Comparison of clinical characteristics and surgical outcomes of cystic and solid vestibular schwannomas

Ji Hyuk Han, Kwang Ha Baek, Young Woo Lee, Young Kyun Hur, Hyun Ji Kim, In Seok Moon

Research output: Contribution to journalArticle

Abstract

Objective: The aim of this study was to compare the clinical characteristics of cystic vestibular schwannomas (CVSs) and solid vestibular schwannomas (SVSs). Study Design: Retrospective review. Setting: Tertiary care center. Patients: A total of 220 patients who underwent microsurgery for vestibular schwannomas between 2007 and 2016. Intervention: CVSs were defined as cystic components ≥1/3 of total tumor volume based on automated volume measurement. Tumors larger than 5 cm 3 were defined as large tumors. Main Outcome Measures: Clinical characteristics and surgical outcomes, including preoperative symptoms, hearing threshold, vestibular function, tumor volume, extent of resection, facial nerve outcomes, and nonfacial complications were evaluated. Results: Tumor volume was significantly larger in CVSs (20.44 ± 13.85 cm 3 in CVSs; 4.75 ± 6.48 cm 3 in SVSs, p < 0.001) and the proportion of larger tumors was also greater in CVSs (66.0% in CVSs; 11.4% in SVSs, p < 0.001). Preoperative dizziness was highly prevalent in CVSs (32.1% in CVSs; 18.6% in SVSs, p = 0.038) and postoperative facial nerve outcomes were significantly worse in CVSs (67.9% favorable rate in CVSs; 87.4% favorable rate in SVSs, p = 0.001). When the comparison was limited to large tumors, no clinical characteristics or surgical outcomes were significantly different. Tumor volume had a greater effect than tumor type on the surgical outcomes. The odds ratios for subtotal resection and unfavorable facial nerve function with a large tumor were 5.77 (confidence interval [CI]: 1.52-21.95, p = 0.010) and 5.34 (CI: 1.41-20.22, p = 0.014), respectively. Conclusion: CVSs tend to be larger than SVSs. Tumor volume, not cystic component, is thought to be a major determinant of surgical outcomes.

Original languageEnglish
Pages (from-to)e381-e386
JournalOtology and Neurotology
Volume39
Issue number5
DOIs
Publication statusPublished - 2018 Jun 1

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Acoustic Neuroma
Tumor Burden
Facial Nerve
Neoplasms
Confidence Intervals
Microsurgery
Dizziness

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Han, Ji Hyuk ; Baek, Kwang Ha ; Lee, Young Woo ; Hur, Young Kyun ; Kim, Hyun Ji ; Moon, In Seok. / Comparison of clinical characteristics and surgical outcomes of cystic and solid vestibular schwannomas. In: Otology and Neurotology. 2018 ; Vol. 39, No. 5. pp. e381-e386.
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title = "Comparison of clinical characteristics and surgical outcomes of cystic and solid vestibular schwannomas",
abstract = "Objective: The aim of this study was to compare the clinical characteristics of cystic vestibular schwannomas (CVSs) and solid vestibular schwannomas (SVSs). Study Design: Retrospective review. Setting: Tertiary care center. Patients: A total of 220 patients who underwent microsurgery for vestibular schwannomas between 2007 and 2016. Intervention: CVSs were defined as cystic components ≥1/3 of total tumor volume based on automated volume measurement. Tumors larger than 5 cm 3 were defined as large tumors. Main Outcome Measures: Clinical characteristics and surgical outcomes, including preoperative symptoms, hearing threshold, vestibular function, tumor volume, extent of resection, facial nerve outcomes, and nonfacial complications were evaluated. Results: Tumor volume was significantly larger in CVSs (20.44 ± 13.85 cm 3 in CVSs; 4.75 ± 6.48 cm 3 in SVSs, p < 0.001) and the proportion of larger tumors was also greater in CVSs (66.0{\%} in CVSs; 11.4{\%} in SVSs, p < 0.001). Preoperative dizziness was highly prevalent in CVSs (32.1{\%} in CVSs; 18.6{\%} in SVSs, p = 0.038) and postoperative facial nerve outcomes were significantly worse in CVSs (67.9{\%} favorable rate in CVSs; 87.4{\%} favorable rate in SVSs, p = 0.001). When the comparison was limited to large tumors, no clinical characteristics or surgical outcomes were significantly different. Tumor volume had a greater effect than tumor type on the surgical outcomes. The odds ratios for subtotal resection and unfavorable facial nerve function with a large tumor were 5.77 (confidence interval [CI]: 1.52-21.95, p = 0.010) and 5.34 (CI: 1.41-20.22, p = 0.014), respectively. Conclusion: CVSs tend to be larger than SVSs. Tumor volume, not cystic component, is thought to be a major determinant of surgical outcomes.",
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Comparison of clinical characteristics and surgical outcomes of cystic and solid vestibular schwannomas. / Han, Ji Hyuk; Baek, Kwang Ha; Lee, Young Woo; Hur, Young Kyun; Kim, Hyun Ji; Moon, In Seok.

