{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:09:06Z","timestamp":1791374946026,"version":"4.3.1"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T00:00:00Z","timestamp":1524528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>(1) Assess 3\u2010dimensional volumetric growth of untreated sporadic vestibular schwannomas (VSs) in a large cohort of patients treated with conservative observation. (2) Compare volumetric and conventional linear diameter measurements for detecting tumor growth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary skull base referral center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Patients with sporadic VS who elected initial conservative treatment with at least 2 serial magnetic resonance imaging (MRI) scans were included. Tumor volume was determined with 3\u2010dimensional segmentation of MRI sequences. The volumetric threshold for tumor growth was an increase \u226520% from baseline tumor volume. Tumor size based on linear diameter was assessed with the 1995 American Academy of Otolaryngology\u2014Head and Neck Surgery Foundation guidelines for VS outcome reporting, with growth defined as an increase \u22652\u00a0mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 361 patients were included with a median radiologic follow\u2010up of 4.1 years (interquartile range [IQR], 2.5\u20106.8). At diagnosis, 232 VSs (64%) were purely intracanalicular, and 129 (36%) extended into the cerebellopontine angle. The median baseline tumor volume was 0.161\u00a0cm<jats:sup>3<\/jats:sup> (IQR, 0.054\u20100.418). Overall, 69% of tumors demonstrated volumetric growth at a median of 1.1 years (IQR, 0.6\u20102.1) after initial MRI. In contrast, based on linear measurement assessment, 48% of tumors demonstrated growth at a median of 1.8 years (IQR, 0.8\u20103.1) from first MRI scan. Disequilibrium, facial hypoesthesia, aural fullness, initial tumor size, and nonincidental diagnosis were associated with tumor growth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Three\u2010dimensional volumetric assessment of VS provides a more sensitive measure of tumor growth when compared with linear diameter assessment. Through volumetric analysis, the current study revealed that a significant proportion of VSs demonstrate growth during observation.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599818770413","type":"journal-article","created":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T04:02:46Z","timestamp":1524542566000},"page":"535-542","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":129,"title":["Natural History of Sporadic Vestibular Schwannoma: A Volumetric Study of Tumor Growth"],"prefix":"10.1002","volume":"159","author":[{"given":"Katherine A.","family":"Lees","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M.","family":"Tombers","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"},{"name":"Department of Neurologic Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin L.","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"},{"name":"Department of Neurologic Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Neff","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie J.","family":"Van Gompel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"},{"name":"Department of Neurologic Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John I.","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic School of Medicine Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Lohse","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research Mayo Clinic School of Medicine Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"},{"name":"Department of Neurologic Surgery Mayo Clinic School of Medicine Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815590105"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000217528.37106.2D"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200606000-00018"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2015.02.003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26589"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2007.5.16836"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otorri.2014.01.002"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.8.GKS101058"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-009-0529-4"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2016.04.010"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812447766"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(95)70101-X"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001180"},{"key":"e_1_2_9_15_1","first-page":"244","article-title":"The growth of acoustic neuromas in volumetric radiologic assessment","volume":"20","author":"Niemczyk K","year":"1999","journal-title":"Am J Otol"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25976"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3182040d9f"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001219"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31823f5afa"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2006.01161.x"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000333303.79931.83"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2010.02099.x"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818770413","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599818770413","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818770413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:29:59Z","timestamp":1760970599000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599818770413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,24]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1177\/0194599818770413"],"URL":"https:\/\/doi.org\/10.1177\/0194599818770413","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,24]]},"assertion":[{"value":"2017-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}