Acoustic neuroma natural history, complications & prognosis: Difference between revisions

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{{CMG}}{{AE}}{{Simrat}}
{{CMG}}{{AE}}{{Simrat}}
==Overview==
==Overview==
If left untreated, an acoustic neuroma can block the flow of cerebrospinal fluid and cause [[hydrocephalus]], which may lead to severe vision problems and difficulty breathing and swallowing. Acoustic neuroma patients have a very good [[prognosis]] with minimal complications if treated.
Approximately 50% of all acoustic neuromas grow slowly (1 - 2 mm/year). The growth rate is more rapid (greater than 2 mm/year) in about 20% of the [[Patient|patients]]. The [[tumor]] does not [[Metastasis|metastasize]] to other parts of the [[Human body|body]]. [[Hearing impairment|Hearing loss]], when occurs, is irreversible. If left untreated, an acoustic neuroma can block the flow of [[cerebrospinal fluid]] and cause [[hydrocephalus]], which may lead to severe [[Visual system|vision]] problems and difficulty [[breathing]] and [[swallowing]]. [[Complication (medicine)|Complications]] of acoustic neuroma include [[Hearing impairment|hearing loss]], [[Hydrocephalus]], and recurrence of the [[tumor]]. Small, slow-growing [[Tumor|tumors]] may not need treatment. [[Patient|Patients]] experience similar [[quality of life]] whether treatment is [[observation]], [[radiation]], or [[surgery]].  


==Natural History==
==Natural History, Complications, and Prognosis==
If left untreated, an acoustic neuroma can block the flow of cerebrospinal fluid and cause hydrocephalus, which may lead to severe vision problems and difficulty breathing and swallowing. About 50% of acoustic neuromas grow slowly (1-2 mm/year). The growth rate is more rapid (greater than 2 mm/year) in about twenty percentage of patients. In more than 30% of patients acoustic neuromas seem not to grow. Acoustic neuromas does not metastasize to other parts of the body. Acoustic neuroma does not [[metastasize]] to other parts of the body. AN may continue to grow and press on structures in the skull. Once hearing loss occurs, it does not return after surgery or radiosurgery. If treated acoustic neuroma patients have a very good prognosis with minimal complications. People with small, slow-growing tumors may not need treatment.<ref>{{Cite journal
 
=== Natural History ===
* Approximately 50% of all acoustic neuromas grow slowly (1 - 2 mm/year). The growth rate is more rapid (greater than 2 mm/year) in about 20% of the [[Patient|patients]].  
* In more than 30% of the [[Patient|patients]], acoustic neuromas exhibit no growth at all.  
* The [[tumor]] does not [[Metastasis|metastasize]] to other parts of the [[Human body|body]].
* As  the [[tumor]] grows, it can start pressing on the surrounding [[brain]] tissue.  
* [[Hearing impairment|Hearing loss]], when occurs, is irreversible.  
* If treated, acoustic neuroma [[Patient|patients]] have a very good [[prognosis]] with minimal [[Complication (medicine)|complications]].  
* People with small, slow-growing [[Tumor|tumors]] may not need treatment.
* If left untreated, an acoustic neuroma can block the flow of [[cerebrospinal fluid]] and cause [[hydrocephalus]], which may lead to severe [[Visual system|vision]] problems and difficulty [[breathing]] and [[swallowing]].<ref>{{Cite journal
  | author = [[S. I. Rosenberg]]
  | author = [[S. I. Rosenberg]]
  | title = Natural history of acoustic neuromas
  | title = Natural history of acoustic neuromas
Line 29: Line 38:
  | pmid = 8072358
  | pmid = 8072358
}}</ref><ref>{{Cite journal
}}</ref><ref>{{Cite journal
| author = [[Sven-Eric Stangerup]], [[Per Caye-Thomasen]], [[Mirko Tos]] & [[Jens Thomsen]]
<nowiki> </nowiki><nowiki>|</nowiki> author = [[Sven-Eric Stangerup]], [[Per Caye-Thomasen]], [[Mirko Tos]] & [[Jens Thomsen]]
  | title = The natural history of vestibular schwannoma
  | title = The natural history of vestibular schwannoma
  | journal = [[Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology]]
  | journal = [[Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology]]
| volume = 27
<nowiki> </nowiki><nowiki>|</nowiki> volume = 27
| issue = 4
<nowiki> </nowiki><nowiki>|</nowiki> issue = 4
| pages = 547–552
<nowiki> </nowiki><nowiki>|</nowiki> pages = 547–552
| year = 2006
<nowiki> </nowiki><nowiki>|</nowiki> year = 2006
| month = June
<nowiki> </nowiki><nowiki>|</nowiki> month = June
| doi = 10.1097/01.mao.0000217356.73463.e7
<nowiki> </nowiki><nowiki>|</nowiki> doi = 10.1097/01.mao.0000217356.73463.e7
| pmid = 16791048
<nowiki> </nowiki><nowiki>|</nowiki> pmid = 16791048
}}</ref><ref name="NHS">Acoustic neuroma. NHS(2014) http://www.nhs.uk/Conditions/Acoustic-neuroma/Pages/Complications.aspx Accessed on October 2 2015</ref>
}}</ref><ref name="NHS">Acoustic neuroma. NHS(2014) http://www.nhs.uk/Conditions/Acoustic-neuroma/Pages/Complications.aspx Accessed on October 2 2015</ref>


