Growing versus non-growing vestibular schwannomas: assessment of natural history

J Laryngol Otol. 2022 Oct;136(10):934-938. doi: 10.1017/S0022215121002681. Epub 2021 Oct 1.

Abstract

Objective: Vestibular schwannomas can demonstrate great heterogeneity in their behaviour; approximately one-third will grow and two-thirds will not. This study aimed to determine whether there are factors present at diagnosis that can help predict outcomes.

Methods: This retrospective cohort study compared data from 735 patients from the past 20 years. Analysis of serial magnetic resonance imaging was carried out to place patients into growing and non-growing cohorts. Factors including size, age, follow-up time and presence of balance symptoms were compared.

Results: The median size of a growing vestibular schwannoma at diagnosis was 13 mm, whereas the non-growing median size was 10.65 mm (p < 0.001). Balance symptoms were present in 60.76 per cent of growing vestibular schwannoma patients but only in 38.75 per cent of patients with non-growing vestibular schwannomas (p < 0.001).

Conclusion: This study highlights initial tumour size and balance symptoms as potential predictors of whether or not a vestibular schwannoma will grow; these results better facilitate our understanding of vestibular schwannoma natural history.

Keywords: Dizziness; Growth; Neuroma; Vertigo; Vestibular Schwannoma.

MeSH terms

  • Humans
  • Magnetic Resonance Imaging / methods
  • Neuroma, Acoustic* / diagnostic imaging
  • Neuroma, Acoustic* / pathology
  • Retrospective Studies