A Subset of Intracanalicular Vestibular Schwannomas Demonstrates Minimal Growth Over a 10-Year Period. Issue 3 (11th March 2022)

• Record Type: Journal Article
• Authors: Wu, Matthew J.; Knoll, Renata M.; Chen, Jenny X.; Reinshagen, Katherine; Roychowdhury, Prithwijit; McKenna, Michael J.; Kozin, Elliott D.; Remenschneider, Aaron K.; Jung, David H.
• Is Part Of: Otology & neurotology. Volume 43:Issue 3(2022)
• Page Start: 376
• Page End: 384
• Publication Date: 2022-03-11
• Subjects: Acoustic neuroma -- Growth rate -- Intracanalicular tumor -- Tertile -- Vestibular schwannoma -- Volumetric tumor analysis; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000003436
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : Objective: Vestibular schwannomas (VS) commonly undergo magnetic resonance imaging (MRI) surveillance, but long-term data to support the ideal frequency is limited. Herein, we aim to investigate intracanalicular VS growth predictors and long-term growth rates (GR). Study Design: Retrospective chart review. Setting: Two tertiary care centers. Patients: Sporadic intracanalicular VS with initial conservative management and at least two sequential MRIs. Intervention: Serial MRI. Main Outcome Measure(s): VS were categorized by baseline internal auditory canal tertile sublocalization (fundus, midpoint, porus) and size (≤100, 100–200, >200 mm 3 ). Throughout follow-up, volumetric GR (mm 3 /yr) were determined (baseline–3 yrs, 3–5 yrs, 5–10 yrs) and treatment rates were assessed. Results: Ninety-nine intracanalicular VS were identified (mean follow-up of 6.1 ± 4.5 yrs). Mean GR before 5-year follow-up were comparable for baseline tertile involvement and size. After 5-year follow-up, mean GR of VS involving the fundus at baseline were lower than those involving the midpoint and fundus (6.17 ± 21.16 and 119.74 ± 117.57 mm 3 /yr, respectively; p = 0.034). Mean GR of VS with less than or equal to 100 mm 3 at baseline (–7.29 ± 25.44 mm 3 /yr) were lower than those with 100 to 200 mm 3 (86.55 ± 103.99 mm 3 /yr; p = 0.011) and more than 200 mm 3 (45.70 ± 35.71 mm 3 /yr; p = 0.031). Vestibular schwannomas involving the midpoint and fundus had greater treatment rates compared with VS involving only the fundus ( p < 0.001). Conclusions: Baseline tertile involvement and size may predict long-term intracanalicular VS growth where fundal tumors or those less than or equal to 100 mm 3 exhibit little long-term growth. Extending surveillance after 5-year follow-up may be reasonable for fundal VS.