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. 2023 Oct;165(10):2903-2911.
doi: 10.1007/s00701-023-05665-9. Epub 2023 Jul 15.

Incidence and presentation of vestibular schwannoma: a 3-year cohort registry study

Rocio Fernández-Méndez  1 , Yizhou Wan  2 , Patrick Axon  1 , Alexis Joannides  1
Affiliations

Incidence and presentation of vestibular schwannoma: a 3-year cohort registry study

Rocio Fernández-Méndez et al. Acta Neurochir (Wien). 2023 Oct.

Abstract

Background: Vestibular schwannoma (VS) is the most common benign tumour arising in the lateral skull base. Reported incidence rates of VS vary across geographical locations and over time. There is scarce updated evidence over the past decade on the epidemiology and mode of presentation of VS.

Objective: To describe the epidemiology and mode of presentation of VS in the East of England between 2013 and 2016.

Methods: A retrospective epidemiological analysis of data from a national VS registry and electronic patient records was conducted, including all newly diagnosed adult patients in a UK tertiary referral centre, between April 1st, 2013, and March 31st, 2016.

Results: There were 391 new cases identified resulting in an overall mean incidence of 2.2 VS cases per 100,000 person-year. The incidence rate for all patients in the <40 age group ranged between 0.3 and 0.7 per 100,000 person-year, increasing to a range of 5.7 to 6.1 per 100,000 person-year in the 60-69 age group. The top three combinations of symptoms on presentation per patient were hearing loss and tinnitus (97, 24.8%), hearing loss alone (79, 20.2%) and hearing loss, tinnitus, and balance symptoms (61, 15.6%). The median duration of symptoms was 12 months, with a wide range from 1.4 to 300 months. Age was negatively correlated with tumour size (r = -0.14 [-0.24 to -0.04], p=0.01) and positively correlated with symptom duration (r = 0.16 [0.03-0.29], p=0.02).

Conclusions: The incidence of vestibular schwannoma has increased compared to previous studies in the UK and is similar to incidence rates reported in other countries during the past decade. It peaks in the seventh decade of life, mainly because of an increase in the diagnosis of small tumours with a long duration of audio-vestibular symptoms in older patients, compared to earlier studies.

Keywords: Acoustic neuroma; Clinical registry; Epidemiology study; Vestibular schwannoma.

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Figures

Fig. 1
Fig. 1
Number (label) and percentage (bar size) of newly diagnosed vestibular schwannoma tumours, by tumour size and age group
Fig. 2
Fig. 2
Percentage of patients presenting with each symptom profile, and median duration of each of symptom profile (n = 390). HL, hearing loss; IQR, interquartile range
Fig. 3
Fig. 3
Correlation plot of Pearson residuals (standardised residuals) for each symptom profile and sex pair. The highest standardised residuals contribute the most to the chi-square test
Fig. 4
Fig. 4
Number (label) and percentage (bar size) of presentation types (based on symptom duration) in each group of tumour size (n = 390). Tumour size classified in millimetres. Incidental: discovered after an unrelated investigation in asymptomatic patients; emergency: presented with hydrocephalus; sudden: with sudden onset of symptoms; acute: with symptoms for less than four weeks; subacute: with symptoms for four weeks to less than 12 months; chronic: with symptoms for 12 months or longer
See this image and copyright information in PMC

References

    1. Axon P, Joannides AJ, Wan Y (2017) The british skull base society national VS audit 2015. University of Cambridge, Cambridge
    1. Babu R, Sharma R, Bagley JH, Hatef J, Friedman AH, Adamson C. Vestibular schwannomas in the modern era: epidemiology, treatment trends, and disparities in management: Clinical article. J Neurosurg. 2013;119(1):121–130. doi: 10.3171/2013.1.JNS121370. - DOI - PubMed
    1. Carlson ML, Habermann EB, Wagie AE, Driscoll CL, Van Gompel JJ, Jacob JT, Link MJ. The changing landscape of vestibular schwannoma management in the United States—a shift toward conservatism. Otolaryngol-Head Neck Surg. 2015;153(3):440–446. doi: 10.1177/0194599815590105. - DOI - PubMed
    1. Carlson ML, Vivas EX, McCracken DJ, Sweeney AD, Neff BA, Shepard NT, Olson JJ. Congress of neurological surgeons systematic review and evidence-based guidelines on hearing preservation outcomes in patients with sporadic vestibular schwannomas. Neurosurg. 2018;82(2):E35–E39. doi: 10.1093/neuros/nyx511. - DOI - PubMed
    1. Evans DGR, Moran A, King A, Saeed S, Gurusinghe N, Ramsden R. Incidence of vestibular schwannoma and neurofibromatosis 2 in the North West of England over a 10-year period: higher incidence than previously thought. Otol Neurotol. 2005;26(1):93–97. doi: 10.1097/00129492-200501000-00016. - DOI - PubMed