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Clinical spectrum and postoperative development of patients from Cyprus with unilateral vestibular schwannomas
18 April 2018 (online)
A vestibular schwannoma (VS) can expand from the inner auditory canal to the cerebellopontine angle and trigger a wide range of symptoms. Therapy options include regular monitoring (wait-and-scan), radiotherapy and surgery via 3 possible access paths, which can cause various complications. It is our aim to combine the information on clinical, diagnostic and therapeutic aspects, in order to provide an overview of the clinical occurence of VS in patients (p) from Cyprus.
A retrospective analysis of 13 p from Cyprus who suffered from a VS and were treated at the Freiburg University Hospital within the past 10 years has been conducted.
At the time of the first diagnosis the p were 47.7 years old on average (o.a.). The most common symptom was hearing loss (84.6%, n = 11), but also tinnitus (76.9%, n = 10) and vertigo (38.5%, n = 5) were often reported. The average time span between the first occurrence of symptoms and the diagnosis of the tumor was 60.7 months (5.1 years). The largest tumor extend was 18.4 mm o.a.. One p (7.7%, n = 1) had been monitored by wait-and-scan for 3.5 years and finally received surgery. 23.1% (n = 3) of p received radiotherapy. However, in all of these cases secondary surgery was performed due to size progression. All p (100%, n = 13) recieved surgery: 46.2% (n = 6) via a translabyrinthine and 53.8% (n = 7) via a suboccipital access. Postoperatively, 76.9% (n = 10) of the p suffered complications, most commonly facial paresis (61.5%, n = 8).
Hearing loss as the most common symptom and facial nerve palsy as the most frequent complication are consistent with information in the literature. After primary irradiation a size progression frequently occurs. Thus, secondary surgery is often indicated.