Introducing an Evidence-Based Approach to Wait-And-Scan Management of Sporadic Vestibular Schwannoma: Size Threshold Surveillance.
Otolaryngol Clin North Am
; 56(3): 445-457, 2023 Jun.
Article
em En
| MEDLINE
| ID: mdl-37019767
ABSTRACT
The advent of MRI has led to more sporadic vestibular schwannomas diagnosed today than ever before. Despite the average patient being diagnosed in their sixth decade of life with a small tumor and minimal symptoms, population-based data demonstrate that more tumors per capita are treated today than ever before. Emerging natural history data justify either an upfront treatment approach or the "Size Threshold Surveillance" approach. Specifically, if the patient elects to pursue observation, then existing data support the tolerance of some growth during observation in appropriately selected patients up until a specific size threshold range (about 15 mm of CPA extension). The current article discusses the rationale behind a shift in the existing observation management approach, where initial detection of growth typically begets treatment, and outlines the application of a more flexible and nuanced approach based on existing evidence.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neuroma Acústico
Tipo de estudo:
Screening_studies
Limite:
Humans
Idioma:
En
Revista:
Otolaryngol Clin North Am
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos