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 naturalhistory of vestibularschwannoma

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.

  • 1123 Operatedafterdiagnosis

  • 16 Fractionatedirradiation

  • 1144 Allocated to ”wait and scan”


Annualnumber of diagnosedvestibularschwannomas pr. million people in Denmark


Meantumoursize at the time of diagnosis


Mean age at the time of diagnosis


”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

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”

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 & 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 groups


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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