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

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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%


Epidemiology and natural history of vestibular schwannoma

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


Epidemiology and natural history of vestibular schwannoma

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


Epidemiology and natural history of vestibular schwannoma

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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