Romanian Neurosurgery (Nov 2024)

CLINICAL PRESENTATION, TREATMENT OUTCOMES, AND DEMOGRAPHIC TRENDS IN VESTIBULAR SCHWANNOMAS

  • Mugurel Petrinel Radoi,
  • Corneliu Toader,
  • Milena-Monica Ilie,
  • Razvan-Adrian Covache-Busuioc,
  • Horia Petre Costin,
  • Luca-Andrei Glavan,
  • Matei Serban,
  • Antonio Daniel Corlatescu

DOI
https://doi.org/10.33962/roneuro-2024-121
Journal volume & issue
Vol. 38, no. Special Issue

Abstract

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Introduction Vestibular schwannomas (VS) are benign tumors affecting the vestibulocochlear nerve. This study analyzed the clinical presentations and treatment outcomes of 68 VS cases managed between 2014 and 2023 at the National Institute of Neurology and Neurovascular Diseases in Bucharest, Romania. Methods A retrospective analysis was conducted on patient demographics, clinical symptoms, tumor characteristics, treatment modalities, and outcomes. Statistical analysis was performed using Python 3.10. Results The study cohort exhibited a male-to-female ratio of 1:1.6, with a median age of 54 years at diagnosis. The most common symptoms were balance and gait disorders (91.8%), and hearing impairment (71.8%). A notable correlation was observed between facial palsy and hearing loss, with 60% of patients experiencing both symptoms simultaneously. Dysphagia was present in 13.3% of cases. The median size of the tumor was 2,5 cm. While hydrocephalus was responsible for visual impairments in some patients, the study challenges the notion that it is the sole cause of these symptoms. The primary treatment method was open surgery (93.3% of cases) through a retrosigmoid approach, with Gamma Knife radiosurgery used in 6.6% of cases as primary treatment method. Following treatment, 24.4% of patients achieved good recovery from facial palsy, while 54.8% continued to experience dysfunction. The overall relapse rate was 14.9%. Conclusions This study provides valuable insights into the clinical presentation and treatment outcomes of vestibular schwannomas. The findings support the use of open surgery in most cases, particularly when hydrocephalus is present, while also highlighting the importance of considering personalized treatment approaches. The observed gender disparity and symptom correlations suggest the need for further research into potential genetic and environmental risk factors.

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