[Clinical picture of 8th pair schwannoma. Is it expressive enough?]. / Caracterización clínica del schwannoma del VIII par. Son suficientemente expresivos sus síntomas?

OBJECTIVE: To describe the stage-related clinical features of 8th cranial nerve schwannoma. MATERIAL AND METHOD: Descriptive study of 71 patients whose diagnosis and/or treatment have been carried out at our centre between 1997-2003. Gender, age, and symptoms were considered, with special attention to gender. Determination of tumoral stage following Tos and Thomsen image criteria. RESULTS: The mean age was 64.6 (range, 20-87) with a marked incidence between 52 and 70 years (62 % of the whole), slightly higher in females and in the left ear. The main symptoms were those derived from involvement of the 7th and 8th cranial nerves, with other cranial nerves and cerebello-pontine structures being involved in larger tumours, although a high variability was noted in clinical patterns of same-stage cases and in the first symptom. Our study also found a high variability in hearing conservation and a marked frequency of vestibular or facial (motor and sensory) symptoms. There were also very infrequent forms of presentation that are highlighted. CONCLUSIONS: There is no typical clinical pattern and no typical first symptom in 8th cranial nerve schwannomas. Any audiovestibular or facial symptom, even the slightest, may be the first expression of 8th cranial nerve schwannoma. There is no stage-specific symptom except for those with involvement of the cerebello-pontine or cerebral structures.

Caracterización clínica del schwannoma del VIII par. ¿Son suficientemente expresivos sus síntomas? / Clinical picture of 8th pair schwannoma. Is it expressive enough?

Objetivo: Determinar la semiología característica del schwannoma del VIII par craneal en función de su estadio por imagen. Material y método: Estudio descriptivo a partir de 71 sujetos diagnosticados en nuestra consulta o remitidos a nuestro centro para tratamiento entre 1997 y 2003. Se recoge el sexo y la edad, así como los síntomas que presentaba el paciente, diferenciando el síntoma de inicio. Determinación del estadio del tumor según criterios de imagen de la clasificación de Tos y Thomsen. Resultados: La media de edad es de 64,6 (intervalo, 20-87) años. Llama la atención que el tramo de edad entre los 52 y 70 años acumula el 62 % de los casos. La incidencia es levemente mayor en mujeres y en el oído izquierdo. Los síntomas predominantes son los derivados de la afección del VIII y el VII pares craneales, asociándose síntomas por afección de otros pares craneales y del ángulo pontocerebeloso en tumores mayores, aunque existe una enorme variabilidad tanto entre casos del mismo estadio como en la clínica de inicio (first sympthom). Destacamos en nuestro estudio la variabilidad de la preservación de la audición entre los diferentes pacientes y el alto número de casos afectos de clínica vestibular o facial, tanto motriz como sensitiva. Asimismo, hay formas de inicio sorprendentes por su infrecuencia. Conclusiones: No existe patrón clínico típico de comienzo del schwannoma del VIII par. Cualquier síntoma audiovestibular o facial, por sutil que fuere, puede ser la primera expresión clínica de un schwannoma del VIII par. Ningún síntoma es patrimonio de ningún estadio, con la excepción de los propios de la afección de la fosa posterior

Objective: To describe the stage-related clinical features of 8th cranial nerve schwannoma. Material and method: Descriptive study of 71 patients whose diagnosis and/or treatment have been carried out at our centre between 1997-2003. Gender, age, and symptoms were considered, with special attention to gender. Determination of tumoral stage following Tos and Thomsen image criteria. Results: The mean age was 64.6 (range, 20-87) with a marked incidence between 52 and 70 years (62 % of the whole), slightly higher in females and in the left ear. The main symptoms were those derived from involvement of the 7th and 8th cranial nerves, with other cranial nerves and cerebello-pontine structures being involved in larger tumours, although a high variability was noted in clinical patterns of same-stage cases and in the first symptom. Our study also found a high variability in hearing conservation and a marked frequency of vestibular or facial (motor and sensory) symptoms. There were also very infrequent forms of presentation that are highlighted. Conclusions: There is no typical clinical pattern and no typical first symptom in 8th cranial nerve schwannomas. Any audiovestibular or facial symptom, even the slightest, may be the first expression of 8th cranial nerve schwannoma. There is no stage-specific symptom except for those with involvement of the cerebello-pontine or cerebral structures