Predictors of Volumetric Growth and Auditory Deterioration in Vestibular Schwannomas Followed in a Wait and Scan Policy

Abstract

Hypointensity on T2-weighted image of the affected labyrinth will result in a significant faster deterioration of hearing. Hearing loss was more profound, and hearing will deteriorate significantly faster in patients presenting with complaints of hearing loss. Significant growth during the first year of FU predicts further growth during FU. Sequential MRI cannot be substituted by audiologic examinations solely because increase in VS volume does not correlate with audiologic deterioration significantly.

Mutation spectrum and differential gene expression in cystic and solid vestibular schwannoma

“…On the basis of the clinical features, such as tumor size, tumor growth rate, hearing level, and the patient's individual life situation and preferences, the management options of VS could be chosen from "wait and scan, " stereotactic radiosurgery, fractioned radiotherapy, and surgical resection. 4,5 Depending on neuroradiological appearance, VS could be categorized as one of two subtypes: solid VS (SVS) and cystic VS (CVS). The more formidable subtype, CVS, accounts for 6.8 to 20.4% of VS based on several reports with larger series [6][7][8][9] and is notorious for aggressive clinical features, including rapid tumor growth (2-6 mm/year), 10 much more severe symptoms, 11,12 intensive adherence to the facial nerve, 13 and difficulty predicting its biological behavior.…”

Predictive factors of acoustic neuroma growth

“…Similar findings were also presented in a smaller study, including 36 patients, by van de Langeberg et al, in which growth at first visit was identified as a prognostic factor too. 27 Stereotactic radiotherapy appears to be effective up to 95% of the cases, even after 15 years of follow up. 28,29 Source of radiation in SR and fractionated SR is either gamma ray photons or a linear accelerator which uses Xray photons derived from high-energy electrons.…”

An allograft mouse model for the study of hearing loss secondary to vestibular schwannoma growth

“…The mechanisms underlying deafness in NF2 are still unclear and are supposed to be multifactorial [9,10]. Tumor size and increase in tumor volume are not correlated to hearing status [7,9,11], but multiple changes affecting the cochlea correlate with hearing level in these patients [12,13].…”

“…Tumor size and increase in tumor volume are not correlated to hearing status [7,9,11], but multiple changes affecting the cochlea correlate with hearing level in these patients [12,13]. It was also suggested that differences in the course of hearing might result from genetic determinants intrinsic to the tumor [14].…”