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Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007.

Publication ,  Journal Article
Tan, M; Myrie, OA; Lin, FR; Niparko, JK; Minor, LB; Tamargo, RJ; Francis, HW
Published in: Laryngoscope
January 2010

OBJECTIVES/HYPOTHESIS: To assess trends in the management of unilateral vestibular schwannomas over an 11-year period and to identify disease- and provider-related influences. STUDY DESIGN: Retrospective chart review. METHODS: Subjects presented to the Department of Otolaryngology-Head and Neck Surgery and the Department of Neurosurgery for management of unilateral vestibular schwannoma from 1997 through 2007, with at least two visits within the first year of presentation. The proportion of patients for whom initial management consisted of observation, surgical resection, or radiation therapy was determined, and the relative influence of study year, patient age, hearing status, and tumor size was analyzed. RESULTS: Over the study period there was an increase in the proportion of cases that were observed with follow-up scanning (10.5% to 28.0%) and recommended for radiation (0% to 4.0%), whereas the proportion of operated cases declined (89.5% to 68.0%). There were no changes in mean age or hearing status at diagnosis, but mean tumor size declined significantly. Compared to those undergoing surgery, patients choosing observation and radiation therapy were on average 11.7 and 4.5 years older, respectively. Tumors that were surgically removed were on average 11.6 mm larger than those that were observed. The increasing frequency over time of observation relative to surgery was significant even after controlling for age, hearing status, and tumor size. CONCLUSIONS: Among patients managed by our center, there has been a significant shift in management of vestibular schwannomas over the last decade, with increasing tendency towards observation. This trend implies changing provider philosophy and patient expectations.

Duke Scholars

Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

January 2010

Volume

120

Issue

1

Start / End Page

144 / 149

Location

United States

Related Subject Headings

  • United States
  • Otorhinolaryngology
  • Otolaryngology
  • Neuroma, Acoustic
  • Middle Aged
  • Male
  • Humans
  • Hearing
  • Female
  • Ear Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tan, M., Myrie, O. A., Lin, F. R., Niparko, J. K., Minor, L. B., Tamargo, R. J., & Francis, H. W. (2010). Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007. Laryngoscope, 120(1), 144–149. https://doi.org/10.1002/lary.20672
Tan, Marietta, Oluwaseun A. Myrie, Frank R. Lin, John K. Niparko, Lloyd B. Minor, Rafael J. Tamargo, and Howard W. Francis. “Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007.Laryngoscope 120, no. 1 (January 2010): 144–49. https://doi.org/10.1002/lary.20672.
Tan M, Myrie OA, Lin FR, Niparko JK, Minor LB, Tamargo RJ, et al. Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007. Laryngoscope. 2010 Jan;120(1):144–9.
Tan, Marietta, et al. “Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007.Laryngoscope, vol. 120, no. 1, Jan. 2010, pp. 144–49. Pubmed, doi:10.1002/lary.20672.
Tan M, Myrie OA, Lin FR, Niparko JK, Minor LB, Tamargo RJ, Francis HW. Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007. Laryngoscope. 2010 Jan;120(1):144–149.
Journal cover image

Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

January 2010

Volume

120

Issue

1

Start / End Page

144 / 149

Location

United States

Related Subject Headings

  • United States
  • Otorhinolaryngology
  • Otolaryngology
  • Neuroma, Acoustic
  • Middle Aged
  • Male
  • Humans
  • Hearing
  • Female
  • Ear Neoplasms