Vestibular schwannomas with spontaneous shrinkage: about 35 cases

Purposes The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on volumetric measurements on MRI to define which regressions are significant. The secondary aim is to look for a correlation between a shrinkage of...

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Published in:	European archives of oto-rhino-laryngology Vol. 278; no. 11; pp. 4235 - 4241
Main Authors:	Trau, Guillaume, Venkatasamy, Aïna, Charpiot, Anne
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2021 Springer Verlag
Subjects:	Head and Neck Surgery Mechanics Medicine Medicine & Public Health Neurosurgery Otology Otorhinolaryngology Physics Regression Volumetric analysis Spontaneous shrinkage Magnetic resonance imaging Acoustic neuroma Vestibular schwannoma
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Abstract	Purposes The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on volumetric measurements on MRI to define which regressions are significant. The secondary aim is to look for a correlation between a shrinkage of the tumor and the medical history, and the presence of clinical symptoms. Methods We first selected all patients presenting with a VS who underwent two or more MRI of the internal auditory canal on the same 3 T MRI machine retrospectively between January 2013 and June 2018. All MRI images were evaluated independently by two radiologists. The volumetric analysis was performed contrast-enhanced 2D spin-echo T1-weighted sequence and expressed in cubic centimeters. Results Thirty-five patients presented with a regressive VS on MRI (14%). The annual mean shrinkage rate was 0.08 cm 3 /year. Eighty percent of the patients present both a shrinkage by more than 0.01 cm 3 /year and a decrease of the initial tumor volume by more than 20%. The majority of patients are asymptomatic or presented moderate balance disorders, which remained stable or improved over time. Tinnitus was observed in 47% and was stable or improved in the majority of cases and the mean annual mean hearing loss was by < or = 4 dB/year. Conclusion Out of 247 VS, 14% decreased using follow-up (by > or = 2 MRI), and a spontaneous shrinkage greater than 0.01 cm 3 /year and greater than 20% could be considered significant.
AbstractList	The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on volumetric measurements on MRI to define which regressions are significant. The secondary aim is to look for a correlation between a shrinkage of the tumor and the medical history, and the presence of clinical symptoms. We first selected all patients presenting with a VS who underwent two or more MRI of the internal auditory canal on the same 3 T MRI machine retrospectively between January 2013 and June 2018. All MRI images were evaluated independently by two radiologists. The volumetric analysis was performed contrast-enhanced 2D spin-echo T1-weighted sequence and expressed in cubic centimeters. Thirty-five patients presented with a regressive VS on MRI (14%). The annual mean shrinkage rate was 0.08 cm /year. Eighty percent of the patients present both a shrinkage by more than 0.01 cm /year and a decrease of the initial tumor volume by more than 20%. The majority of patients are asymptomatic or presented moderate balance disorders, which remained stable or improved over time. Tinnitus was observed in 47% and was stable or improved in the majority of cases and the mean annual mean hearing loss was by < or = 4 dB/year. Out of 247 VS, 14% decreased using follow-up (by > or = 2 MRI), and a spontaneous shrinkage greater than 0.01 cm /year and greater than 20% could be considered significant. Purposes The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on volumetric measurements on MRI to define which regressions are significant. The secondary aim is to look for a correlation between a shrinkage of the tumor and the medical history, and the presence of clinical symptoms. Methods We first selected all patients presenting with a VS who underwent two or more MRI of the internal auditory canal on the same 3 T MRI machine retrospectively between January 2013 and June 2018. All MRI images were evaluated independently by two radiologists. The volumetric analysis was performed contrast-enhanced 2D spin-echo T1-weighted sequence and expressed in cubic centimeters. Results Thirty-five patients presented with a regressive VS on MRI (14%). The annual mean shrinkage rate was 0.08 cm 3 /year. Eighty percent of the patients present both a shrinkage by more than 0.01 cm 3 /year and a decrease of the initial tumor volume by more than 20%. The majority of patients are asymptomatic or presented moderate balance disorders, which remained stable or improved over time. Tinnitus was observed in 47% and was stable or improved in the majority of cases and the mean annual mean hearing loss was by < or = 4 dB/year. Conclusion Out of 247 VS, 14% decreased using follow-up (by > or = 2 MRI), and a spontaneous shrinkage greater than 0.01 cm 3 /year and greater than 20% could be considered