A CLINICAL STUDY OF VESTIBULAR SCHWANNOMA AND NEUROFIBROMATOSIS TYPE 2

Abstract

The clinical records of 187 patients with vestibular schwannoma (VS) diagnosed at the University of Tsukuba Hospital between 1988 and 2011 were reviewed. There were 11 cases of neurofibromatosis type 2 (NF2). Of these 11 cases with NF2, 10 had bilateral VSs and one had a unilateral VS and multiple meningiomas and schwannomas.
There were 2 cases of unilateral VS who were under the age of 20 years. On the other hand, there were also 2 cases of NF2 over the age of 60 years. The mean age±standard deviation of the patients with unilateral VS and NF2 was 52.9±14.3 and 39.0±18.1, respectively.
Hearing loss was the most common chief complaint among the VS patients. Bilateral hearing loss was revealed in 4 of the 11 patients with NF2 at the first visit. However, 12 of 21 ears with VS among the 11 patients with NF2 had progressed to profound hearing loss by the last follow-up audiometry. Hearing preservation was difficult in most cases of NF2, irrespective of the treatment strategy, which was selected from among (a) wait and scan, (b) tumor resection, and (c) radiotherapy.
The treatment strategies in the patients with unilateral VS depended mainly on the tumor size; those for NF2 also depended on the hearing status. Obtainment of informed consent was extremely important for appropriate decision-making for the treatment of NF2.