Pediatric vestibular schwannomas: Evaluation of clinical features, treatment strategies and long-term results of 10 cases

Objectives: This study aims to analyze and discuss the epidemiology, clinical-radiological features, differential diagnosis, histopathological characteristics, treatment strategies and long-term follow-up results of pediatric vestibular schwannomas VSs treated at a single institution. Patients and Methods: Medical records of 10 pediatric patients 3 males, 7 females; mean age 14.9±2.3 years; range 11 to 18 years who were operated for VSs in our department between January 2000 and December 2017 were retrospectively reviewed. The prognostic variables were age, gender, neurological examination at the time of application, radiologic findings, localization, associated factors, amount of resection total [100%], near total [90-100%] or subtotal [

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  • Tos M, Stangerup SE, Cayé-Thomasen P, Tos T, Thomsen J. What is the real incidence of vestibular schwannoma? Arch Otolaryngol Head Neck Surg 2004;130:216-20.
  • Babu R, Sharma R, Bagley JH, Hatef J, Friedman AH, Adamson C. Vestibular schwannomas in the modern era: epidemiology, treatment trends, and disparities in management. J Neurosurg 2013;119:121-30.
  • Lin EP, Crane BT. The Management and Imaging of Vestibular Schwannomas. AJNR Am J Neuroradiol 2017;38:2034-2043.
  • Samii M, Matthies C. Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve-- preservation and restitution of function. Neurosurgery 1997;40:684-94.
  • Mautner VF, Lindenau M, Baser ME, Hazim W, Tatagiba M, Haase W, et al. The neuroimaging and clinical spectrum of neurofibromatosis 2. Neurosurgery 1996;38:880-5.
  • Rusell DS, Rubinstein LJ. Pathology of Tumors of the Nervous System. 4th ed. London: Edward Amold; 1977.
  • Rout D, Pillai SM, Radhakrishnan VV. Cervical intramedullary schwannoma. Case report. J Neurosurg 1983;58:962-4.
  • Grossman RG, Hamilton WJ. Acoustic neuromas. In: Grossman RG, editor. Principles of Neurosurgery. New York: Raven Press Ltd; 1991. p.149-52.
  • Harner SG, Laws ER Jr. Clinical findings in patients with acoustic neurinoma. Mayo Clin Proc 1983;58:721-8.
  • Holman MA, Schmitt WR, Carlson ML, Driscoll CL, Beatty CW, Link MJ. Pediatric cerebellopontine angle and internal auditory canal tumors: clinical article. J Neurosurg Pediatr 2013;12:317-24.
  • Matthies C, Samii M. Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation. Neurosurgery 1997;40:1-9.
  • Kasantikul V, Brown WJ. Estrogen receptors in acoustic neurilemmomas. Surg Neurol 1981;15:105-9.
  • Brackmann DE, Bartels LJ. Rare tumors of the cerebellopontine angle. Otolaryngol Head Neck Surg (1979) 1980;88:555-9.
  • Hitselberger WE, Gardner G Jr. Other tumors of the cerebellopontine angle. Arch Otolaryngol 1968;88:712-4.
  • Cunningham CD 3rd, Friedman RA, Brackmann DE, Hitselberger WE, Lin HW. Neurotologic skull base surgery in pediatric patients. Otol Neurotol 2005;26:231-6.
  • Zşccaro G, Sosa F. Cerebellopontine angle lesions in children. Childs Nerv Syst 2007;23:177-83.
  • Matthies C, Thomas S, Moshrefi M, Lesinski-Schiedat A, Frohne C, Battmer RD, et al. Auditory brainstem implants: current neurosurgical experiences and perspective. J Laryngol Otol Suppl 2000;27:32-6.
  • Evans DG, Ramsden RT, Gokhale C, Bowers N, Huson SM, Wallace A. Should NF2 mutation screening be undertaken in patients with an apparently isolated vestibular schwannoma? Clin Genet 2007;71:354-8.
  • Baser ME, Friedman JM, Wallace AJ, Ramsden RT, Joe H, Evans DG. Evaluation of clinical diagnostic criteria for neurofibromatosis 2. Neurology 2002;59:1759-65.
  • Evans DG, Birch JM, Ramsden RT. Paediatric presentation of type 2 neurofibromatosis. Arch Dis Child 1999;81:496-9.
  • Evans DG, Huson SM, Donnai D, Neary W, Blair V, Newton V, et al. A genetic study of type 2 neurofibromatosis in the United Kingdom. II. Guidelines for genetic counselling. J Med Genet 1992;29:847-52.
  • Badie B, Pyle GM, Nguyen PH, Hadar EJ. Elevation of internal auditory canal pressure by vestibular schwannomas. Otol Neurotol 2001;22:696-700.
  • Chandrasekhar SS, Brackmann DE, Devgan KK. Utility of auditory brainstem response audiometry in diagnosis of acoustic neuromas. Am J Otol 1995;16:63-7.
  • Luse SA. Electron microscopic studies of brain tumors. Neurology 1960;10:881-905.
  • Neu M, Strauss C, Romstöck J, Bischoff B, Fahlbusch R. The prognostic value of intraoperative BAEP patterns in acoustic neurinoma surgery. Clin Neurophysiol 1999;110:1935-41.
  • Moffat DA, Ballagh RH. Rare tumours of the cerebellopontine angle. Clin Oncol (R Coll Radiol) 1995;7:28-41.
