&lt;p&gt;Epidemiology Of Vestibular Schwannomas – Prospective 40-Year Data From An Unselected National Cohort&lt;/p&gt;

Reznitsky, Martin; Petersen, Mette Marie Babiel Schmidt; West, Niels; Stangerup, Sven‐Eric; Cayé‐Thomasen, Per

doi:10.2147/clep.s218670

Cited by 119 publications

(116 citation statements)

References 41 publications

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“…Hirnnerven mit einer Inzidenz von aktuell ca. 3,4/10 5 Einwohner [41]. Meist gehen sie vom N. vestibularis aus und treten als einseitige, sporadische, nicht syndromal assoziierte Tumoren auf.…”

Section: Einführungunclassified

Management transmodiolärer und transmakulärer Vestibularis- und Cochlearisschwannome mit und ohne Cochleaimplantation

Plontke

Cayé‐Thomasen

Strauß

et al. 2020

HNO

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Zusammenfassung Einführung Die Hörrehabilitation mittels Cochleaimplantat (CI) ist auch für Patienten mit cochleovestibulären Schwannomen von zunehmendem Interesse. Berichtet wird über Erfahrungen bezüglich des chirurgischen Managements von Tumoren mit einer seltenen transmodiolären oder transmakulären Ausdehnung und über die Ergebnisse bei Hörrehabilitation mit CI. Methode In die retrospektive Fallserie wurden 9 Patienten mit primären intralabyrinthären Schwannomen oder mit sekundärer Invasion des Tumors vom inneren Gehörgang in das Innenohr eingeschlossen. Primärer Zielparameter bei CI-Patienten war das Sprachverstehen bei 65 dB SPL („sound pressure level“), sekundäre Zielparameter waren intra- und postoperative elektrophysiologische Parameter: elektrisch ausgelöste Summenaktionspotenziale eCAP, Impedanzmessungen, das Vorhandensein einer Welle V in den elektrisch (über das CI) evozierten Hirnstammpotenzialen (eBERA), Besonderheiten bei der postoperativen CI-Programmierung und unerwünschte Ereignisse. Ergebnisse Alle 6 implantierten Patienten erreichten ein gutes Sprachverstehen für Zahlwörter in Ruhe (80–100 % bei 65 dB SPL, spätestens 12 Monate nach Erstanpassung). Im Zeitraum von einem bis 36 Monaten erreichten 4 der 6 Patienten mit CI gute bis sehr gute Ergebnisse im Freiburger Einsilbertest in Ruhe (65–85 % bei 65 dB SPL), 2 erreichten 6 Monate nach Erstanpassung nur geringe Werte (25 und 15 % bei 65 dB SPL) mit im weiteren Verlauf abnehmendem Zahlen- und Einsilberverstehen. Schlussfolgerungen Cochleovestibuläre Schwannome mit transmodiolärer und transmakulärer Ausdehnung stellen eine sehr seltene und bezüglich des Managements besondere Entität dar. Das therapeutische Vorgehen erfordert eine differenzierte Abwägung. Auch bei diesen Tumoren stellt die Cochleaimplantation prinzipiell eine Option zur Hörrehabilitation dar.

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Section: Einführungunclassified

Management transmodiolärer und transmakulärer Vestibularis- und Cochlearisschwannome mit und ohne Cochleaimplantation

Plontke

Cayé‐Thomasen

Strauß

et al. 2020

HNO

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“…They usually originate within the internal auditory meatus (IAM) and grow out into the CPA, resulting in an "ice cream cone" shape. These tumors are in most cases sporadic and unilateral with median age at diagnosis increasing gradually from 49.2 years in 1976 to 60 years in 2015 [140]. Approximately 5% of VS are associated with neurofibromatosis type 2 (NF2).…”

