Acoustic neuroma: An investigation of associations between tumor size and diagnostic delays, facial weakness, and surgical complications

• Published in: Ear, nose, & throat journal Vol. 93; no. 8; pp. 304 - 316
• Main Authors: Olshan, Marc, Srinivasan, Visish M, Landrum, Tre, Sataloff, Robert T
• Format: Journal Article
• Language: English
• Published: United States Sage Publications, Inc 01.08.2014; SAGE PUBLICATIONS, INC
• Subjects: Acoustic neuroma; Adolescent; Adult; Aged; Aged, 80 and over; Care and treatment; Cerebrospinal Fluid Leak - etiology; Delayed Diagnosis; Diagnosis; Facial Muscles - physiopathology; Female; Growth rate; Hearing loss; Humans; Infection - etiology; Male; Medical imaging; Middle Aged; Muscle Weakness - etiology; Neuroma, Acoustic - complications; Neuroma, Acoustic - pathology; Neuroma, Acoustic - surgery; Neurosurgical Procedures - adverse effects; NMR; Nuclear magnetic resonance; Patient outcomes; Patients; Retrospective Studies; Socioeconomic factors; Surgery; Surgical outcomes; Time Factors; Time-to-Treatment; Tumor Burden; Tumors; Young Adult
• ISSN: 0145-5613; 1942-7522
• DOI: 10.1177/014556131409300808

We conducted a retrospective case review to ascertain the clinical characteristics associated with acoustic neuromas and their treatment. Our study population was made up of 96 patients-41 men and 55 women, aged 17 to 84 years (mean: 54)-who had undergone treatment for acoustic neuromas and for whom necessary data were available. We compiled data on presenting symptoms, the interval from symptom onset to diagnosis, tumor size at diagnosis, facial weakness, the interval from diagnosis to surgery, the type of surgical approach, and surgical complications. Our primary goals were to determine if tumor size was correlated to (1) the interval from symptom onset to diagnosis, (2) the degree of preoperative facial weakness, and (3) surgical complications. We also sought to document various other clinical characteristics of these cases. The mean interval from the first symptom to diagnosis was 4.5 years; the time to diagnosis did not correlate with tumor size. Nor was tumor size correlated with the degree of preoperative facial weakness as determined by facial electroneurography. Surgical complications occurred in 15 of the 67 patients who underwent surgery (22.4%), and they did correlate with tumor size. The most common complications were postoperative facial weakness (13.4% of operated patients), cerebrospinal fluid leak (6.0%), and infection (3.0%). Since tumors typically grow about 2 mm per year and since larger tumors are associated with more severe symptoms and surgical complications, we expected that the time to diagnosis would correlate with tumor size, but we found no significant association.