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Screening for vestibular schwannoma in the context of an ageing population

Published online by Cambridge University Press:  01 August 2019

S Basu ,
R Youngs  and
A Mitchell-Innes
S Basu*
Affiliation:
ENT Department, Gloucester Hospital NHS Foundation Trust, UK
R Youngs
Affiliation:
ENT Department, Gloucester Hospital NHS Foundation Trust, UK
A Mitchell-Innes
Affiliation:
ENT Department, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
*
Author for correspondence: Mr Syamaprasad Basu, 1A Lonsdale Road, Gloucester GL2 0TA, UK E-mail: [email protected]
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Abstract

Objective

To review the literature regarding screening for vestibular schwannoma in the context of demographic changes leading to increasing numbers of elderly patients presenting with asymmetric auditory symptoms.

Methods

A systematic review of the literature was performed, with narrative synthesis and statistical analysis of data where appropriate.

Results

Vestibular schwannomas diagnosed in patients aged over 70 years exhibit slower growth patterns and tend to be of smaller size compared to those tumours in younger age groups. This fact, combined with reduced life expectancy, renders the probability of these tumours in the elderly requiring active treatment with surgery or stereotactic radiotherapy to be extremely low. Vestibular schwannomas in the elderly are much more likely to be managed by serial monitoring with magnetic resonance imaging. The weighted yield of magnetic resonance imaging in the diagnosis of vestibular schwannoma in all age groups is 1.18 per cent, with almost 85 scans required to diagnose 1 tumour.

Conclusion

An evidence-based approach to the investigation of asymmetric hearing loss and tinnitus in the elderly patient can be used to formulate guidelines for the rational use of magnetic resonance imaging in this population.

Keywords

Acoustic NeuromaVestibular SchwannomaScreening
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 8 , August 2019 , pp. 640 - 649
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Mr S Basu takes responsibility for the integrity of the content of the paper

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