In: Otology and Neurotology, Vol. 39, No. 5, 01.06.2018, p. e381-e386.

Research output: Contribution to journalArticle

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T1 - Comparison of clinical characteristics and surgical outcomes of cystic and solid vestibular schwannomas

AU - Han, Ji Hyuk

AU - Baek, Kwang Ha

AU - Lee, Young Woo

AU - Hur, Young Kyun

AU - Kim, Hyun Ji

AU - Moon, In Seok

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N2 - Objective: The aim of this study was to compare the clinical characteristics of cystic vestibular schwannomas (CVSs) and solid vestibular schwannomas (SVSs). Study Design: Retrospective review. Setting: Tertiary care center. Patients: A total of 220 patients who underwent microsurgery for vestibular schwannomas between 2007 and 2016. Intervention: CVSs were defined as cystic components ≥1/3 of total tumor volume based on automated volume measurement. Tumors larger than 5 cm 3 were defined as large tumors. Main Outcome Measures: Clinical characteristics and surgical outcomes, including preoperative symptoms, hearing threshold, vestibular function, tumor volume, extent of resection, facial nerve outcomes, and nonfacial complications were evaluated. Results: Tumor volume was significantly larger in CVSs (20.44 ± 13.85 cm 3 in CVSs; 4.75 ± 6.48 cm 3 in SVSs, p < 0.001) and the proportion of larger tumors was also greater in CVSs (66.0% in CVSs; 11.4% in SVSs, p < 0.001). Preoperative dizziness was highly prevalent in CVSs (32.1% in CVSs; 18.6% in SVSs, p = 0.038) and postoperative facial nerve outcomes were significantly worse in CVSs (67.9% favorable rate in CVSs; 87.4% favorable rate in SVSs, p = 0.001). When the comparison was limited to large tumors, no clinical characteristics or surgical outcomes were significantly different. Tumor volume had a greater effect than tumor type on the surgical outcomes. The odds ratios for subtotal resection and unfavorable facial nerve function with a large tumor were 5.77 (confidence interval [CI]: 1.52-21.95, p = 0.010) and 5.34 (CI: 1.41-20.22, p = 0.014), respectively. Conclusion: CVSs tend to be larger than SVSs. Tumor volume, not cystic component, is thought to be a major determinant of surgical outcomes.

AB - Objective: The aim of this study was to compare the clinical characteristics of cystic vestibular schwannomas (CVSs) and solid vestibular schwannomas (SVSs). Study Design: Retrospective review. Setting: Tertiary care center. Patients: A total of 220 patients who underwent microsurgery for vestibular schwannomas between 2007 and 2016. Intervention: CVSs were defined as cystic components ≥1/3 of total tumor volume based on automated volume measurement. Tumors larger than 5 cm 3 were defined as large tumors. Main Outcome Measures: Clinical characteristics and surgical outcomes, including preoperative symptoms, hearing threshold, vestibular function, tumor volume, extent of resection, facial nerve outcomes, and nonfacial complications were evaluated. Results: Tumor volume was significantly larger in CVSs (20.44 ± 13.85 cm 3 in CVSs; 4.75 ± 6.48 cm 3 in SVSs, p < 0.001) and the proportion of larger tumors was also greater in CVSs (66.0% in CVSs; 11.4% in SVSs, p < 0.001). Preoperative dizziness was highly prevalent in CVSs (32.1% in CVSs; 18.6% in SVSs, p = 0.038) and postoperative facial nerve outcomes were significantly worse in CVSs (67.9% favorable rate in CVSs; 87.4% favorable rate in SVSs, p = 0.001). When the comparison was limited to large tumors, no clinical characteristics or surgical outcomes were significantly different. Tumor volume had a greater effect than tumor type on the surgical outcomes. The odds ratios for subtotal resection and unfavorable facial nerve function with a large tumor were 5.77 (confidence interval [CI]: 1.52-21.95, p = 0.010) and 5.34 (CI: 1.41-20.22, p = 0.014), respectively. Conclusion: CVSs tend to be larger than SVSs. Tumor volume, not cystic component, is thought to be a major determinant of surgical outcomes.

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