Prospective Evaluation of the Clinical Profile and Referral Pattern Differences of Vestibular Schwannomas and Other Cerebellopontine Angle Tumors

Objective: To evaluate the clinical profile, referral pattern, delay in diagnosis, and impact of tumor size of cases involving vestibular schwannomas (VS) versus other cerebellopontine angle (CPA) tumors in an Egyptian population. Study Design: Case series study. Setting: Tertiary referral center. Patients: A prospective study of possible retrocochlear lesions was conducted from 2008 to 2010. Intervention(s): Patients were subjected to a full clinical history, complete otorhinolaryngological examination, a basic audiologic evaluation, auditory brainstem response assay, and gadolinium-enhanced magnetic resonance imaging. According to the findings of magnetic resonance imaging, patients with retrocochlear lesions were divided into 2 groups: those with VS (n = 17) and those with other CPA lesions (n = 14). Main Outcome Measure(s): Diagnostic delay and criteria of VS and CPA tumors. Results: Unilateral hearing loss and tinnitus were presented in 52.9% of VS cases with a diagnostic delay of 15.5 months. For cases involving other CPA lesions, a combination of otologic symptoms was observed in 9 (64%) of 14 cases, and a diagnostic delay of 47.5 months was experienced. An absence of auditory brainstem response waves was identified significantly (p < 0.05) for the affected ears of both groups. Only differences in Wave V latency were significant between the 2 groups (p < 0.05). Conclusion: A longer diagnostic delay was associated with cases involving other types of CPA lesions versus cases of VS, and tumor size and volume did not affect the diagnostic delay of the former. Moreover, the only significant difference in clinical presentation for these 2 groups of intracranial tumor involved Wave V latency.