Aktan Serra L, Finucane Sarah, Kircher Matthew, Moore Dennis, Bashir Mariah
Radiology, Loyola University Medical Center, Maywood, USA.
Otolaryngology - Head and Neck Surgery, Loyola University Medical Center, Maywood, USA.
Cureus. 2022 Feb 15;14(2):e22231. doi: 10.7759/cureus.22231. eCollection 2022 Feb.
Objective The incidence of vestibular schwannomas is increasing, and the average tumor size at diagnosis is decreasing. Therefore, understanding the specific growth pattern of small vestibular schwannomas is becoming increasingly important to guide clinical management. The objectives of this study were to evaluate the growth patterns of very small intracanalicular vestibular schwannomas measuring ≤ 4 mm in linear diameter and to assess the likelihood of these lesions ever requiring treatment. Methods A retrospective review was performed. A search of all MRI brain and internal auditory canal studies suggestive of a vestibular schwannoma from 1995 to 2019 was performed at our institution. This resulted in 372 cases, which were then evaluated for the presence of a vestibular schwannoma measuring ≤ 4 mm. All patients had to have at least one follow-up MRI to be included. Images were reviewed by a neuroradiologist. Results Eight ≤ 4 mm vestibular schwannomas were found that met all search criteria. The distribution of tumor sizes was as follows: three 2 mm, one 3 mm and four 4 mm. None of the ≤ 4 mm vestibular schwannomas identified demonstrated any significant growth in the linear dimension defined as greater than 2 mm of growth over observation times of 1-13 years (mean 6.3 years). None of the lesions ever required a treatment intervention per available medical records. Conclusion None of the ≤ 4 mm intracanalicular vestibular schwannomas identified in this study grew significantly or required treatment. Overall, the findings in this study suggest that vestibular schwannomas measuring ≤ 4 mm are unlikely to grow and ever require treatment.
目的 前庭神经鞘瘤的发病率正在上升，且诊断时的平均肿瘤大小正在减小。因此，了解小型前庭神经鞘瘤的具体生长模式对于指导临床管理变得越来越重要。本研究的目的是评估直径≤4mm的极小型内听道内前庭神经鞘瘤的生长模式，并评估这些病变需要治疗的可能性。方法 进行了一项回顾性研究。在我们机构对1995年至2019年所有提示前庭神经鞘瘤的脑部和内听道MRI研究进行了检索。这产生了372例病例，然后对其中直径≤4mm的前庭神经鞘瘤的存在情况进行评估。所有患者必须至少有一次随访MRI才能纳入。图像由神经放射科医生进行审查。结果 发现8例直径≤4mm的前庭神经鞘瘤符合所有检索标准。肿瘤大小分布如下：3例2mm，1例3mm，4例4mm。在1至13年（平均6.3年）的观察期内，所识别的直径≤4mm的前庭神经鞘瘤均未显示出在定义为生长超过2mm的线性维度上有任何显著生长。根据现有病历，没有一个病变需要治疗干预。结论 本研究中识别出的直径≤4mm的内听道内前庭神经鞘瘤均未显著生长或需要治疗。总体而言，本研究结果表明，直径≤4mm的前庭神经鞘瘤不太可能生长且需要治疗。
