Department of Otolaryngology, Alexandria University, Egypt; Department of Otology, King Abdullah Medical City, Makkah, Saudi Arabia.
Gruppo Otologico, Piacenza-Rome, Italy.
Otol Neurotol. 2022 Jul 1;43(6):676-684. doi: 10.1097/MAO.0000000000003562.
To report on the results of intracanalicular vestibular schwannomas (ICVS) that were managed by wait and scan and to analyze the possible predictors of tumor growth and hearing deterioration throughout the observation period.
A retrospective case series.
Quaternary referral center for skull base pathologies.
Patients with sporadic ICVS managed by wait and scan.
Serial resonance imaging (MRI) with size measurement and serial audiological evaluation.
Tumor growth defined as 2 mm increase of maximal tumor diameter, further treatment, and hearing preservation either maintain initial modified Sanna hearing class, or maintain initial serviceable hearing (class A/B).
339 patients were enrolled. The mean follow-up was 36.5±31.7 months with a median of 24 months. Tumor growth occurred in 141 patients (40.6%) either as slow growth (SG) in 26.3% of cases or fast growth (FG) in 15.3% of cases. Intervention was performed in only 64 cases (18.8%). Out of 271 patients who underwent hearing analysis, 86 patients (33.5%) showed hearing deterioration to a lower hearing class of the modified Sanna classification. Tumor growth and older age were predictors of hearing deterioration. Of the 125 cases with initial serviceable hearing (Class A/B), 91 cases (72.8%) maintained serviceable hearing at last follow-up. Tumor growth and a worse initial pure tone average (PTA) were predictors of hearing deterioration.
Wait and scan management of ICVS is a viable option and only 18.8% of patients needed further treatment. Hearing tends to deteriorate over time.
报告采用等待和扫描策略治疗的管内前庭神经鞘瘤（ICVS）的结果，并分析整个观察期间肿瘤生长和听力恶化的可能预测因素。
回顾性病例系列研究。
颅底病变的四级转诊中心。
采用等待和扫描策略治疗的散发性 ICVS 患者。
连续磁共振成像（MRI）测量肿瘤大小和连续听力学评估。
肿瘤生长定义为最大肿瘤直径增加 2mm，进一步治疗和听力保护，保持初始改良 Sanna 听力分级，或保持初始可利用听力（A/B 级）。
共纳入 339 例患者。平均随访 36.5±31.7 个月，中位数为 24 个月。141 例患者（40.6%）发生肿瘤生长，其中 26.3%为缓慢生长（SG），15.3%为快速生长（FG）。仅 64 例（18.8%）进行了干预。271 例接受听力分析的患者中，86 例（33.5%）听力下降至改良 Sanna 分级的较低听力级别。肿瘤生长和年龄较大是听力恶化的预测因素。在 125 例初始可利用听力（A/B 级）的患者中，91 例（72.8%）在最后一次随访时保持可利用听力。肿瘤生长和初始纯音平均听力（PTA）较差是听力恶化的预测因素。
采用等待和扫描策略治疗 ICVS 是一种可行的选择，只有 18.8%的患者需要进一步治疗。听力随时间推移而恶化。