Section: Introductionmentioning

confidence: 99%

Surgical management for large vestibular schwannomas: a systematic review, meta-analysis, and consensus statement on behalf of the EANS skull base section

et al. 2020

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Background and objective The optimal management of large vestibular schwannomas continues to be debated. We constituted a task force comprising the members of the EANS skull base committee along with international experts to derive recommendations for the management of this problem from a European perspective. Material and methods A systematic review of MEDLINE database, in compliance with the PRISMA guidelines, was performed. A subgroup analysis screening all surgical series published within the last 20 years (January 2000 to March 2020) was performed. Weighted summary rates for tumor resection, oncological control, and facial nerve preservation were determined using meta-analysis models. This data along with contemporary practice patterns were discussed within the task force to generate consensual recommendations regarding preoperative evaluations, optimal surgical strategy, and follow-up management. Results Tumor classification grades should be systematically used in the perioperative management of patients, with large vestibular schwannomas (VS) defined as > 30 mm in the largest extrameatal diameter. Grading scales for pre- and postoperative hearing (AAO-HNS or GR) and facial nerve function (HB) are to be used for reporting functional outcome. There is a lack of consensus to support the superiority of any surgical strategy with respect to extent of resection and use of adjuvant radiosurgery. Intraoperative neuromonitoring needs to be routinely used to preserve neural function. Recommendations for postoperative clinico-radiological evaluations have been elucidated based on the surgical strategy employed. Conclusion The main goal of management of large vestibular schwannomas should focus on maintaining/improving quality of life (QoL), making every attempt at facial/cochlear nerve functional preservation while ensuring optimal oncological control, thereby allowing to meet patient expectations. Despite the fact that this analysis yielded only a few Class B evidences and mostly expert opinions, it will guide practitioners to manage these patients and form the basis for future clinical trials.

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“…Vestibular schwannomas (VS) are benign skull base tumors with an increasing incidence rate of 34 tumors per million [1]. Although benign, the tumor has the potential of causing serious symptoms, comprising hearing loss, tinnitus, and balance disturbance.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes and toxicity of proton radiotherapy for vestibular schwannomas: a systematic review

et al. 2019

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Objective Vestibular schwannomas are benign tumors that are often managed by radiotherapy. Minimizing long-term toxicity is paramount for a population that remains at normal life expectancy and at risk for loss of quality of life for years if not decades. Whereas current radiotherapy standard utilizes photon radiation, proton radiotherapy characteristics may enable a reduction of toxicity by reducing the volume of collateral irradiated healthy tissue. A systematic review was conducted to assess tumor control and short-and long-term sequelae after proton irradiation. Methods Studies that reported on treatment outcomes of proton radiotherapy in vestibular schwannoma patients were included. Results Five peer-reviewed retrospective series met the inclusion criteria. Quality of the studies varied from low to good. There were 276 unique patients described. Tumor control rates ranged from 85 to 100% (radiological median follow-up of 2.2-7.4 years). Hearing loss rates, defined as losing Gardner Robertson class I/II hearing, showed an weighted crude average 52% (depending on follow-up duration). The weighted averages for post-irradiation facial and trigeminal neuropathy were 5% and 4%, respectively. The risk of neuropathy seems to decrease with lower radiation dosages. Conclusion Proton irradiation for vestibular schwannomas achieves high tumor control rates, equivalent to photon irradiation. Reported cranial nerve preservation rates vary, partly due to an apparent selection bias with a high percentage of patients with clinical symptoms prior to treatment. Results of cranial nerve function preservation, quality of life, and cognitive functioning are currently insufficiently reported. In addition, advances in proton radiotherapy technology warrant re-evaluation of current techniques and protocols for the management of vestibular schwannomas.

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<p>Epidemiology Of Vestibular Schwannomas – Prospective 40-Year Data From An Unselected National Cohort</p>

Cited by 119 publications

References 41 publications

Management transmodiolärer und transmakulärer Vestibularis- und Cochlearisschwannome mit und ohne Cochleaimplantation

Management transmodiolärer und transmakulärer Vestibularis- und Cochlearisschwannome mit und ohne Cochleaimplantation

Surgical management for large vestibular schwannomas: a systematic review, meta-analysis, and consensus statement on behalf of the EANS skull base section

Clinical outcomes and toxicity of proton radiotherapy for vestibular schwannomas: a systematic review

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