Epidemiology and natural history of vestibular schwannoma
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Epidemiology and natural history of vestibular schwannoma. S-E.Stangerup , P.Caye-Thomasen , J.Thomsen , M.Tos ENT Department Gentofte University Hospital Copenhagen, Denmark. Subjects. 2283 Diagnosed VS in the period ; from January 1976 to end December 2008.

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Epidemiology and natural history of vestibular schwannoma

Epidemiology and naturalhistory of vestibularschwannoma

S-E.Stangerup, P.Caye-Thomasen, J.Thomsen, M.Tos

ENT Department

Gentofte University Hospital

Copenhagen, Denmark


Subjects
Subjects

  • 2283 Diagnosed VS in the period; from January 1976 to end December 2008.

  • 1123 Operatedafterdiagnosis

  • 16 Fractionatedirradiation

  • 1144 Allocated to ”wait and scan”


Annual number of diagnosed vestibular schwannomas pr million people in denmark
Annualnumber of diagnosedvestibularschwannomas pr. million people in Denmark


Mean tumour size at the time of diagnosis
Meantumoursize at the time of diagnosis


Mean age at the time of diagnosis
Mean age at the time of diagnosis


Wait scan subjects 1144
Wait & scan” Subjects (1144)

  • MRI x 2 999

  • Audiometry (PTA,Sd) x 2 932

  • Localisation : Intrameatal 461

  • Extrameatal 683

  • Sex: female/male : 548/596

  • Mean age: 58.6 years


Aao hns and wrs classification of hearing quality
AAO-HNS and WRS classification of hearing quality

Dl (%) Dl (%)

0 30 50 100

0 30 50 100

A

B

D

C

I II III

0 IV

30

50

PTA

(dB)

AAO-HNS WRS


Change in hearing during wait scan
Change in hearing during ”wait & scan”

WRS classification

Diagnosis Last evaluation

I

I

61%


Loss of goodhearingduring observation, for patients withAAO class A and WRS class I hearing at diagnosis (n=932)


Change in hearing during wait scan1
Change in hearing during ”wait & scan”

WRS classification

I:

Dl<=30%

Dl: 0%

Dl: 1-10%

Dl: 11-20%

Dl:21-30%

33%

24%

26%

17%

61%


Loss of good hearing sd 70 in the different prognostic groups
Loss of good hearing (Sd >= 70%) in the different prognostic groups


Loss of good hearing sd 70 in the different prognostic groups1
Loss of good hearing (Sd >= 70%) in the different prognostic groups


Loss of good hearing sd 70 in the different prognostic groups2
Loss of good hearing (Sd >= 70%) in the different prognostic groups


Loss of good hearing sd 70 in the different prognostic groups3
Loss of good hearing (Sd >= 70%) in the different prognostic groups


Meanannual speech discriminationloss in relation to observation periodbeforeloosing WRS class 1 hearing


Treatment algoritm for VS patients

Tumor size at diagnosis

<=15 mm 15-20 mm >20 mm

MRI after one year Op/irrad. Operation

No growth Growth (more than 2 mm)

MRI after 2,3,4,5, Irradiation or operation

7,9 and 14 years


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