==Complications==
===Complications===
Complications of acoustic neuroma include:<ref name="NHS">Acoustic neuroma. NHS(2014) http://www.nhs.uk/Conditions/Acoustic-neuroma/Pages/Complications.aspx Accessed on October 2 2015</ref>
[[Complication (medicine)|Complications]] of acoustic neuroma include:<ref name="NHS">Acoustic neuroma. NHS(2014) http://www.nhs.uk/Conditions/Acoustic-neuroma/Pages/Complications.aspx Accessed on October 2 2015</ref>
*[[Hearing impairment|Hearing loss]]
*[[Hydrocephalus]]
*[[Hydrocephalus]]
*Recurrence of tumor
*Recurrence of [[tumor]]
==Prognosis==
===Prognosis===
*An acoustic neuroma is not cancer. The tumor does not ([[metastasize]]) to other parts of the body.
*Small, slow-growing [[Tumor|tumors]] may not need treatment.<ref>{{Cite web | title =NIH  acoustic neuroma Prognosis| url =https://www.nlm.nih.gov/medlineplus/ency/article/000778.htm }}</ref>
*The tumor may continue to grow and press on structures in the skull.
*If treated, acoustic neuroma [[Patient|patients]] have a very good [[prognosis]] with minimal [[Complication (medicine)|complications]].
*Once [[hearing loss]] occurs, it does not return after surgery or [[radiosurgery]].
*A control rate of greater than 90% is found in [[Tumor|tumors]] treated with focused [[radiation]].
*People with small, slow-growing tumors may not need treatment.<ref>{{Cite web | title =NIH  acoustic neuroma Prognosis| url =https://www.nlm.nih.gov/medlineplus/ency/article/000778.htm }}</ref>
*Acoustic neuroma patients have a very good prognosis with minimal complications if treated.
*Forty to sixty percentage of small tumors may not require treatment.  
*A control rate of greater than 90% is found in tumors treated with focused [[radiation]].
*A recurrence rate of less than 5% has been found following [[surgery]].
*A recurrence rate of less than 5% has been found following [[surgery]].
*Patients experience similar quality of life whether treatment is [[observation]], [[radiation]], or [[surgery]].
*[[Patient|Patients]] experience similar [[quality of life]] whether treatment is [[observation]], [[radiation]], or [[surgery]].  
*With the emergence of magnetic resonance imaging([[MRI]]) with [[gadolinium]], acoustic neuroma tumors as small as 2 mm in diameter can be accurately detected. Due to improved surgical techniques and early [[diagnosis]], the morbidity associated with surgical removal of these lesions is reduced.<ref name="pmid8072358">{{cite journal| author=Strasnick B, Glasscock ME, Haynes D, McMenomey SO, Minor LB| title=The natural history of untreated acoustic neuromas. | journal=Laryngoscope | year= 1994 | volume= 104 | issue= 9 | pages= 1115-9 | pmid=8072358 | doi=10.1288/00005537-199409000-00011 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8072358  }} </ref>  In select group of patients(patients older than 65 years with acoustic neuroma): however, no treatment may be the most appropriate management.<ref name="pmid10763994">{{cite journal| author=Rosenberg SI| title=Natural history of acoustic neuromas. | journal=Laryngoscope | year= 2000 | volume= 110 | issue= 4 | pages= 497-508 | pmid=10763994 | doi=10.1097/00005537-200004000-00002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10763994  }} </ref>
*Due to improved [[Surgery|surgical techniques]] and early [[diagnosis]], the [[morbidity]] associated with [[surgery]] is reduced.<ref name="pmid8072358">{{cite journal| author=Strasnick B, Glasscock ME, Haynes D, McMenomey SO, Minor LB| title=The natural history of untreated acoustic neuromas. | journal=Laryngoscope | year= 1994 | volume= 104 | issue= 9 | pages= 1115-9 | pmid=8072358 | doi=10.1288/00005537-199409000-00011 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8072358  }} </ref>   
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 20:02, 24 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Approximately 50% of all acoustic neuromas grow slowly (1 - 2 mm/year). The growth rate is more rapid (greater than 2 mm/year) in about 20% of the patients. The tumor does not metastasize to other parts of the body. Hearing loss, when occurs, is irreversible. If left untreated, an acoustic neuroma can block the flow of cerebrospinal fluid and cause hydrocephalus, which may lead to severe vision problems and difficulty breathing and swallowing. Complications of acoustic neuroma include hearing loss, Hydrocephalus, and recurrence of the tumor. Small, slow-growing tumors may not need treatment. Patients experience similar quality of life whether treatment is observation, radiation, or surgery.

