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Conservative management of vestibular schwannomas of 15 to 31 mm intracranial diameter

Published online by Cambridge University Press:  14 August 2014

C E E Reddy ,
H G Lewis-Jones ,
M Javadpour ,
I Ryland  and
T H J Lesser
C E E Reddy*
Affiliation:
Department of Otolaryngology, University Hospital Aintree NHS Foundation Trust, Liverpool, UK
H G Lewis-Jones
Affiliation:
Department of Radiology, University Hospital Aintree NHS Foundation Trust, Liverpool, UK
M Javadpour
Affiliation:
Department of Neurosurgery, Walton Centre NHS Foundation Trust, Liverpool, UK
I Ryland
Affiliation:
Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
T H J Lesser
Affiliation:
Department of Otolaryngology, University Hospital Aintree NHS Foundation Trust, Liverpool, UK
*
Address for correspondence: Mr C Ekambar E Reddy, Department of Otolaryngology, University Hospital Aintree, Liverpool L9 7AL, UK E-mail: [email protected]
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Abstract

Objective:

To study the natural course of vestibular schwannomas 15 to 31 mm in diameter.

Methods:

A retrospective study of 45 patients conservatively managed with interval scanning was performed. Outcome measures were: changes in tumour size, clinical features and hearing. A tumour was considered to be growing if it increased in size by more than 2 mm.

Results:

Initial tumour sizes ranged from 15 to 31 mm, with a mean (± standard deviation) diameter of 20.1 ± 4.3 mm. The duration of follow up ranged from 6 months to 14 years (median, 3 years). Tumours grew in 11 cases (24.4 per cent), remained stable in 30 cases (66.7 per cent) and regressed in 4 cases (8.9 per cent). The overall mean tumour growth rate was 0.9 ± 2.2 mm per year; in growing tumours, it was 3.6 ± 2.9 mm per year.

Conclusion:

Outcomes were similar to those reported for smaller tumours. These findings suggest that patients with medium or moderately large tumours can be safely offered an initial period of conservative management before intervention is considered.

Keywords

Patient MonitoringPrognosisAcoustic NeuromaSchwannoma, VestibularMagnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 9 , September 2014 , pp. 752 - 758
Copyright
Copyright © JLO (1984) Limited 2014 

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Footnotes

Presented at the 6th International Congress of the World Federation of Skull Base Societies and the 10th European Skull Base Society Congress, 16–19 May 2012, Brighton, UK, and at the 14th British Academic Conference in Otolaryngology, 4–6 July 2012, Glasgow, Scotland, UK.

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