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Vestibular schwannomas with spontaneous shrinkage: about 35 cases

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purposes

The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on volumetric measurements on MRI to define which regressions are significant. The secondary aim is to look for a correlation between a shrinkage of the tumor and the medical history, and the presence of clinical symptoms.

Methods

We first selected all patients presenting with a VS who underwent two or more MRI of the internal auditory canal on the same 3 T MRI machine retrospectively between January 2013 and June 2018. All MRI images were evaluated independently by two radiologists. The volumetric analysis was performed contrast-enhanced 2D spin-echo T1-weighted sequence and expressed in cubic centimeters.

Results

Thirty-five patients presented with a regressive VS on MRI (14%). The annual mean shrinkage rate was 0.08 cm3/year. Eighty percent of the patients present both a shrinkage by more than 0.01 cm3/year and a decrease of the initial tumor volume by more than 20%. The majority of patients are asymptomatic or presented moderate balance disorders, which remained stable or improved over time. Tinnitus was observed in 47% and was stable or improved in the majority of cases and the mean annual mean hearing loss was by < or = 4 dB/year.

Conclusion

Out of 247 VS, 14% decreased using follow-up (by > or = 2 MRI), and a spontaneous shrinkage greater than 0.01 cm3/year and greater than 20% could be considered significant.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Strasbourg, 1 Avenue Molière, Strasbourg, France

    Guillaume Trau & Anne Charpiot

  2. Institute of Image-Guided Surgery, IHU Strasbourg, 1 place de l’Hôpital, Strasbourg, France

    Aïna Venkatasamy

Authors
  1. Guillaume Trau
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  2. Aïna Venkatasamy
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  3. Anne Charpiot
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Corresponding author

Correspondence to Guillaume Trau.

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Ethical approval

This study was approved by the Strasbourg University Hospital Ethics Committee (approval number RNI 2019–HUS N°7417 and NCT number: NCT03970681) and patients gave their written consent for the participation in this study.

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Trau, G., Venkatasamy, A. & Charpiot, A. Vestibular schwannomas with spontaneous shrinkage: about 35 cases. Eur Arch Otorhinolaryngol 278, 4235–4241 (2021). https://doi.org/10.1007/s00405-020-06530-6

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  • DOI: https://doi.org/10.1007/s00405-020-06530-6

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