vestibular schwannoma (acoustic neuroma)

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Introduction

schwannoma or neurilemmoma of 8th nerve; acoustic neuroma is misnomer.

Etiology

Epidemiology

  • 8% of all intracranial neoplasms
  • lifetime prevalence of 1 in 500 persons
  • increasing incidence due to enhanced detection
  • most common in 6th or 7th decade in life
    • 20 cases per 100,000 person years[8]

Pathology

Clinical manifestations

Diagnostic procedures

  • audiometry 6 months after diagnostic MRI, then annually
  • confirmatory biopsy rarely needed[8]

Radiology

Complications

Differential diagnosis

* Weber test lateralizes to affected ear

Management

More general terms

References

  1. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  2. 2.0 2.1 UpToDate 14.1 http://www.utdol.com
  3. 3.0 3.1 3.2 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
    Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  4. McDonald R Acoustic neuroma: what the evidence says about evaluation and treatment. J Fam Pract. 2011 Jun;60(6):E1-4. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21647465
  5. deprecated reference
  6. Acoustic Neuroma. NIH Consensus Statement Online 1991 Dec 11-13;9(4):1-24 http://consensus.nih.gov/cons/087/087_statement.htm
  7. 7.0 7.1 Dunn IF, Bi WL, Mukundan S et al. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Role of Imaging in the Diagnosis and Management of Patients With Vestibular Schwannomas. Neurosurgery. 2018 Feb 1;82(2)E32-34. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29309686 https://academic.oup.com/neurosurgery/article/82/2/E32/4764045
    Sweeney AD, Carlson ML, Shepard, NT. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Otologic and Audiologic Screening for Patients With Vestibular Schwannomas. Congress of Neurological Surgeons. 2017. Neurosurgery. 2018 Feb 1;82(2):E29-E31. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29309699 https://www.cns.org/guidelines/guidelines-management-patients-vestibular-schwannoma/chapter_2
  8. 8.00 8.01 8.02 8.03 8.04 8.05 8.06 8.07 8.08 8.09 8.10 Carlson ML, Link MJ Vestibular Schwannomas. N Engl J Med 2021; 384:1335-1348. April 8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33826821 https://www.nejm.org/doi/full/10.1056/NEJMra2020394
  9. Gupta VK, Thakker A, Gupta KK. Vestibular schwannoma: what we know and where we are heading. Head Neck Pathol. 2020;14(4):1058-1066 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32232723 PMCID: PMC7669921 Free PMC article https://link.springer.com/article/10.1007/s12105-020-01155-x
  10. 10.0 10.1 Dhayalan D, Tveiten OV, Finnkirk M et al Upfront Radiosurgery vs a Wait-and-Scan Approach for Small- or Medium-Sized Vestibular Schwannoma. The V-REX Randomized Clinical Trial. JAMA. 2023;330(5):421-431. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37526718 PMCID: PMC10394573 Free PMC article https://jamanetwork.com/journals/jama/fullarticle/2807745
  11. 11.0 11.1 Mistarz N, Reznitsky M, Hostmark K et al Life Expectancy After Diagnosis of a Vestibular Schwannoma in Patients 70 Years and Older. JAMA Otolaryngol Head Neck Surg. 2023 Oct 26. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37883070 https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2811314
  12. Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis [NIDCD Health Information] http://www.nidcd.nih.gov/health/hearing/acoustic_neuroma.asp

Patient information

vestibular schwannoma (acoustic neuroma) patient information