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Sporadic vestibular schwannoma in a pediatric population: a case series

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Abstract

Purpose

To describe the characteristics, management, and outcomes of pediatric patients with sporadic vestibular schwannoma (sVS).

Methods

This was a case series at a tertiary care center. Patients were identified through a research repository and chart review. Interventions were microsurgery, stereotactic radiosurgery (SRS), and observation. Outcome measures were tumor control, facial nerve function, and hearing.

Results

Eight patients over 2006–2022 fulfilled inclusion criteria (unilateral VS without genetic or clinical evidence of neurofibromatosis type 2 (NF2); age ≤ 21) with a mean age of 17 years (14–20). Average greatest tumor length in the internal auditory canal was 9.7 mm (4.0–16.1). Average greatest tumor dimension (4/8 tumors) in the cerebellopontine angle was 19.1 mm (11.3–26.8). Primary treatment was microsurgery in five (62.5%) patients, observation in two (25%), and SRS in one (12.5%). Four (80%) surgical patients had gross total resections, and one (20%) had regrowth post-near total resection and underwent SRS. One observed patient and the primary SRS patient have remained radiographically stable for 3.5 and 7 years, respectively. The other observed patient required surgery for tumor growth after 12 months of observation. Two surgical patients had poor facial nerve outcomes. All post-procedural patients developed anacusis. Mean follow-up was 3 years (0.5–7).

Conclusions

We describe one of the largest reported cohorts of pediatric sVS in the USA. Diligent exclusion of NF2 is critical. Given the high likelihood of eventually requiring intervention and known adverse effects of SRS, microsurgery remains the preferred treatment. However, observation can be considered in select situations.

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Authors and Affiliations

  1. Division of Otology/Neurotology, Department of Otolaryngology — Head & Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Palo Alto, Stanford, CA, 94305-5739, USA

    Nikitha Kosaraju, Lindsay S. Moore, Jip Y. Mulders & Nikolas H. Blevins

  2. David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Nikitha Kosaraju

  3. Leiden University Medical Center, Leiden, The Netherlands

    Jip Y. Mulders

Authors
  1. Nikitha Kosaraju
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  2. Lindsay S. Moore
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  3. Jip Y. Mulders
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Contributions

NK, LSM, and NHB conceived the study. NK and LSM designed the study. NK, LSM, and JYM collected data. NK wrote the manuscript. NHB supervised all aspects of the work. All authors critically edited the manuscript and approved the submitted version.

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Correspondence to Nikolas H. Blevins.

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Kosaraju, N., Moore, L.S., Mulders, J.Y. et al. Sporadic vestibular schwannoma in a pediatric population: a case series. Childs Nerv Syst 40, 635–645 (2024). https://doi.org/10.1007/s00381-023-06184-9

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