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Neurology (Expert Forum)
Re: Acoustic Neuroma
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Re: Acoustic Neuroma
by cf-neuro-MD, Jan 01, 1995 12:00AM
Posted By ccf neuro M.D. on May 25, 1997 at 19:52:57:
In Reply to: Acoustic Neuroma posted by John on May 13, 1997 at 23:25:35:
:
I have recently been dx'd with a 1.5cm AN - right side; sx: slight hearing loss and slight tinnitus. I have gotten much info from
net sources, but I was told the tumor grows 1cm per year - by an ear surgeon; and 1mm per year by a non-medical, but
well-educated (regarding ANs) source. What is the current thought on AN growth rate? What is the best way to find out how
fast mine is (or is not) growing?
Acoustic neuromas are usually benign tumors arising from the Schwann cells or insulating cells surrounding the vestibular (balance) portion of the eight cranial nerve. In reviewing the recent medcial literature for information specifically on growth rate. The one study I found that was willing to quote a specific number, a Danish article, stated that in their series an annual growth rate ranging from 0 to 4.8 millimeters per year, with an average growth rate of 1.1 millimeters per year. All of the articles more or less consistently state that the shorter a period of time during which a person has symptoms and the younger a person is, and the larger the tumor is at the time of diagnosis, the faster the likely growth rate and the more inclined one should be to treat rather than observe the tumor. The best way to observe the growth rate of any one tumor in any one person is to obtain serial MRI scans; every 6 months to one year is reasonable depending on the duration of initial symptoms. There is no way to
guarantee that the growth rate observed during any given period of time will be sustained in the next period of time, nor is there any way to accurately "predict" the growth rate in any given patient. The longer you wait to receive definitive treatment, obviously the greater the risk of the tumor expanding and compressing additional nearby nerves and brain structures and the greater the risk of deafness, although excision of the tumor obviously usually results in deafness of the affected ear and often results in facial weakness, depending on the size of the tumor, how adherent it is to nearby structures, and the experience level of the operating neurosurgeon (I would not recommend having one of these operated on by a neurosurgeon who does not frequently operate on these types of tumors). There are other treatment options, including so-called radiosurgery, with a gamma knife for instance. Such "knifeless surgery" has about an 80% plus rate of arresting tumor growth, but like conventional surgery, usually
in severe hearing loss or deafness of the affected ear, although this is typically delayed. All the reprts I encountered in the literature regarding this option had followup periods averaging less than two years, thus, very little data is available on the LONG TERM risks of this option, despite overall promising short term results. The neurosurgical group with the most experience in managing these tumors is at the Baptist Hospital in Memphis, Tennessee, although many other skilled neurosurgeons exist that could render an appropriate opinion and discuss in more detail the treatment options with their respective risks and benefits in your particular case. Again, the experiance level of the surgeon is a critical factor. I hope you find this information useful, although nowhere will you find a simple, magic answer to your main question--- only God knows how fast your particular tumor will grow!!!
In Reply to: Acoustic Neuroma posted by John on May 13, 1997 at 23:25:35:
:
I have recently been dx'd with a 1.5cm AN - right side; sx: slight hearing loss and slight tinnitus. I have gotten much info from
net sources, but I was told the tumor grows 1cm per year - by an ear surgeon; and 1mm per year by a non-medical, but
well-educated (regarding ANs) source. What is the current thought on AN growth rate? What is the best way to find out how
fast mine is (or is not) growing?
Acoustic neuromas are usually benign tumors arising from the Schwann cells or insulating cells surrounding the vestibular (balance) portion of the eight cranial nerve. In reviewing the recent medcial literature for information specifically on growth rate. The one study I found that was willing to quote a specific number, a Danish article, stated that in their series an annual growth rate ranging from 0 to 4.8 millimeters per year, with an average growth rate of 1.1 millimeters per year. All of the articles more or less consistently state that the shorter a period of time during which a person has symptoms and the younger a person is, and the larger the tumor is at the time of diagnosis, the faster the likely growth rate and the more inclined one should be to treat rather than observe the tumor. The best way to observe the growth rate of any one tumor in any one person is to obtain serial MRI scans; every 6 months to one year is reasonable depending on the duration of initial symptoms. There is no way to
guarantee that the growth rate observed during any given period of time will be sustained in the next period of time, nor is there any way to accurately "predict" the growth rate in any given patient. The longer you wait to receive definitive treatment, obviously the greater the risk of the tumor expanding and compressing additional nearby nerves and brain structures and the greater the risk of deafness, although excision of the tumor obviously usually results in deafness of the affected ear and often results in facial weakness, depending on the size of the tumor, how adherent it is to nearby structures, and the experience level of the operating neurosurgeon (I would not recommend having one of these operated on by a neurosurgeon who does not frequently operate on these types of tumors). There are other treatment options, including so-called radiosurgery, with a gamma knife for instance. Such "knifeless surgery" has about an 80% plus rate of arresting tumor growth, but like conventional surgery, usually
in severe hearing loss or deafness of the affected ear, although this is typically delayed. All the reprts I encountered in the literature regarding this option had followup periods averaging less than two years, thus, very little data is available on the LONG TERM risks of this option, despite overall promising short term results. The neurosurgical group with the most experience in managing these tumors is at the Baptist Hospital in Memphis, Tennessee, although many other skilled neurosurgeons exist that could render an appropriate opinion and discuss in more detail the treatment options with their respective risks and benefits in your particular case. Again, the experiance level of the surgeon is a critical factor. I hope you find this information useful, although nowhere will you find a simple, magic answer to your main question--- only God knows how fast your particular tumor will grow!!!
