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Influence of cystic tumor degeneration on management strategy in vestibular schwannoma

Presenting Author: Zhihua Zhang

Published online by Cambridge University Press:  03 June 2016

Zhihua Zhang ,
Zirong Huo ,
Qi Huang ,
Zhaoyan Wang ,
Jun Yang  and
Hao Wu
Zhihua Zhang
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai 200092, China
Zirong Huo
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai 200092, China
Qi Huang
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai 200092, China
Zhaoyan Wang
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai 200092, China
Jun Yang
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai 200092, China
Hao Wu
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai 200092, China
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Abstract

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Learning Objectives:

Objective: In this study, we focused on the influence of cystic tumor degeneration on management strategy of vestibular schwannoma.

Methods: The patients with vestibular schwannomawhowere operated at our center from 2006 January to 2013 December were retrospectively analyzed. There were 96 patients having sproradic cystic vestibular schwannomas, recognized by the presence of cystic components both on the preoperative magnetic resonance imaging and intraoperatively, were included. And 96 random cases with solid vestibular schwannomas were used as a control group. The clinical, operative feature and surgical outcomes were reported.

Results: Cystic vestibular schwannomas are associated with rapid growth, worse hearing level (94.8% of patients with hearing level in class C or D) and more frequent onsets of suddent hearing loss than solid tumor. The longterm good facial nerve function rate in cystic tumor is worse than that in solid tumor because of strong adhesion between tumor capsule and facial nerve (30.2% vs 44.8%, p = 0.037). There was no significant difference in complications, mortality and recurrence.

Conclusion: Surgical resection should be the prefer management strategy for cystic vestibular schwannomas. Physician should inform patient with cystic tumor. In case of difficult dissection in peripheral thin wall cystic tumor, near total tumor resection is suggested for protection of facial nerve function and quality of life.