  • Wong RH, Copeland WR, Jacob JT, Sivakanthan S, Van Gompel JJ, van Loveren H, et al. Anterior Extension of Tumor is as Important as Tumor Size to Facial Nerve Outcome and Extent of Resection for Vestibular Schwannomas. J Neurol Surg B Skull Base 2017;78:473-480.
  • Walcott BP, Sivarajan G, Bashinskaya B, Anderson DE, Leonetti JP, Origitano TC. Sporadic unilateral vestibular schwannoma in the pediatric population. Clinical article. J Neurosurg Pediatr 2009;4:125-9.
  • Stuart FA, Segal TY, Keady S. Adverse psychological effects of corticosteroids in children and adolescents. Arch Dis Child 2005;90:500-6.
  • Kluwe L, Mautner V, Heinrich B, Dezube R, Jacoby LB, Friedrich RE, et al. Molecular study of frequency of mosaicism in neurofibromatosis 2 patients with bilateral vestibular schwannomas. J Med Genet 2003;40:109-14.
  • Matthies C, Samii M, Krebs S. Management of vestibular schwannomas (acoustic neuromas): radiological features in 202 cases--their value for diagnosis and their predictive importance. Neurosurgery 1997;40:469-81.
  • Otto SR, Brackmann DE, Hitselberger WE, Shannon RV, Kuchta J. Multichannel auditory brainstem implant: update on performance in 61 patients. J Neurosurg 2002;96:1063-71.
  • Bennett M, Haynes DS. Surgical approaches and complications in the removal of vestibular schwannomas. 2007. Neurosurg Clin N Am 2008;19:331-43.
  • Briggs RJ, Luxford WM, Atkins JS Jr, Hitselberger WE. Translabyrinthine removal of large acoustic neuromas. Neurosurgery 1994;34:785-90.
  • Jung S, Kang SS, Kim TS, Kim HJ, Jeong SK, Kim SC, et al. Current surgical results of retrosigmoid approach in extralarge vestibular schwannomas. Surg Neurol 2000;53:370-7.
  • Samii M, Matthies C. Management of 1000 vestibular schwannomas (acoustic neuromas): surgical management and results with an emphasis on complications and how to avoid them. Neurosurgery 1997;40:11-21.
  • Samii M, Matthies C. Management of 1000 vestibular schwannomas (acoustic neuromas): hearing function in 1000 tumor resections. Neurosurgery 1997;40:248-60.
  • Samii M, Matthies C. Acoustic neurinomas associated with vascular compression syndromes. Acta Neurochir (Wien) 1995;134:148-54.
  • Schmerber S, Palombi O, Boubagra K, Charachon R, Chirossel JP, Gay E. Long-term control of vestibular schwannoma after a translabyrinthine complete removal. Neurosurgery 2005;57:693-8.
  • Prasad D, Steiner M, Steiner L. Vestibular schwannoma. Crit Rev Neurosurg 1999;9:340-8.
  • Samii M, Matthies C, Tatagiba M. Management of vestibular schwannomas (acoustic neuromas): auditory and facial nerve function after resection of 120 vestibular schwannomas in patients with neurofibromatosis 2. Neurosurgery 1997;40:696-705.
  • Zolotova SV, Golanov AV, Kotel’nikova TM, Soboleva OI, Gorlachev GE, Fil’chenkova NA, et al. Stereotactic radiotherapy and radiosurgery in treatment of patients with intracranial schwannomas. Zh Vopr Neirokhir Im N N Burdenko 2010;1:18-23. [Abstract]
  • Puanhvuan D, Chumnanvej S, Wongsawat Y. Peripheral nerve function estimation by linear model of multi-CMAP responses for surgical intervention in acoustic neuroma surgery. Physiol Rep 2017:23.
  • Yin L, Ma Z, Li C, Luo S. Unilateral Vestibular Schwannomas in Childhood without Evidence of Neurofibromatosis: Experience of 10 Patients at a Single Institute. Turk Neurosurg 2017;27:333-338.
  • Kartush JM, Graham MD, LaRouere MJ. Meatal decompression following acoustic neuroma resection: minimizing delayed facial palsy. Laryngoscope 1991;101(6 Pt 1):674-5.
  • Bozorg Grayeli A, Kalamarides M, Ferrary E, Bouccara D, El Gharem H, Rey A, et al. Conservative management versus surgery for small vestibular schwannomas. Acta Otolaryngol 2005;125:1063-8.
  • Hoistad DL, Melnik G, Mamikoglu B, Battista R, O’Connor CA, Wiet RJ. Update on conservative management of acoustic neuroma. Otol Neurotol 2001;22:682-5.
  • Rosahl SK, Tatagiba M, Gharabaghi A, Matthies C, Samii M. Acoustic evoked response following transection of the eighth nerve in the rat. Acta Neurochir (Wien) 2000;142:1037-45.
  • Selesnick SH, Jackler RK. Clinical manifestations and audiologic diagnosis of acoustic neuromas. Otolaryngol Clin North Am 1992;25:521-51.
  • Brokinkel B, Sauerland C, Holling M, Ewelt C, Horstmann G, van Eck AT, et al. Gamma Knife radiosurgery following subtotal resection of vestibular schwannoma. J Clin Neurosci 2014;21:2077-82.
  • Choi JW, Lee JY, Phi JH, Wang KC, Chung HT, Paek SH, et al. Clinical course of vestibular schwannoma in pediatric neurofibromatosis Type 2. J Neurosurg Pediatr 2014;13:650-7.