NONSURGICAL TREATMENT OF VESTIBULAR SCHWANNOMA PATIENTS

The aim of the study was to evaluate the course of vestibular schwanno ma (VS) when surgery was not attempted. The tumor may be slowly growin g and surgery a risk for a patient. Twenty-eight patients out of 390 V S patients during years 1981-1995 were primarily recommended a non-sur gical treatment. Another 3 patients refused the operation. Altogether 23 women and 8 men were evaluated. Their age varied from 30.6 to 74.6 years (median 56.7 years). Tumor size varied from 5 to 30 mm (median 1 5.0 mm) at the beginning of the follow-up. Patients symptoms, conditio n and other illnesses were recorded. Seven patients had neurofibromato sis 2 (3 of them had one hearing ear), 2 had severe mental problems, 5 patients had their only hearing ear and II patients were not recommen ded an operation because of their age and other illnesses. Patients we re controlled with MRI at intervals from 1 to 3 years. The follow-up t ime varied from 1 to 20 years (median 2.0 years). The average tumor gr owth rate,among unilateral VS patients was 0.035 cm/year and among bil ateral tumors the average tumor growth rate was 0.015 cm/year. Two pat ients were later operated on, one 2 years after diagnosis because of t he tumor growth and the other one 4 years after diagnosis-she had refu sed an operation earlier. Two patients could not be reached. Another p atient had tumor growth but because of his illnesses he got a radiatio n beam instead of an operation. The majority of the patients could liv e fairly normal lives and required no treatment. Surgery is not the on ly alternative to VS patients. Wait-and-see policy is also a good alte rnative to those who have high operation risk or who refuse an operati on.