Norwegian National Advisory Unit on Vestibular Disorders, Haukeland University Hospital, Bergen, Norway.
Department of Otorhinolaryngology-Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
Otolaryngol Head Neck Surg. 2019 Nov;161(5):846-851. doi: 10.1177/0194599819860831. Epub 2019 Jul 16.
To study the development of dizziness, caloric function, and postural sway during long-term observation of untreated vestibular schwannoma patients.
Retrospective review of a prospectively maintained longitudinal cohort.
Tertiary referral hospital.
Patients with vestibular schwannoma undergoing wait-and-scan management were included-specifically, those who did not require treatment during a minimum radiologic follow-up of 1 year. Baseline data and follow-up included magnetic resonance imaging, posturography, bithermal caloric tests, and a dizziness questionnaire. Main outcomes were prevalence of moderate to severe dizziness, canal paresis, and postural instability at baseline and follow-up, as compared with McNemar's test.
Out of 433 consecutive patients with vestibular schwannoma, 114 did not require treatment during follow-up and were included. Median radiologic follow-up was 10.2 years (interquartile range, 4.5 years). Age ranged from 31 to 78 years (mean, 59 years; SD, 10 years; 62% women). Median tumor volume at baseline was 139 mm (interquartile range, 314 mm). This did not change during follow-up ( = .446). Moderate to severe dizziness was present in 27% at baseline and 19% at follow-up ( = .077). Postural unsteadiness was present in 17% at baseline and 21% at follow-up ( = .424). Canal paresis was present in 51% at baseline and 56% at follow-up ( = .664).
There was no significant change in the prevalence of dizziness, postural sway, or canal paresis during conservative management of vestibular schwannoma, while tumor volume remained unchanged. This indicates a favorable prognosis in these patients with regard to vestibular symptoms.
研究未经治疗的前庭神经鞘瘤患者在长期观察过程中头晕、冷热功能和姿势摆动的发展情况。
前瞻性维持的纵向队列回顾性研究。
三级转诊医院。
纳入接受等待-观察管理的前庭神经鞘瘤患者，具体来说，是那些在至少 1 年的放射学随访中不需要治疗的患者。基线数据和随访包括磁共振成像、姿势描记术、冷热双侧试验和头晕问卷。主要结局是在基线和随访时比较梅内尔氏检验中中度至重度头晕、管腔麻痹和姿势不稳定的患病率。
在 433 例连续的前庭神经鞘瘤患者中，有 114 例在随访期间不需要治疗，并被纳入研究。中位放射学随访时间为 10.2 年（四分位间距，4.5 年）。年龄范围为 31 岁至 78 岁（平均年龄为 59 岁；标准差为 10 岁；62%为女性）。基线时肿瘤体积中位数为 139mm（四分位间距，314mm）。在随访期间没有变化（ =.446）。基线时中度至重度头晕的发生率为 27%，随访时为 19%（ =.077）。基线时姿势不稳定的发生率为 17%，随访时为 21%（ =.424）。基线时管腔麻痹的发生率为 51%，随访时为 56%（ =.664）。
在保守治疗前庭神经鞘瘤期间，头晕、姿势摆动或管腔麻痹的患病率没有显著变化，而肿瘤体积保持不变。这表明这些患者的前庭症状预后良好。
