Xavier Dubernard1, Thomas Somers, Konstantinos Veros, Christophe Vincent, Valérie Franco-Vidal, Olivier Deguine, Philippe Bordure, Thomas Linder, Emmanuel Lescanne, Denis Ayache, Michel Mondain, Sébastien Schmerber, Myriam Dahmani-Causse, Eric Truy, Vincent Darrouzet. 1. *Department of Otolaryngology, Reims University Hospital, Reims University, Reims, France; †Department of Otolaryngology, St Augustinus Hospital, Wilrijk, Antwerp, Belgium; ‡Department of Otorhinolaryngology-Head and Neck Surgery, ENT Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece; §Department of Otolaryngology, Lille University Hospital, Lille University, Lille; ∥Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, Bordeaux Segalen University, Bordeaux; ¶Department of Otolaryngology and Skull Base Surgery, Toulouse University Hospital, Toulouse University, Toulouse; #Department of Otolaryngology, Nantes University Hospital, Nantes University, Nantes, France; **Department of Otorhinolaryngology-Head and Neck Surgery, Kantonsspital Luzern, Luzern, Switzerland; ††Department of Otolaryngology, Tours University Hospital, Tours University, Tours; Department of Otolaryngology-Head and Neck Surgery, Fondation A. de Rothschild, Paris; §§Department of Otolaryngology, Montpellier University Hospital, Montpellier University, Montpellier; ∥∥Department of Otolaryngology, Grenoble University Hospital, Grenoble University, Grenoble; and ¶¶Department of Otolaryngology, Lyon University Hospital, Lyon University, Lyon, France.
Abstract
OBJECTIVE: To describe the presentation of intralabyrinthine schwannomas (ILSs). STUDY DESIGN AND SETTING: Retrospective multicenter study involving 12 European skull base surgery tertiary referral centers. PATIENTS: One hundred ten patients with the diagnosis of ILS, either labyrinth confined or extending into the internal auditory meatus for less than 50% of their volume. MAIN OUTCOME MEASURES: Data collected were age, sex, nature and timing of presenting symptoms, hearing (according to the AAO-HNS grading system), results of vestibular tests (caloric tests and cervical vestibular-evoked myogenic potentials [c-VEMPs]), and tumor localization. Presenting symptoms and laboratory test results were studied according to the extension of the lesion into the cochlea (C) and vestibule (V), on one hand, and according to unifocal (L1) or plurifocal (L2) extension into the labyrinth, on the other. RESULTS: Intracochlear type was more common (50%) than vestibular (19.1%) and more diffuse forms (30.9%). The mean delay for diagnosis was long (72.5 mo; SD, 76.6). Mean age was 53.9 years (SD, 13.2). Deafness was the most common symptom (77.8 dB HL [SD, 33.6], with only 24.6% of patients keeping viable hearing. Caloric tests (65.5% of patients) were abnormal in 77.8% of cases. c-VEMPs were abnormal in 65.7% of the 36 cases analyzed. In V forms, hearing was significantly better (class A + B in 21.1% in C and 45.8% in V forms) (p = 0.03), and vestibular function was more altered (C: 57%, V: 100%, p = 0.0009*). L2 forms were diagnosed later (L1: 59.1 mo, L2: 104.5 mo; p = 0.004*) and were associated more frequently with a dead ear (L1: 13.1%, L2: 41.2%, p = 0.002*) than L1 forms. CONCLUSIONS: This series, which is the largest in the literature, demonstrates that even very small and localized ILSs heavily compromise labyrinthine functions.
OBJECTIVE: To describe the presentation of intralabyrinthine schwannomas (ILSs). STUDY DESIGN AND SETTING: Retrospective multicenter study involving 12 European skull base surgery tertiary referral centers. PATIENTS: One hundred ten patients with the diagnosis of ILS, either labyrinth confined or extending into the internal auditory meatus for less than 50% of their volume. MAIN OUTCOME MEASURES: Data collected were age, sex, nature and timing of presenting symptoms, hearing (according to the AAO-HNS grading system), results of vestibular tests (caloric tests and cervical vestibular-evoked myogenic potentials [c-VEMPs]), and tumor localization. Presenting symptoms and laboratory test results were studied according to the extension of the lesion into the cochlea (C) and vestibule (V), on one hand, and according to unifocal (L1) or plurifocal (L2) extension into the labyrinth, on the other. RESULTS: Intracochlear type was more common (50%) than vestibular (19.1%) and more diffuse forms (30.9%). The mean delay for diagnosis was long (72.5 mo; SD, 76.6). Mean age was 53.9 years (SD, 13.2). Deafness was the most common symptom (77.8 dB HL [SD, 33.6], with only 24.6% of patients keeping viable hearing. Caloric tests (65.5% of patients) were abnormal in 77.8% of cases. c-VEMPs were abnormal in 65.7% of the 36 cases analyzed. In V forms, hearing was significantly better (class A + B in 21.1% in C and 45.8% in V forms) (p = 0.03), and vestibular function was more altered (C: 57%, V: 100%, p = 0.0009*). L2 forms were diagnosed later (L1: 59.1 mo, L2: 104.5 mo; p = 0.004*) and were associated more frequently with a dead ear (L1: 13.1%, L2: 41.2%, p = 0.002*) than L1 forms. CONCLUSIONS: This series, which is the largest in the literature, demonstrates that even very small and localized ILSs heavily compromise labyrinthine functions.
Authors: S K Plontke; T Rahne; M Pfister; G Götze; C Heider; N Pazaitis; C Strauss; P Caye-Thomasen; S Kösling Journal: HNO Date: 2017-05 Impact factor: 1.284
Authors: S K Plontke; T Rahne; M Pfister; G Götze; C Heider; N Pazaitis; C Strauss; P Caye-Thomasen; S Kösling Journal: HNO Date: 2017-08 Impact factor: 1.284