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Conservative Management Of Acoustic Neuromas.

J. Nedzelski, D. Schessel, A. Pfleiderer, E. Kassel, D. Rowed
Published 1992 · Medicine

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The results of this study and others document the biologic behavior of acoustic neuromas. In view of the evidence presented, which describes both variable rates of individual tumor growth and spontaneous regression in size, it would seem prudent that before selecting a nonsurgical treatment modality, the growth rate for the particular tumor in question should be established. To date, none of the literature that addresses the use of focused irradiation has attempted to do so. Our study as well as those of others suggests that the growth rate of acoustic neuromas becomes predictable over time. Based on this observation, a conservative (nontumor excision) management strategy is proposed for selected individuals. Patients to whom this management philosophy has been recommended or who themselves have chosen this option are seen twice yearly. Each visit consists of a thorough neurotologic examination as well as high-definition CT or MRI. Careful comparison of the clinical course as well as calculation of the tumor size is carried out in each instance. If the clinical course and rate of tumor growth remain unchanged over a 3-year follow-up, annual assessments are recommended. In the event of tumor enlargement, surgery may or may not be recommended, depending on the rate of growth and the age of the patient. Our experience suggests that a rate of growth equal to or exceeding 0.2 cm per year constitutes an indication for tumor removal.
This paper references
A review of acoustic tumors: 1983-1988.
B. De (1990)
10.1016/s0030-6665(20)30992-0
Selection of surgical approach to acoustic neuroma.
R. Jackler (1992)
10.1288/00005537-198507000-00002
Conservative management of acoustic neuroma in the elderly patient
H. Silverstein (1985)
10.1097/00129492-198907000-00011
Growth potential of acoustic neuromas.
J. Wennerberg (1989)
Acoustic neuroma: clinical aspects, audiovestibular assessment, diagnostic delay, and growth rate.
J. Thomsen (1990)
10.1177/019459988809800118
Spontaneous Acoustic Tumor Involution: A Case Report
C. Luetje (1988)
10.1288/00005537-198608000-00001
Is no treatment good treatment in the management of acoustic neuromas in the elderly?
J. Nedzelski (1986)
10.1288/00005537-198911000-00012
Gadolinium‐DTPA‐Enhanced magnetic resonance scanning in cerebellopontine angle tumors
John W. Wayman (1989)
10.1288/00005537-198702000-00001
Acoustic tumor management in senior citizens
J. House (1987)
10.1017/S0022215100147292
Epidemiology of acoustic neuromas.
M. Tos (1984)
10.1227/00006123-198506000-00011
Nonsurgical management of small and intracanalicular acoustic tumors.
W. C. Clark (1985)
10.1177/019459988609400312
Nonsurgical Management of Small and Intracanalicular Acoustic Tumors
G. Gardner (1986)
Age considerations in acoustic neuroma surgery: the horns of a dilemma.
R. Wiet (1989)
10.1007/BF00548193
Volume growth rate of acoustic neurinomas
E. Laasonen (2004)
10.1097/00006123-199105000-00002
Conservative treatment of patients with acoustic tumors.
Joshua B. Bederson (1991)
10.1177/019459988509300204
Preoperative and Postoperative Growth Rates in Acoustic Neuromas Documented with CT Scanning
J. Wazen (1985)
10.1055/S-2008-1056973
Clinical growth rate of acoustic schwannomas: correlation with the growth fraction as defined by the monoclonal antibody ki-67.
T. Lesser (1991)
10.1016/0090-3019(89)90005-0
The proliferative activity of neurilemomas.
K. Lee (1989)
10.1001/ARCHOTOL.1975.00780310013004
Occult schwannomas of the vestibular nerve.
T. Stewart (1975)



