*Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon; and †Department of Otorhinolaryngology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Otol Neurotol. 2014 Jun;35(5):918-21. doi: 10.1097/MAO.0000000000000338.
Periodic observation with imaging is an acceptable option for patients with small vestibular schwannomas (VSs). The objective of this study was to evaluate the outcome of conservative management of intracanalicular VSs (ICVSs).
We reviewed 31 patients who were followed up for more than 1 year among patients diagnosed as having VS limited to the internal auditory canal. The median follow-up period was 31 months (range, 12-84 mo). We analyzed the patients' clinical features, clinical courses, and audiologic changes.
The most frequent initial presenting symptom in patients with ICVS was hearing loss, and one-half of the patients (8 of 16) had a history of sudden hearing loss. Seven patients (22.5%) showed tumor growth during the follow-up period. When we considered the initial tumor size in ICVS, the patients larger in size than the median showed a significantly higher rate of tumor growth. In terms of the initial hearing levels of ICVS according to the Consensus Meeting Guidelines, five patients were classified as Class A (normal hearing) and six patients were classified as Class B. Only one patient among patients with useful hearing (Classes A and B) showed tumor growth. The follow-up hearing levels of all Class A patients were preserved; however, all Class B patients deteriorated to Class C.
Patients with ICVS showed favorable results with conservative management. Among them, patients with small tumors and normal hearing showed a good prognosis.
对于小前庭神经鞘瘤（VSs）患者，定期进行影像学观察是一种可接受的选择。本研究旨在评估管内型前庭神经鞘瘤（ICVS）保守治疗的结果。
我们回顾了 31 例在诊断为局限于内听道的 VS 患者中随访时间超过 1 年的患者。中位随访时间为 31 个月（范围 12-84 个月）。我们分析了患者的临床特征、病程和听力变化。
ICVS 患者最常见的首发症状是听力下降，半数患者（16 例中有 8 例）有突发性听力下降病史。7 例（22.5%）患者在随访期间出现肿瘤生长。当我们考虑 ICVS 的初始肿瘤大小时，大于中位数的患者肿瘤生长率显著更高。根据共识会议指南，根据初始听力水平，5 例 ICVS 患者被归类为 A 类（正常听力），6 例被归类为 B 类。只有 1 例有有用听力（A 类和 B 类）的患者出现肿瘤生长。所有 A 类患者的随访听力水平均保持不变；然而，所有 B 类患者的听力均恶化至 C 类。
ICVS 患者的保守治疗结果良好。其中，肿瘤较小且听力正常的患者预后较好。
