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Epidemiology and natural history of vestibular schwannoma

Epidemiology and natural history of vestibular schwannoma. S-E.Stangerup , P.Caye-Thomasen , J.Thomsen , M.Tos ENT Department Gentofte University Hospital Copenhagen, Denmark. Subjects. 2283 Diagnosed VS in the period ; from January 1976 to end December 2008.

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Epidemiology and natural history of vestibular schwannoma

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  1. Epidemiology and naturalhistory of vestibularschwannoma S-E.Stangerup, P.Caye-Thomasen, J.Thomsen, M.Tos ENT Department Gentofte University Hospital Copenhagen, Denmark

  2. Subjects • 2283 Diagnosed VS in the period; from January 1976 to end December 2008. • 1123 Operatedafterdiagnosis • 16 Fractionatedirradiation • 1144 Allocated to ”wait and scan”

  3. Annualnumber of diagnosedvestibularschwannomas pr. million people in Denmark

  4. Meantumoursize at the time of diagnosis

  5. Mean age at the time of diagnosis

  6. ”Wait & scan” Subjects (1144) • MRI x 2 999 • Audiometry (PTA,Sd) x 2 932 • Localisation : Intrameatal 461 • Extrameatal 683 • Sex: female/male : 548/596 • Mean age: 58.6 years

  7. AAO-HNS and WRS classification of hearing quality Dl (%) Dl (%) 0 30 50 100 0 30 50 100 A B D C I II III 0 IV 30 50 PTA (dB) AAO-HNS WRS

  8. Change in hearing during ”wait & scan” WRS classification Diagnosis Last evaluation I I 61%

  9. Loss of goodhearingduring observation, for patients withAAO class A and WRS class I hearing at diagnosis (n=932)

  10. Change in hearing during ”wait & scan” WRS classification I: Dl<=30% Dl: 0% Dl: 1-10% Dl: 11-20% Dl:21-30% 33% 24% 26% 17% 61%

  11. Loss of good hearing (Sd >= 70%) in the different prognostic groups

  12. Loss of good hearing (Sd >= 70%) in the different prognostic groups

  13. Loss of good hearing (Sd >= 70%) in the different prognostic groups

  14. Loss of good hearing (Sd >= 70%) in the different prognostic groups

  15. Meanannual speech discriminationloss in relation to observation periodbeforeloosing WRS class 1 hearing

  16. Treatment algoritm for VS patients Tumor size at diagnosis <=15 mm 15-20 mm >20 mm MRI after one year Op/irrad. Operation No growth Growth (more than 2 mm) MRI after 2,3,4,5, Irradiation or operation 7,9 and 14 years

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