management approach may be more appropriate for small tumours, and that patients who are due to undergo microsurgery or radiosurgery may benefit from counselling about the potential impact of treatment on quality of life.

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“…The overall failure rate, defined as conversion to an active treatment, has been found to be 15%-50%. 5,21,29,39,40 Smouha et al 29 reported that 43% of patients undergoing conservative management ultimately demonstrate positive tumor growth. However, only 20% of the patients undergoing a conservative regimen required definitive treatment, suggesting that treatment failure is not directly linked to tumor growth.…”

Section: Conversion To Active Treatmentmentioning

confidence: 99%

Incidental vestibular schwannomas: a review of prevalence, growth rate, and management challenges

Schmidt¹,

Boghani²,

Choudhry³

et al. 2012

FOC

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With the relatively recent increase in the use of MRI techniques, there has been a concurrent rise in the number of vestibular schwannomas (VSs) detected as incidental findings. These incidental VSs may be prevalent in up to 0.02%–0.07% of individuals undergoing MRI and represent a significant portion of all diagnosed VSs. The management of these lesions poses a significant challenge for practitioners. Most incidental VSs tend to be small and associated with minimal symptoms, permitting them to be managed conservatively at the time of diagnosis. However, relatively few indicators consistently predict tumor growth and patient outcomes. Furthermore, growth rates have been shown to vary significantly over time with a large variety of long-term growth patterns. Thus, early MRI screening for continued tumor growth followed by repeated MRI studies and clinical assessments throughout the patient's life is an essential component in a conservative management strategy. Note that tumor growth is typically associated with a worsening of symptoms in patients who undergo conservative management, and many of these symptoms have been shown to significantly impact the patient's quality of life. Specific indications for the termination of conservative management vary across studies, but secondary intervention has been shown to be a relatively safe option in most patients with progressive disease. Patients with incidental VSs will probably qualify for a course of conservative management at diagnosis, and regular imaging combined with the expectation that the tumor and symptoms may change at any interval is crucial to ensuring positive long-term outcomes in these patients. In this report, the authors discuss the current literature pertaining to the prevalence of incidental VSs and various considerations in the management of these lesions. It is hoped that by incorporating an understanding of tumor growth, patient outcomes, and management strategies, practitioners will be able to effectively address this challenging disease entity.

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Acoustic Neuroma: Outcome Study

Cited by 8 publications

References 0 publications

Systematic review of the natural history of vestibular schwannoma

Systematic review of the natural history of vestibular schwannoma

Quality of life following microsurgery, radiosurgery and conservative management for unilateral vestibular schwannoma

Incidental vestibular schwannomas: a review of prevalence, growth rate, and management challenges

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