Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-19T20:31:10.204Z Has data issue: false hasContentIssue false
  • English
  • Français

Change in hearing during ‘wait and scan’ management of patients with vestibular schwannoma

Published online by Cambridge University Press:  19 December 2007

S-E Stangerup ,
P Caye-Thomasen ,
M Tos  and
J Thomsen
S-E Stangerup*
Affiliation:
ENT Department, Gentofte University Hospital, Copenhagen, Denmark
P Caye-Thomasen
Affiliation:
ENT Department, Gentofte University Hospital, Copenhagen, Denmark
M Tos
Affiliation:
ENT Department, Gentofte University Hospital, Copenhagen, Denmark
J Thomsen
Affiliation:
ENT Department, Gentofte University Hospital, Copenhagen, Denmark
*
Address for correspondence: Professor Sven-Eric Stangerup, ENT Department, Gentofte University Hospital, Niels Andersens vej 65, 2900 Hellerup, Copenhagen, Denmark. Fax: +45 39 77 76 34 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

To evaluate hearing changes during ‘wait and scan’ management of patients with vestibular schwannoma.

Subjects:

Over a 10-year period, 636 patients have prospectively been allocated to ‘wait and scan’ management, with annual magnetic resonance scanning and audiological examination.

Results:

At the time of diagnosis, 334 patients (53 per cent) had good hearing and speech discrimination of better than 70 per cent; at the end of the 10-year observation period, this latter percentage was 31 per cent. In 17 per cent of the patients, speech discrimination at diagnosis was 100 per cent; of these, 88 per cent still had good hearing at the end of the observation period. However, in patients with even a small initial speech discrimination loss, only 55 per cent maintained good hearing at the end of the observation period.

Conclusion:

After comparing the hearing results of hearing preservation surgery and of radiation therapy with those of ‘wait and scan’ management, it appears that, in vestibular schwannoma patients with a small tumour and normal speech discrimination, the main indication for active treatment should be established tumour growth.