significant. PURPOSESThe first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on volumetric measurements on MRI to define which regressions are significant. The secondary aim is to look for a correlation between a shrinkage of the tumor and the medical history, and the presence of clinical symptoms. METHODSWe first selected all patients presenting with a VS who underwent two or more MRI of the internal auditory canal on the same 3 T MRI machine retrospectively between January 2013 and June 2018. All MRI images were evaluated independently by two radiologists. The volumetric analysis was performed contrast-enhanced 2D spin-echo T1-weighted sequence and expressed in cubic centimeters. RESULTSThirty-five patients presented with a regressive VS on MRI (14%). The annual mean shrinkage rate was 0.08 cm3/year. Eighty percent of the patients present both a shrinkage by more than 0.01 cm3/year and a decrease of the initial tumor volume by more than 20%. The majority of patients are asymptomatic or presented moderate balance disorders, which remained stable or improved over time. Tinnitus was observed in 47% and was stable or improved in the majority of cases and the mean annual mean hearing loss was by < or = 4 dB/year. CONCLUSIONOut of 247 VS, 14% decreased using follow-up (by > or = 2 MRI), and a spontaneous shrinkage greater than 0.01 cm3/year and greater than 20% could be considered significant. PURPOSES: The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on volumetric measurements on MRI to define which regressions are significant. The secondary aim is to look for a correlation between a shrinkage of the tumor and the medical history, and the presence of clinical symptoms. METHODS: We first selected all patients presenting with a VS who underwent two or more MRI of the internal auditory canal on the same 3 T MRI machine retrospectively between January 2013 and June 2018. All MRI images were evaluated independently by two radiologists. The volumetric analysis was performed contrast-enhanced 2D spin-echo T1-weighted sequence and expressed in cubic centimeters. RESULTS: Thirty-five patients presented with a regressive VS on MRI (14%). The annual mean shrinkage rate was 0.08 cm3/year. Eighty percent of the patients present both a shrinkage by more than 0.01 cm3/year and a decrease of the initial tumor volume by more than 20%. The majority of patients are asymptomatic or presented moderate balance disorders, which remained stable or improved over time. Tinnitus was observed in 47% and was stable or improved in the majority of cases and the mean annual mean hearing loss was by < or = 4 dB/year. CONCLUSION: Out of 247 VS, 14% decreased using follow-up (by > or = 2 MRI), and a spontaneous shrinkage greater than 0.01 cm3/year and greater than 20% could be considered significant.
Author	Charpiot, Anne Trau, Guillaume Venkatasamy, Aïna
Author_xml	– sequence: 1 givenname: Guillaume orcidid: 0000-0002-3861-6519 surname: Trau fullname: Trau, Guillaume email: guillaume.trau@chru-strasbourg.fr organization: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Strasbourg – sequence: 2 givenname: Aïna surname: Venkatasamy fullname: Venkatasamy, Aïna organization: Institute of Image-Guided Surgery, IHU Strasbourg – sequence: 3 givenname: Anne surname: Charpiot fullname: Charpiot, Anne organization: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Strasbourg
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Cites_doi	10.1097/00129492-200606000-00018 10.1017/S0022215113001266 10.1177/0194599812447766 10.1177/0194599819827812 10.1097/00129492-200109000-00021 10.1017/S0022215107001077 10.1080/00016480701881803 10.1177/0194599818770413 10.3171/jns.2005.103.1.0059 10.1016/j.anl.2012.01.011 10.1097/01.MLG.0000217528.37106.2D 10.1016/j.wjorl.2016.10.002 10.1055/s-2006-934112 10.1227/NEU.0b013e3181f22660 10.1016/j.clineuro.2016.04.010 10.1016/j.otorri.2014.08.003 10.1111/j.1749-4486.2008.01705.x 10.1016/j.clineuro.2015.08.003 10.1002/lary.27114 10.1007/s00234-009-0529-4 10.3171/2011.12.JNS111662 10.1093/aje/kwr465 10.1007/s00405-018-5199-6 10.1016/S0196-0709(00)80050-2
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Keywords	Regression Volumetric analysis Spontaneous shrinkage Magnetic resonance imaging Acoustic neuroma Vestibular schwannoma
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Snippet	Purposes The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on... The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on volumetric... PURPOSESThe first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on... PURPOSES: The first aim is to describe the epidemiological, clinical, and radiological characteristics of regressive vestibular schwannomas (VS), based on...
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SubjectTerms	Head and Neck Surgery Mechanics Medicine Medicine & Public Health Neurosurgery Otology Otorhinolaryngology Physics
Title	Vestibular schwannomas with spontaneous shrinkage: about 35 cases
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