{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:14:47Z","timestamp":1790720087128,"version":"4.1.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>\n            Objective\u2003This study was aimed to determine the role of clinical presentation and tumor characteristics in vestibular schwannoma (VS) at diagnosis, initially treated with conservative management.<\/jats:p><jats:p>\n            Design\u2003The study was designed as a retrospective chart review.<\/jats:p><jats:p>\n            Setting\u2003The study was prepared at national tertiary referral center for VS patients.<\/jats:p><jats:p>\n            Participants\u2003A total of 836 VS patients, initially treated conservatively, were included.<\/jats:p><jats:p>\n            Main Outcome Measures\u2003Patient characteristics: age at diagnosis, gender, frequency, and duration of, hearing loss, tinnitus, balance disorder (unsteadiness, dizziness, and vertigo), respectively; and tumor characteristics: laterality, growth, cystic component, and location were analyzed in relation to tumor size at diagnosis and change in treatment strategy.<\/jats:p><jats:p>\n            Results\u2003In total, 169 (20%) patients had a change in treatment strategy. Factors at diagnosis that had a high influence on intervention were a short duration of hearing loss (hazard ratio [HR]: 4.8, p\u2009&lt;\u20090.001) and cystic tumors (HR\u2009=\u20092.6, p\u2009&lt;\u20090.001). Balance disorders and extracanalicular (EC) tumor location have a medium influence on intervention (HR\u2009=\u20091.6, p\u2009&lt;\u20090.01). Tumour growth was seen in 55% of the intervention group; we found a significant correlation with a short duration of hearing loss. Cystic VS was significantly higher between the medium and large tumors, 24.3% and 38.1%. (p\u2009=\u20090.001), respectively.<\/jats:p><jats:p>\n            Conclusions\u2003Patients with a short duration of hearing loss, balance disorders, EC located tumors, and cystic tumors have a significantly higher chance of a change in treatment strategy. Large tumor size at diagnosis and a cystic component were related to age\u2009&gt;\u200965 years at diagnosis.<\/jats:p>","DOI":"10.1055\/s-0039-1678708","type":"journal-article","created":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T18:47:19Z","timestamp":1549306039000},"page":"015-021","source":"Crossref","is-referenced-by-count":18,"title":["Clinical Predictors Leading to Change of Initial Conservative Treatment of 836 Vestibular Schwannomas"],"prefix":"10.1055","volume":"81","author":[{"given":"Maarten","family":"Kleijwegt","sequence":"additional","affiliation":[{"name":"Department of ENT, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floris","family":"Bettink","sequence":"additional","affiliation":[{"name":"Department of ENT, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Malessy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hein","family":"Putter","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andel","family":"van der Mey","sequence":"additional","affiliation":[{"name":"Department of ENT, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2019,2,4]]},"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1678708.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T18:31:02Z","timestamp":1580754662000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1678708"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,4]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2020,2,3]]},"published-print":{"date-parts":[[2020,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1678708","relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,4]]}}}