Keywords

Acoustic NeuromaMagnetic Resonance ImagingNatural HistoryHearingSpeech Discrimination
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 7 , July 2008 , pp. 673 - 681
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Tos, M, Thomsen, J, Charabi, S. Incidence of acoustic neuromas. Ear Nose Throat J 1992;71:391–3CrossRefGoogle ScholarPubMed
2 Howitz, MF, Johansen, C, Tos, M, Charabi, S, Olsen, JH. Incidence of vestibular schwannoma in Denmark, 1977–1995. Am J Otol 2000;21:690–4Google ScholarPubMed
3 Stangerup, SE, Tos, M, Caye-Thomasen, P, Tos, T, Klokker, M, Thomsen, J. Increasing annual incidence of vestibular schwannoma and age at diagnosis. J Laryngol Otol 2004;118:622–7CrossRefGoogle ScholarPubMed
4 Seedat, RY, Claassen, AJ, Mol, DA. Incidence and management of acoustic neuromas in South Africa. Otol Neurotol 2002;23:996–8CrossRefGoogle ScholarPubMed
5 Evans, DG, Moran, A, King, A, Saeed, S, Gurusinghe, N, Ramsden, R. Incidence of vestibular schwannoma and neurofibromatosis 2 in the North West of England over a 10-year period: higher incidence than previously thought. Otol Neurotol 2005;26:93–7CrossRefGoogle Scholar
6 Mirz, F, Jorgensen, BG, Pedersen, CB. Vestibular schwannoma: incidence of the disease and the consequences [in Danish]. Ugeskr Laeger 1998;160:6516–19Google ScholarPubMed
7 Mathew, GD, Facer, GW, Suh, KW, Houser, OW, O'Brien, PC. Symptoms, findings, and methods of diagnosis in patients with acoustic neuroma. Laryngoscope 1978;88:1893–903CrossRefGoogle ScholarPubMed
8 Harcourt, JP, Vijaya-Sekaran, S, Loney, E, Lennox, P. The incidence of symptoms consistent with cerebellopontine angle lesions in a general ENT out-patient clinic. J Laryngol Otol 1999;113:518–22CrossRefGoogle Scholar
9 Sharpe, J. Should patients with asymmetrical noise-induced hearing loss be screened for vestibular schwannomas? Clin Otolaryngol Allied Sci 2004;29:291CrossRefGoogle ScholarPubMed
10 Shah, RK, Blevins, NH, Karmody, CS. Mid-frequency sensorineural hearing loss: aetiology and prognosis. J Laryngol Otol 2005;119:529–33CrossRefGoogle ScholarPubMed
11 Sauvaget, E, Kici, S, Kania, R, Herman, P, Tran Ba, HP. Sudden sensorineural hearing loss as a revealing symptom of vestibular schwannoma. Acta Otolaryngol 2005;125:592–5CrossRefGoogle ScholarPubMed
12 Walsh, RM, Bath, AP, Bance, ML, Keller, A, Tator, CH, Rutka, JA. The natural history of untreated vestibular schwannomas. Is there a role for conservative management? Rev Laryngol Otol Rhinol (Bord) 2000;121:21–6Google Scholar
13 O'Reilly, B, Murray, CD, Hadley, DM. The conservative management of acoustic neuroma: a review of forty-four patients with magnetic resonance imaging. Clin Otolaryngol Allied Sci 2000;25:93–7CrossRefGoogle ScholarPubMed
14 Flint, D, Fagan, P, Panarese, A. Conservative management of sporadic unilateral acoustic neuromas. J Laryngol Otol 2005;119:424–8Google ScholarPubMed
15 Herwadker, A, Vokurka, EA, Evans, DG, Ramsden, RT, Jackson, A. Size and growth rate of sporadic vestibular schwannoma: predictive value of information available at presentation. Otol Neurotol 2005;26:86–92CrossRefGoogle ScholarPubMed
16 Tschudi, DC, Linder, TE, Fisch, U. Conservative management of unilateral acoustic neuromas. Am J Otol 2000;21:722–8Google ScholarPubMed
17 Pollock, BE, Driscoll, CL, Foote, RL, Link, MJ, Gorman, DA, Bauch, CD et al. Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery. Neurosurgery 2006;59:77–85Google ScholarPubMed
18 Rutherford, SA, King, AT. Vestibular schwannoma management: What is the ‘best’ option? Br J Neurosurg 2005;19:309–16CrossRefGoogle ScholarPubMed
19 Sandooram, D, Grunfeld, EA, McKinney, C, Gleeson, MJ. Quality of life following microsurgery, radiosurgery and conservative management for unilateral vestibular schwannoma. Clin Otolaryngol Allied Sci 2004;29:621–7CrossRefGoogle ScholarPubMed
20 MacAndie, C, Crowther, JA. Quality of life in patients with vestibular schwannomas managed conservatively. Clin Otolaryngol Allied Sci 2004;29:215–18CrossRefGoogle ScholarPubMed
21 Tos, T, Caye-Thomasen, P, Stangerup, SE, Tos, M, Thomsen, J. Patients' fears, expectations and satisfaction in relation to management of vestibular schwannoma: a comparison of surgery and observation. Acta Otolaryngol 2003;123:600–5CrossRefGoogle ScholarPubMed
22 Tos, T, Caye-Thomasen, P, Stangerup, SE, Tos, M, Thomsen, J. Long-term socio-economic impact of vestibular schwannoma for patients under observation and after surgery. J Laryngol Otol 2003;117:955–64CrossRefGoogle ScholarPubMed
