Management and Outcomes of Sporadic Vestibular Schwannoma: A Longitudinal Study Over 12 Years

xlomafota13 shared this article with you from Inoreader Management and Outcomes of Sporadic Vestibular Schwannoma: A Longitudinal Study Over 12 Years Via The Laryngoscope Objectives To evaluate the management of sporadic vestibular schwannomas (VS) with a 12‐year follow‐up. Study Design Retrospective study of all VS patients initially treated in 2005 in a tertiary referent center. Methods Initial decision making for microsurgical resection (MSR) or wait‐and‐scan (WaS) was according to VS size and hearing; subsequently, MSR or stereotactic radiosurgery (SRS) was proposed dependent on VS growth and size, hearing, and patient's age or willingness. Results Two hundred and one sporadic VS were included. The first management apportionment was 120 WaS (61.5%), 72 MSR (37%), three SRS (1.5%), and six others refused MSR and were lost to follow‐up (LFU). Within 1 year, 95 (47%) VS were surgically removed; 17 (8.5%) were treated by SRS; and 35 (17.5%) were LFU. The proportions for SRS and LFU were virtually unchanged for the following years, and the proportion under MSR increased slightly within 3 years and then remained stable. Finally, at 12 years, 104 (51.5%) cases had been operated on, 21 (10.5%) treated by SRS, 23 (11.5%) still under WaS, and 53 (26.5%) LFU, which were mainly intracanalicular. The initially and subsequently operated cases presented similar hearing preservation rates and good facial nerve function outcomes. Conclusion This longitudinal study of a large number of VS, which were diagnosed over a short period of time and followed for 12 years, provides new information on both the natural history of these benign tumors and individual patient concerns. This study recommends use of the WaS policy for small and mid‐sized VS before active therapeutic decision making. Level of Evidence 3 Laryngoscope, 131:E970–E976, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.