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Predictors of volumetric growth and auditory deterioration in vestibular schwannomas followed in a wait and scan policy.
MedLine Citation:
PMID:  21150682     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to identify factors predicting growth and audiologic deterioration during follow-up (FU) in a wait and scan (W&S) policy of vestibular schwannomas (VSs) using a novel volumetric measuring tool. So far, only consecutive magnetic resonance imaging (MRI) is able to show growth objectively, and growth, combined with hearing function, generally dictates further intervention. Other factors predicting growth or hearing deterioration would be invaluable and might ease clinical decision making.
STUDY DESIGN: Retrospective case study.
SETTING: Tertiary referral center.
PATIENTS: Sixty-three patients diagnosed with VS at Maastricht University Medical Center between 2003 and 2008, with FU data available from 36 patients.
INTERVENTION(S): A W&S policy for unilateral VS with sequential contrast-enhanced T1- and T2-weighted MRI and audiograms during FU.
MAIN OUTCOME MEASURE(S): 1. Patient and radiologic VS features potentially related to growth and auditory function during a W&S policy. 2. The correlation between increase in VS volume and audiologic deterioration during FU.
RESULTS: Labyrinthine hypointensity on T2-weighted magnetic resonance images and complaints of hearing loss at presentation are predictive of a faster deterioration of hearing (p < 0.05). Growth during the first FU year predicts further growth. Vestibular schwannoma volume does not correlate with audiologic deterioration significantly.
CONCLUSION: Hypointensity on T2-weighted image of the affected labyrinth will result in a significant faster deterioration of hearing. Hearing loss was more profound, and hearing will deteriorate significantly faster in patients presenting with complaints of hearing loss. Significant growth during the first year of FU predicts further growth during FU. Sequential MRI cannot be substituted by audiologic examinations solely because increase in VS volume does not correlate with audiologic deterioration significantly.
Authors:
Rick van de Langenberg; Bert-J de Bondt; Patty J Nelemans; Amy J C Dohmen; Brigitta G Baumert; Robert J Stokroos
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  32     ISSN:  1537-4505     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  338-44     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Maastricht University Medical Centre, The Netherlands. rickvandelangenberg@hotmail.com
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