DOI: https://doi.org/10.25305/unj.189530

Epidemiology of the vestibular schwannomas in Ukraine and our experience of surgical and radiosurgical treatment

Volodymyr O. Fedirko, Olga Y. Chuvashova , Oleksandr M. Lisianyi , Andriy B. Gryazov , Viktor V. Gudkov , Petro M. Onishchenko , Andrii G. Naboichenko , Oksana Y. Skobska , Oksana V. Zemskova , Anna N. Nikiforova , Oleksandra Y. Malysheva , Oleg M. Borisenko , Anastasiya E. Pedachenko, Yaroslav V. Kmetyuk , Olga  S. Silaieva, Neonilla Y. Tsibriy, Ruslan R. Novikov , Vladyslav M. Buryk 

Abstract


Aim: Figuring out the occurrence of vestibular schwannomas (VS) and their management tendencies in Ukraine.

Materials and methods: Data about VS detection and treatment were collected among all Ukrainian neurosurgical and radiological facilities which are enrolled in providing care for these patients. Together with those who were treated overseas the total number in 2016-2018 was 903 people. There were 665 cases (73.6  %) treated surgically, 124 cases (13.8  %) irradiated and 114 (12.6  %) observed via serial imaging.

Results: The prevalence of VS in Ukraine is about 7.27 per 1 million people which corresponds to data around the world (CBTRUS trial suggested VS incidence 10-20 people per 1 million during 2004-2009).

Most of verified VSs were treated surgically (73.6  %), lesser part was irradiated (13.8  %) and 12.7 % were followed-up by wait-and-scan strategy. Our data regarding surgical management was higher than worldwide. At the same time, the volume of detected tumors was much larger in comparison to published data. Seventy-three per cent of all cases were Koos T4 tumors as a possible result of poor diagnosis and lack of alertness making surgical interventions more common and difficult.

Total and subtotal resection rate was 79  % as the result of combined microsurgical and endoscopic techniques under intraoperative electrophysiological neuromonitoring guidance. The facial nerve was preserved in 94.2  % of cases, cochlear — in 8.5  % of cases. The average mortality rate during 2016-2018 in Ukraine was 3.1  % with 1.3  % in Subtentorial Neurooncology Department of the Romodanov Neurosurgery Institute.

Conclusions: For further improvements and development of optimal management strategies for patients with VS, it is necessary to improve earlier diagnosis and reasonable to provide neurosurgical care in high-volume centers based on the profound expertise with further advances in technologies for functionally favorable outcomes.


Keywords


vestibular schwannomas; epidemiology; prevalence; surgical treatment; radiosurgical treatment

References


1. Foley RW, Shirazi S, Maweni RM, Walsh K, McConn Walsh R, Javadpour M, Rawluk D. Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis. Cureus. 2017 Nov 15;9 (11):e1846. [CrossRef] [PubMed] [PubMed Central]

2. 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 Jul;119 (1):121-30. [CrossRef] [PubMed]

3. Stangerup SE, Tos M, Thomsen J, Caye-Thomasen P. True incidence of vestibular schwannoma? Neurosurgery. 2010 Nov;67 (5):1335-40; discussion 1340. [CrossRef] [PubMed]

4. Stangerup SE, Tos M, Caye-Thomasen P, Tos T, Klokker M, Thomsen J. Increasing annual incidence of vestibular schwannoma and age at diagnosis. J Laryngol Otol. 2004 Aug;118 (8):622-7. [CrossRef] [PubMed]

5. Stangerup SE, Caye-Thomasen P, Tos M, Thomsen J. The natural history of vestibular schwannoma. Otol Neurotol. 2006 Jun;27 (4):547-52. [CrossRef] [PubMed]

6. 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 Feb;130 (2):216-20. [CrossRef] [PubMed]

7. Propp JM, McCarthy BJ, Davis FG, Preston-Martin S. Descriptive epidemiology of vestibular schwannomas. Neuro Oncol. 2006 Jan;8 (1):1-11. [CrossRef] [PubMed] [PubMed Central]

8. Koo M, Lai JT, Yang EY, Liu TC, Hwang JH. Incidence of Vestibular Schwannoma in Taiwan from 2001 to 2012: A Population-Based National Health Insurance Study. Ann Otol Rhinol Laryngol. 2018 Oct;127 (10):694-697. [CrossRef] [PubMed]

9. Reznitsky M, Petersen MMBS, West N, Stangerup SE, Cayé-Thomasen P. Epidemiology Of Vestibular Schwannomas - Prospective 40-Year Data From An Unselected National Cohort. Clin Epidemiol. 2019 Nov 8;11:981-986. [CrossRef] [PubMed] [PubMed Central]

