Natural history of vestibular schwannoma growth and hearing decline in newly diagnosed neurofibromatosis type 2 patients

Otol Neurotol. 2014 Jan;35(1):e50-6. doi: 10.1097/MAO.0000000000000239.

Abstract

Objective: To determine the rate of growth in vestibular schwannomas and the rate of hearing decline in neurofibromatosis type 2 (NF2) patients not undergoing active treatment

Study design: Prospective study.

Setting: Data were collected at 10 NF2 centers, including hospital-based, academic, and tertiary care centers.

Patients: 120 NF2 patients with 200 vestibular schwannomas.

Outcome measures: Hearing decline, defined as a decrease in word recognition score outside the 95% critical difference compared with baseline, and radiographic progression, defined as a 20% or greater increase in tumor volume compared with baseline.

Results: During a total of 313.4 patient-years of follow-up, the rate of hearing decline was 5% at 1 year, 13% at 2 years, and 16% at 3 years; the rate of tumor progression was 31% at 1 year, 64% at 2 years, and 79% at 3 years. For this cohort, the median time to tumor progression (14 mo) was significantly shorter than the median time to hearing decline (62.0 mo).

Conclusion: These data provide potentially useful information for the design of clinical trials for NF2 vestibular schwannoma.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Hearing Loss / pathology*
  • Humans
  • Male
  • Middle Aged
  • Neurofibromatosis 2 / pathology*
  • Neuroma, Acoustic / pathology*
  • Prospective Studies
  • Young Adult