전정신경초종의 자연 경과에 따른 종양의 성장과 청력의 변화

초록

Background and Objectives Vestibular schwannoma is a benign neoplasm originatingfrom the vestibular nerve, and the most common symptom caused by the tumor is unilateralhearing loss. This study is aimed to review the clinical outcomes of tumor growth and hearingchanges in the natural progress of vestibular schwannoma. Subjects and Method We retrospectively reviewed 28 patients who were diagnosed withvestibular schwannoma and treated with the ‘wait and scan’ modality for more than a year. We analyzed the patients’ audiological changes and tumor growth by reviewing the temporalbone MR images. Patients were classified into an intrameatal group and extrameatal group accordingto the involvement of the cerebropontine angle. Results The overall mean follow-up was 45.6±25.8 months. Among the 28 patients, 6(21.4%) showed tumor growth after ‘wait and scan.’ Hearing thresholds and speech discriminationscores showed deterioration after ‘wait and scan’ in both groups. Among the 12 patientswith serviceable hearing at initial diagnosis, 9 (75.0%) preserved serviceable hearing after‘wait and scan.’ When the pure tone average and speech discrimination scores were applied tothe scattergram, most values were positioned near the center of the scattergram, which impliedslight changes after ‘wait and scan.’Conclusion The percentage of patients showing tumor growth after the ‘wait and scan’ policywas low. Patients with serviceable hearing at diagnosis would most likely preserve theirhearing after ‘wait and scan.’ Considering the limited tumor growth and minimal hearingchanges, rather than microsurgery or radiation surgery, the conservative ‘wait and scan’ policycan be an alternative treatment modality in patients with small-sized, non-growing vestibularschwannomas.

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