10. Wiegand DA, Fickel V. Acoustic neuroma--the patient’s perspective: subjective assessment of symptoms, diagnosis, therapy, and outcome in 541 patients. Laryngoscope. 1989 Feb;99 (2):179-87. [CrossRef] [PubMed]

11. Moffat DA, Baguley DM, Beynon GJ, Da Cruz M. Clinical acumen and vestibular schwannoma. Am J Otol. 1998 Jan;19 (1):82-7. [PubMed]

12. DeLong M, Kirkpatrick J, Cummings T, Adamson DC. Vestibular Schwannomas: Lessons for the Neurosurgeon. Part II. Molecular Biology and Histology. Contemporary Neurosurgery. 2011 Oct 31;33 (21):1-3. [CrossRef]

13. Talfer S, Dutertre G, Conessa C, Desgeorges M, Poncet JL. Surgical treatment of large vestibular schwannomas (stages III and IV). Eur Ann Otorhinolaryngol Head Neck Dis. 2010 May;127 (2):63-9. [CrossRef] [PubMed]

14. Pinna MH, Bento RF, Neto RV. Vestibular schwannoma: 825 cases from a 25-year experience. Int Arch Otorhinolaryngol. 2012 Oct;16 (4):466-75. [CrossRef] [PubMed] [PubMed Central]

15. Huang X, Xu J, Xu M, Chen M, Ji K, Ren J, Zhong P. Functional outcome and complications after the microsurgical removal of giant vestibular schwannomas via the retrosigmoid approach: a retrospective review of 16-year experience in a single hospital. BMC Neurol. 2017 Jan 31;17 (1):18. [CrossRef] [PubMed] [PubMed Central]

16. Ward BK, Gourin CG, Francis HW. Vestibular schwannoma surgical volume and short-term outcomes in Maryland. Arch Otolaryngol Head Neck Surg. 2012 Jun;138 (6):577-83. [CrossRef] [PubMed]

17. Zhang Z, Nguyen Y, De Seta D, Russo FY, Rey A, Kalamarides M, Sterkers O, Bernardeschi D. Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients. Trattamento chirurgico degli schwannomi vestibolari: risultati su una serie di 1006 pazienti. Acta Otorhinolaryngol Ital. 2016 Oct;36 (5):408-414. [CrossRef] [PubMed] [PubMed Central]

18. Sekelj A, Đanić D. Acoustic Reflex and House-Brackmann Rating Scale as Prognostic Indicators of Peripheral Facial Palsy in Neuroborreliosis. Acta Clin Croat. 2017 Sep;56 (3):425-436. [CrossRef] [PubMed]

19. Sweeney AD, Carlson ML, Ehtesham M, Thompson RC, Haynes DS. Surgical approaches for vestibular schwannoma. Current Otorhinolaryngology Reports. 2014 Dec 1;2 (4):256-64. [CrossRef]

20. Zou J, Hirvonen T. “Wait and scan” management of patients with vestibular schwannoma and the relevance of non-contrast MRI in the follow-up. J Otol. 2017 Dec;12 (4):174-184. [CrossRef] [PubMed] [PubMed Central]

21. Miller LE, Brant JA, Chen J, Kaufman AC, Ruckenstein MJ. Hearing and Quality of Life Over Time in Vestibular Schwannoma Patients: Observation Compared to Stereotactic Radiosurgery. Otol Neurotol. 2019 Sep;40 (8):1094-1100. [CrossRef] [PubMed]

22. Zanoletti E, Mazzoni A, d’Avella D. Hearing preservation in small acoustic neuroma: observation or active therapy? Literature review and institutional experience. Acta Neurochir (Wien). 2019 Jan;161 (1):79-83. [CrossRef] [PubMed]

23. Huang CW, Tu HT, Chuang CY, Chang CS, Chou HH, Lee MT, Huang CF. Gamma Knife radiosurgery for large vestibular schwannomas greater than 3 cm in diameter. J Neurosurg. 2018 May;128 (5):1380-1387. [CrossRef] [PubMed]

24. Shaffer BT, Cohen MS, Bigelow DC, Ruckenstein MJ. Validation of a disease-specific quality-of-life instrument for acoustic neuroma: the Penn Acoustic Neuroma Quality-of-Life Scale. Laryngoscope. 2010 Aug;120 (8):1646-54. [CrossRef] [PubMed]


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Copyright (c) 2020 Volodymyr O. Fedirko, Olga Y. Chuvashova , Oleksandr M. Lisianyi , Andriy B. Gryazov , Viktor V. Gudkov , Petro M. Onishchenko , Andrii G. Naboichenko , Oksana Y. Skobska , Oksana V. Zemskova , Anna N. Nikiforova , Oleksandra Y. Malysheva , Oleg M. Borise

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