Natural History, Complications, and Prognosis

Natural History

Complications

Complications of acoustic neuroma include:[4]

Prognosis

References

  1. S. I. Rosenberg (2000). "Natural history of acoustic neuromas". The Laryngoscope. 110 (4): 497–508. doi:10.1097/00005537-200004000-00002. PMID 10763994. Unknown parameter |month= ignored (help)
  2. B. Strasnick, M. E. 3rd Glasscock, D. Haynes, S. O. McMenomey & L. B. Minor (1994). "The natural history of untreated acoustic neuromas". The Laryngoscope. 104 (9): 1115–1119. doi:10.1288/00005537-199409000-00011. PMID 8072358. Unknown parameter |month= ignored (help)
  3. {{Cite journal | author = Sven-Eric Stangerup, Per Caye-Thomasen, Mirko Tos & Jens Thomsen | title = The natural history of vestibular schwannoma | journal = [[Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology]] | volume = 27 | issue = 4 | pages = 547–552 | year = 2006 | month = June | doi = 10.1097/01.mao.0000217356.73463.e7 | pmid = 16791048 }}
  4. 4.0 4.1 Acoustic neuroma. NHS(2014) http://www.nhs.uk/Conditions/Acoustic-neuroma/Pages/Complications.aspx Accessed on October 2 2015
  5. "NIH acoustic neuroma Prognosis".
  6. Strasnick B, Glasscock ME, Haynes D, McMenomey SO, Minor LB (1994). "The natural history of untreated acoustic neuromas". Laryngoscope. 104 (9): 1115–9. doi:10.1288/00005537-199409000-00011. PMID 8072358.

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