23 Inoue, Y, Ogawa, K, Kanzaki, J. Quality of life of vestibular schwannoma patients after surgery. Acta Otolaryngol 2001;121:59–61Google ScholarPubMed
24 Van Dijk, JE, Duijndam, J, Graamans, K. Acoustic neuroma: deterioration of speech discrimination related to thresholds in pure-tone audiometry. Acta Otolaryngol 2000;120:627–32CrossRefGoogle ScholarPubMed
25 Graamans, K, Van Dijk, JE, Janssen, LW. Hearing deterioration in patients with a non-growing vestibular schwannoma. Acta Otolaryngol 2003;123:51–4CrossRefGoogle ScholarPubMed
26 Bozorg, GA, Kalamarides, M, Ferrary, E, Bouccara, D, El Gharem, H, Rey, A et al. Conservative management versus surgery for small vestibular schwannomas. Acta Otolaryngol 2005;125:1063–8CrossRefGoogle Scholar
27 Harner, SG, Fabry, DA, Beatty, CW. Audiometric findings in patients with acoustic neuroma. Am J Otol 2000;21:405–11CrossRefGoogle ScholarPubMed
28 Cohen, NL. Acoustic neuroma surgery with emphasis on preservation of hearing. Laryngoscope 1979;89:886–96CrossRefGoogle ScholarPubMed
29 Arts, HA, Telian, SA, El Kashlan, H, Thompson, BG. Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: results using the middle cranial fossa approach. Otol Neurotol 2006;27:234–41CrossRefGoogle ScholarPubMed
30 Sanna, M, Khrais, T, Russo, A, Piccirillo, E, Augurio, A. Hearing preservation surgery in vestibular schwannoma: the hidden truth. Ann Otol Rhinol Laryngol 2004;113:156–63CrossRefGoogle ScholarPubMed
31 Moriyama, T, Fukushima, T, Asaoka, K, Roche, PH, Barrs, DM, McElveen, JT Jr. Hearing preservation in acoustic neuroma surgery: importance of adhesion between the cochlear nerve and the tumor. J Neurosurg 2002;97:337–40Google ScholarPubMed
32 Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 1995;113:179–80CrossRefGoogle Scholar
33 Meyer, TA, Canty, PA, Wilkinson, EP, Hansen, MR, Rubinstein, JT, Gantz, BJ. Small acoustic neuromas: surgical outcomes versus observation or radiation. Otol Neurotol 2006;27:380–92CrossRefGoogle ScholarPubMed
34 Kanzaki, J, Tos, M, Sanna, M, Moffat, DA, Monsell, EM, Berliner, KI. New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma. Otol Neurotol 2003;24:642–8CrossRefGoogle ScholarPubMed
35 Rosenberg, SI. Natural history of acoustic neuromas. Laryngoscope 2000;110:497–508CrossRefGoogle ScholarPubMed
36 Fucci, MJ, Buchman, CA, Brackmann, DE, Berliner, KI. Acoustic tumor growth: implications for treatment choices. Am J Otol 1999;20:495–9Google ScholarPubMed
37 Wade, PJ, House, W. Hearing preservation in patients with acoustic neuromas via the middle fossa approach. Otolaryngol Head Neck Surg 1984;92:184–93Google ScholarPubMed
38 Silverstein, H, McDaniel, A, Norrell, H, Haberkamp, T. Hearing preservation after acoustic neuroma surgery with intraoperative direct eighth cranial nerve monitoring: Part II. A classification of results. Otolaryngol Head Neck Surg 1986;95:285–91CrossRefGoogle Scholar
39 Gardner, G, Robertson, JH. Hearing preservation in unilateral acoustic neuroma surgery. Ann Otol Rhinol Laryngol 1988;97:55–66CrossRefGoogle ScholarPubMed
40 Walsh, RM, Bath, AP, Bance, ML, Keller, A, Rutka, JA. Consequences to hearing during the conservative management of vestibular schwannomas. Laryngoscope 2000;110:250–5CrossRefGoogle ScholarPubMed
41 Kaylie, DM, Horgan, MJ, Delashaw, JB, McMenomey, SO. A meta-analysis comparing outcomes of microsurgery and gamma knife radiosurgery. Laryngoscope 2000;110:1850–6CrossRefGoogle ScholarPubMed
42 Khrais, T, Sanna, M. Hearing preservation surgery in vestibular schwannoma. J Laryngol Otol 2006;120:366–70CrossRefGoogle ScholarPubMed
43 Friedman, RA, Kesser, B, Brackmann, DE, Fisher, LM, Slattery, WH, Hitselberger, WE. Long-term hearing preservation after middle fossa removal of vestibular schwannoma. Otolaryngol Head Neck Surg 2003;129:660–5CrossRefGoogle ScholarPubMed
44 Lapsiwala, SB, Pyle, GM, Kaemmerle, AW, Sasse, FJ, Badie, B. Correlation between auditory function and internal auditory canal pressure in patients with vestibular schwannomas. J Neurosurg 2002;96:872–6CrossRefGoogle ScholarPubMed
45 Badie, B, Pyle, GM, Nguyen, PH, Hadar, EJ. Elevation of internal auditory canal pressure by vestibular schwannomas. Otol Neurotol 2001;22:696–700CrossRefGoogle ScholarPubMed
46 Caye-Thomasen, P, Dethloff, T, Hansen, S, Stangerup, SE, Thomsen, J. Hearing in patients with intracanalicular vestibular schwannomas. Audiol Neurootol 2007;12:1–12CrossRefGoogle ScholarPubMed