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      • Record: found
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      Spontaneous shrinkage of vestibular schwannoma with the recovery of impaired hearing: A case report and literature review

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          Abstract

          Background:

          Sporadically occurring vestibular schwannomas (VSs) are the most frequent tumors in the cerebellopontine cistern and internal meatus and are commonly associated with hearing loss. These tumors have demonstrated spontaneous shrinkage rates of 0–22%; however, the relationship between tumor shrinkage and changes in hearing remains unclear.

          Case Description:

          We report a case of a 51-year-old woman with a diagnosis of a left-sided VS and accompanying moderate hearing loss. The patient was treated with a conservative approach for 3 years, and the tumor showed a regression along with an improvement in her hearing ability during the yearly follow-ups.

          Conclusion:

          The spontaneous shrinkage of a VS along with an associated improvement in hearing is a rare phenomenon. Our case study may support that the “wait and scan” approach is an alternative option for patients with VS and moderate hearing loss. Further investigations are needed to understand spontaneous VS regression and hearing changes.

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          Most cited references22

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          EANO guideline on the diagnosis and treatment of vestibular schwannoma

          Roland Goldbrunner, Michael Weller, Jean Régis … (2020)
          The level of evidence to provide treatment recommendations for vestibular schwannoma is low compared with other intracranial neoplasms. Therefore, the vestibular schwannoma task force of the European Association of Neuro-Oncology assessed the data available in the literature and composed a set of recommendations for health care professionals. The radiological diagnosis of vestibular schwannoma is made by magnetic resonance imaging. Histological verification of the diagnosis is not always required. Current treatment options include observation, surgical resection, fractionated radiotherapy, and radiosurgery. The choice of treatment depends on clinical presentation, tumor size, and expertise of the treating center. In small tumors, observation has to be weighed against radiosurgery, in large tumors surgical decompression is mandatory, potentially followed by fractionated radiotherapy or radiosurgery. Except for bevacizumab in neurofibromatosis type 2, there is no role for pharmacotherapy.
          Article 0 comments Cited 67 times – based on 0 reviews     Review now
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            Conservative Management of Acoustic Neuroma: A Meta-Analysis and Proposed Treatment Algorithm

            Eric E Smouha, Michael Yoo, Kristi Mohr … (2005)
            Conservative management is a viable treatment alternative for acoustic neuroma. Using previous studies to provide evidence-based support, we have attempted to more clearly define the role of conservative management.
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              Systematic review of the natural history of vestibular schwannoma.

              Y Yoshimoto (2005)
              Magnetic resonance (MR) imaging now permits diagnosis of increasing numbers of small, minimally symptomatic vestibular schwannomas (VSs). Because VS growth patterns over time are very important in refining treatment strategies, these matters were systematically reviewed. An extensive MEDLINE search was performed to cull studies on VS growth according to sequential imaging. The percentages of growing and regressing tumors and lesions requiring treatment during follow-up periods were calculated. Factors associated with differences among studies were identified. Twenty-six studies including 1340 patients met all inclusion criteria. The overall frequency of VS growth during a mean follow-up period of 38 months was 46% (95% confidence interval [CI] 43-48%) and that of regression was 8% (95% CI 6-10%). The mean annual tumor growth rate was 1.2 mm/year. Furthermore, the percentage of cases requiring treatment during follow up was 18% (95% CI 16-21%). According to results of a sensitivity analysis, evaluation by serial MR imaging (39%, 95% CI 35-43%) and a prospective study design (29%, 95% CI 21-37%) were associated with less frequent reported tumor growth. Although their applicability may be limited to relatively elderly patients with small tumors, data revealing a limited frequency of VS enlargement and an infrequent necessity for eventual therapy should assist decision-making in the treatment of small VSs causing minimal symptoms.
              Article 0 comments Cited 23 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Ryoto Wachi
                Jun Takei: https://orcid.org/0000-0003-3879-9252
                Shusuke Fujita
                Ken Aoki
                Hiroyasu Nagashima
                Yuichi Murayama
                Journal
                Journal ID (nlm-ta): Surg Neurol Int
                Journal ID (iso-abbrev): Surg Neurol Int
                Title: Surgical Neurology International
                Publisher: Scientific Scholar (USA )
                ISSN (Print): 2229-5097
                ISSN (Electronic): 2152-7806
                Publication date Collection: 2023
                Publication date (Electronic): 26 May 2023
                Volume: 14
                Electronic Location Identifier: 180
                Affiliations
                [1 ]Department of Neurosurgery, The Jikei University Katsushika Medical Center, Tokyo, Japan.
                [2 ]Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan.
                Author notes
                [* ] Corresponding author: Jun Takei, Department of Neurosurgery, The Jikei University Katsushika Medical Center, Tokyo, Japan. j_tki@ 123456jikei.ac.jp
                Article
                Publisher ID: 10.25259/SNI_247_2023
                DOI: 10.25259/SNI_247_2023
                PMC ID: 10246396
                SO-VID: 7664eb4a-5ef0-4f04-917c-f991a58360fc
                Copyright © Copyright: © 2023 Surgical Neurology International
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Date received : 20 March 2023
                Date accepted : 01 May 2023
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Keywords: hearing improvement,hearing loss,intrameatal tumors,spontaneous shrinkage,vestibular schwannoma
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: hearing improvement, hearing loss, intrameatal tumors, spontaneous shrinkage, vestibular schwannoma

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