This paper is referenced by
10.1016/S0030-6665(02)00004-X
Acoustic neuroma. Assessment and management.
S. Ho (2002)
10.1055/s-0030-1265824
Should initial surveillance of vestibular schwannoma be abandoned?
S. Eljamel (2011)
10.4261/1305-3825.DIR.3786-10.1
Evaluation of the necessity of contrast in the follow-up MRI of schwannomas.
S. Bayraktaroğlu (2011)
10.1016/S0194-59989570146-X
False-Positive Magnetic Resonance Imaging of Small Internal Auditory Canal Tumors: A Clinical Radiologic, and Pathologic Correlation Study
Maj Moises A. Arriaga (1995)
10.3171/2007.5.16836
Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequences for treatment.
W. E. Bakkouri (2009)
10.1016/S0385-8146(00)00057-2
Translabyrinthine removal of large acoustic neuromas in young adults.
H. Wu (2000)
10.4236/WJNS.2015.52017
Correlation of Unilateral Sporadic Vestibular Schwannoma Growth Rates with Genetic and Immunohistochemical Abnormalities
Atta Mohyuddin (2015)
10.1046/J.1365-2273.2000.00421.X
A clinical study of vestibular schwannomas in type 2 neurofibromatosis.
A. Kishore (2000)
10.1016/J.OTORRI.2014.01.004
Evolución clínica y radiológica de un grupo de neurinomas del acústico no tratados
Vicente Escorihuela-García (2014)
10.5152/iao.2018.5348
What is the Required Frequency of MRI Scanning in the Wait and Scan Management?
T. Somers (2018)
10.1097/01.mlg.0000154736.38904.c3
Unilateral Acoustic Neuromas: Long‐Term Hearing Results in Patients Managed with Fractionated Stereotactic Radiotherapy, Hearing Preservation Surgery, and Expectantly
Vincent Y. W. Lin (2005)
10.3109/02688690903272634
Vestibular schwannomas – when should conservative management be reconsidered?
K. Whitehouse (2010)
10.1111/J.1365-2273.2004.00852.X
Conservative management of vestibular schwannomas - second review of a prospective longitudinal study.
V. Raut (2004)
10.2176/NMC.46.601
Spontaneous regression of a growing vestibular schwannoma.
Y. Yasumoto (2006)
10.3171/2009.4.JNS08895
The natural history of untreated sporadic vestibular schwannomas: a comprehensive review of hearing outcomes.
M. Sughrue (2010)
10.1177/000348940111000406
Assessment of Vestibular Schwannoma Growth: Application of a New Measuring Protocol to the Results of a Longitudinal Study
Ernestine M. Stipkovits (2001)
10.1111/J.1365-2273.2004.00806.X
Quality of life in patients with vestibular schwannomas managed conservatively.
C. Macandie (2004)
10.1016/S0194-59989770289-4
A Molecular, Clinical and Immunohistochemical Study of Vestibular Schwannoma
R. Irving (1997)
10.1097/MAO.0b013e31818f57c5
Growing Vestibular Schwannomas: What Happens Next?
Paul T. Mick (2009)
10.3171/2017.11.FOCUS17607
Keyhole retrosigmoid approach for large vestibular schwannomas: strategies to improve outcomes.
R. Hoshide (2018)
Acoustic Neuroma: Etiology, Presentation, and Treatment
P. Kongkham (1999)
10.14639/0392-100X-suppl.1-39-2019
Surgery of the lateral skull base: a 50-year endeavour
E. Zanoletti (2019)
10.3766/JAAA.19.3.8
Fall risk, vestibular schwannoma, and anticoagulation therapy.
Janet Shelfer (2008)
10.3171/2011.12.JNS111662
Growth of untreated vestibular schwannoma: a prospective study.
J. K. Varughese (2012)
10.1097/MAO.0b013e31819d3465
Clinical, Radiographic, and Audiometric Predictors in Conservative Management of Vestibular Schwannoma
P. Malhotra (2009)
10.1007/978-3-319-43368-4_4
Natural History, Clinical Symptoms, and Classifications
Ricardo Ramina (2017)
Comparison of two radiologic methods for measuring the size and growth rate of extracanalicular vestibular schwannomas.
R. Walsh (2000)
10.1097/00005537-200001000-00027
Postoperative Quality of Life in Vestibular Schwannoma Patients Measured by the SF36 Health Questionnaire
M. D. da Cruz (2000)
10.1097/00005537-200002010-00012
Consequences to Hearing During the Conservative Management of Vestibular Schwannomas
R. Walsh (2000)
10.1016/S0030-6665(05)70228-0
Distinguishing and treating causes of central vertigo.
D. Solomon (2000)
Effectiveness of conservative management of acoustic neuromas.
Y. J. Shin (2000)
10.1007/978-94-007-2894-3_29
Solitary Vestibular Schwannoma: Decision Making of Treatments
Francesco Dispenza (2012)
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