{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T21:31:15Z","timestamp":1773696675580,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T00:00:00Z","timestamp":1554422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the current state of the diagnosis and management of vestibular schwannoma (VS) as well as treatment trends, and to evaluate the role of treatment setting and various specialists in treatment plan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients diagnosed with VS completed a voluntary and anonymous survey. The questionnaires were distributed through Acoustic Neuroma Association website, Facebook page, and e\u2010mail newsletters from January to March 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 789 VS patients completed the survey. Of those, 414 (52%) underwent surgery; 224 (28%) underwent radiotherapy; and 121 (15%) were observed. General otolaryngologists diagnosed 62% of responders, followed by primary care (11%) and neurotologists (10%). Patients who underwent surgery were significantly younger and had larger tumors compared to those treated with radiation or observation. The ratio of patients having nonsurgical versus surgical resection changed from 1:2 to 1:1 for the periods of 1979 through 2006 versus 2007 through 2017, respectively. Neurosurgeons (40%) and neurotologists (38%) were the most influential in treatment discussion. Neurotologists (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and general otolaryngologists (<jats:italic>P<\/jats:italic> =\u20090.04) were more influential than neurosurgeons for the decision process in patients with smaller tumors. Patients treated at academic versus nonacademic private institutions reported similar tumor sizes (<jats:italic>P<\/jats:italic> =\u20090.27), treatment decisions (<jats:italic>P<\/jats:italic> =\u20090.09), and decision satisfaction (<jats:italic>P<\/jats:italic> =\u20090.78).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a continuing trend toward nonsurgical management, with approximately half of the patients opting for nonsurgical management. In this cohort, the patients commonly presented with otologic symptoms and otolaryngologists made the most diagnoses. Neurotologists and neurosurgeons were the most influential in treatment discussion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 130:482\u2013486, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27950","type":"journal-article","created":{"date-parts":[[2019,4,6]],"date-time":"2019-04-06T10:58:01Z","timestamp":1554548281000},"page":"482-486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["The changing landscape of vestibular schwannoma diagnosis and management: A cross\u2010sectional study"],"prefix":"10.1002","volume":"130","author":[{"given":"Khodayar","family":"Goshtasbi","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California  Irvine, Irvine, California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Abouzari","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California  Irvine, Irvine, California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5088-2019","authenticated-orcid":false,"given":"Omid","family":"Moshtaghi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California  Irvine, Irvine, California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Sahyouni","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California  Irvine, Irvine, California U.S.A."},{"name":"Department of Biomedical Engineering University of California  Irvine, Irvine, California U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Autefeh","family":"Sajjadi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California  Irvine, Irvine, California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harrison W.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California  Irvine, Irvine, California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamid R.","family":"Djalilian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California  Irvine, Irvine, California U.S.A."},{"name":"Department of Biomedical Engineering University of California  Irvine, Irvine, California U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,5]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"690","article-title":"Incidence of vestibular schwannoma in Denmark, 1977\u20131995","volume":"21","author":"Howitz MF","year":"2000","journal-title":"Otol Neurotol"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1215\/S1522851704001097"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815590105"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.2.216"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.01.037"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.1.JNS121370"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813512106"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200503000-00011"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e31819a8df6"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817695800"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-011-0307-8"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1586\/ern.09.66"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/02688697.2013.815323"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818756852"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004050050012"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100047685"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0385-8146(00)00093-6"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199701000-00001"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-950388"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpor.2016.02.002"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-934112"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200604000-00018"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2011.12.008"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811123392003"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.10.010"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e31821e192f"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27421"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001914"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-018-3739-x"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23229"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.8.FOCUS13295"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199307293290507"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0153206"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002075"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.27950","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27950","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.27950","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27950","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T15:49:21Z","timestamp":1692632961000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.27950"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,5]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1002\/lary.27950"],"URL":"https:\/\/doi.org\/10.1002\/lary.27950","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,5]]},"assertion":[{"value":"2019-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}