Acoustic Neuroma (Vestibular Schwannoma)

Jackler, Robert K.; Pfister, M.

doi:10.1016/b978-0-323-01830-2.50051-1

Cited by 23 publications

(27 citation statements)

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“…The clinical stage of the acoustic neuroma was categorized according to the system outlined by Jackler (9). This system was chosen because the categories correlate well with surgical results.…”

Section: Study Groupmentioning

confidence: 99%

Comparison of Growth Patterns of Acoustic Neuromas With and Without Radiosurgery

Battaglia¹,

Mastrodimos²,

Cueva³

2006

Otology &Amp; Neurotology

112

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Objective: To compare the natural history of acoustic neuroma growth to the reported growth rate of acoustic neuromas after radiosurgical therapy, a retrospective review and a metaanalysis of the literature was performed. The retrospective review was of one hundred eleven patients (average age, 71 yr) who chose to have their acoustic neuromas manage conservatively in our institution. These patients underwent serial magnetic resonance imaging for assessment of tumor growth for an average period of 38 months. Growth patterns if these untreated tumors were compared to that of radiosurgically treated acoustic neuromas reported in the literature. Data Sources: The English-language literature on the topic was searched systematically by Medline and Pubmed using the following key words: acoustic neuroma, vestibular schwannoma, conservative management, conservative treatment, nonsurgical, age, elderly, growth, obervation, untreated, radiosurgery, gamma knife, 13 Gy and 12 Gy. There were no limits to the year of publication. Study Selection: Articles that fulfilled inclusion criteria (methods) were studied in detail. Data Extraction: All the articles described in the study selection were used in the review. Conclusion:The average growth rate of the untreated tumors was 0.7 T 1.4 mm/yr. Eighty-two percent grew less than 1 mm/yr, whereas 18% grew equal to or more than 1 mm/yr. Thirteen percent grew more than 2 mm/yr, with growth being noted at an average of 2.2 years after diagnosis. This represents an 87% control rate if tumor control rate is defined as less than 2-mm growth/yr. Meta-analysis indicates that tumor control rates range in the radiosurgical literature from 86% to 100%. The mean follow-up periods in the radiosurgical literature are generally not reported. Tumor control is not uniformly defined. Based on the result of this study, there is no discernable significant difference between growth patterns of untreated acoustic neuromas and those treated radiosurgically. To establish a significant difference, longer-term follow-up studies with larger sample sizes and tumor control rates are needed. Tumor control should be defined as zero growth. Key Words: Acoustic neuromaVVestibular SchwannomaVRadiosurgeryVGamma knifeVConservative managementVConservative treatmentV 12 GyV13 Gy.

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Section: Study Groupmentioning

confidence: 99%

Comparison of Growth Patterns of Acoustic Neuromas With and Without Radiosurgery

Battaglia¹,

Mastrodimos²,

Cueva³

2006

Otology &Amp; Neurotology

112

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“…The most common clinical feature of NF2 is the development of bilateral vestibular schwannomas (VS); the treatment options for VS include simple observation, microsurgical resection with or without hearing preservation and radiation therapy. Unfortunately, regardless of the Vincenti /Pasanisi /Guida /Di Trapani / Sanna Audiol Neurotol 2008;13:273-280 274 treatment modality chosen, the great majority of NF2 patients [Jackler, 1994;Sanna et al, 1998] develop a total bilateral deafness. In the past, once a patient with NF2 had lost hearing, there was no possibility of regaining an auditory input.…”

Section: Introductionmentioning

confidence: 99%

Hearing Rehabilitation in Neurofibromatosis Type 2 Patients: Cochlear versus Auditory Brainstem Implantation

Vincenti¹,

Pasanisi²,

Guida³

et al. 2008

Audiol Neurotol

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Objective: We aimed to evaluate and compare the auditory performance of neurofibromatosis type 2 (NF2) patients with bilateral total deafness fitted with cochlear or auditory brainstem implants. Patients and Methods: A retrospective case review was performed. Nine patients suffering from NF2 who underwent hearing rehabilitation by means of cochlear (4 patients) or auditory brainstem (5 patients) implantation participated in the study. Postoperative auditory performance was assessed using closed- and open-set tests. Results: In the group of patients fitted with a cochlear implant, 3 subjects achieved open-set speech recognition abilities comparable to those of standard adult postlingual implant patients; the remaining patient scored 0% in all open-set format tests, reporting benefits only in environmental sound detection and lip-reading. Among the 5 patients who underwent auditory brainstem implantation, 1 reached good open-set speech recognition skills, scoring 70% in the common phrases comprehension test, and she was able to communicate on the telephone. Two other patients achieved open-set speech understanding (respectively, 33 and 41% in the common phrases comprehension test), reporting daily use of their device. The remaining 2 patients did not achieve any level of open-set speech perception, obtaining only improved access to environmental sound and lip-reading skills. Conclusions: Our study confirmed literature data reporting that cochlear implantation may offer open-set speech communication in NF2 patients. In this small cohort, cochlear implant patients performed better than auditory brainstem implant patients, even if variability in auditory performance was observed with both devices. More studies are needed in order to clarify the role and reliability of electrophysiological tests in predicting the residual functionality of the cochlear nerve after tumor removal.

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“…This hearing loss is often manifested clinically by disproportionately deficient speech discrimination (compared with pure tone loss) as measured by brainstem electric response audiometry. 8 Sudden worsening of hearing deficit occurs commonly (26%) and presumably is associated with occlusion of the internal auditory branch of the anterior inferior cerebellar artery (AICA). A small number of patients have normal hearing (or symmetric loss).…”

Section: Clinical Issuesmentioning

confidence: 99%

“…[6][7][8][9] They are noncalcifying, slow-growing, well-encapsulated lesions of midlife that account for 6% to 10% of all intracranial tumors and 60% to 90% of CPA tumors. They are somewhat more common and tend to be larger in women.…”

Section: Schwannoma Of the Eighth Cranial Nerve (Acoustic Neuroma)mentioning

confidence: 99%

Pathology of the Vestibulocochlear Nerve

Swartz¹

2008

Neuroimaging Clinics of North America

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Acoustic Neuroma (Vestibular Schwannoma)

Cited by 23 publications

References 0 publications

Comparison of Growth Patterns of Acoustic Neuromas With and Without Radiosurgery

Comparison of Growth Patterns of Acoustic Neuromas With and Without Radiosurgery

Hearing Rehabilitation in Neurofibromatosis Type 2 Patients: Cochlear versus Auditory Brainstem Implantation

Pathology of the Vestibulocochlear Nerve

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