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- Title
Pediatric vestibular schwannoma without evidence of neurofibromatosis: consecutive 18 microsurgical experiences.
- Authors
Matsushima, Ken; Kohno, Michihiro; Ichimasu, Norio; Nakajima, Nobuyuki; Yoshino, Masanori
- Abstract
Purpose: Sporadic vestibular schwannoma (VS) is rare in children in contrast to adults, and detailed investigations of case series of these patients using a single fixed protocol are scarce. This study presents our surgical experience of pediatric VSs without clinical evidence of neurofibromatosis type 2 (NF2) at the initial diagnosis. Methods: Among 1385 consecutive sporadic VS surgeries, 18 pediatric patients (1.3%; 11–18 years old) were retrospectively investigated. Results: The most common initial symptom was hearing disturbance (72.2%), and 6 patients (33.3%) experienced a delayed diagnosis (over 2 years after initial symptom onset). Preoperative image characteristics of these tumors included a solid tumor, hypervascularity, and significant extension into the internal acoustic meatus, when compared with adults. Preoperative embolization was successfully accomplished for 2 recent hypervascular tumors. The tumor resection rate was 95–100% under sufficient intraoperative neuromonitoring, and no additional surgery was required during the follow-up period (average: 57.9 months). No patients experienced permanent facial nerve palsy, and serviceable hearing function was preserved in 6 of 11 patients. Signs of NF2, such as bilateral VSs, were not identified in any patients during the follow-up. Conclusion: Safe and sufficient tumor resection was achieved under detailed neuromonitoring in pediatric patients with sporadic VS, although this tends to be difficult owing to hypervascularity, a small cranium, and significant meatal extension. Preoperative embolization may help safe resection of hypervascular tumors. Subsequent development of NF2 has not been observed up to the most recent follow-up, but careful observation is essential for these younger patients.
- Subjects
ACOUSTIC neuroma; NEUROFIBROMATOSIS 2; NEUROFIBROMATOSIS; CHILD patients; SCHWANNOMAS; TUMOR surgery
- Publication
Child's Nervous System, 2022, Vol 38, Issue 8, p1505
- ISSN
0256-7040
- Publication type
Article
- DOI
10.1007/s00381-022-05477-9