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The true incidence of Acoustic neuromas has been difficult to estimate.<ref>Ho SY, Kveton JF. Acoustic neuroma assessment and management. Otolaryngol Clin North Am 2002;35:393-404</ref> <ref>Tos M, Charabi S, Thomsen J. Clincial experience with vestibular schwannomas: epidemiology, symptomatology, diagnosis, and surgical results. Eur Arch Otorhinolaryngol 1998;255:1-6.</ref>  The incidence has been reported to range from 1 to 20 per million per year.<ref> Howitz MF, Johansen C, Tos M, Charabi S, Olsen JH. Incidence of Vestibular Schwannoma in Denmark, 1977-1995. Am J Otol 2000;21:690-694</ref> <ref>Tos M, Charabi S, Thomsen J. Clincial experience with vestibular schwannomas: epidemiology, symptomatology, diagnosis, and surgical results. Eur Arch Otorhinolaryngol 1998;255:1-6.</ref> <ref>Tos M, Stangerup SE, Cayé-Thomasen P, Tos T, Thomsen J. What is the real incidence of vestibular schwannoma? Arch Otolaryngol Head Neck Surg 2004;130:216-220</ref> A study of acoustic neuromas in a review of 24,000 brain MRIs reported a prevalence of 0.07%. When comparing the clinical incidence  
The true incidence of Acoustic neuromas has been difficult to estimate.<ref>Ho SY, Kveton JF. Acoustic neuroma assessment and management. Otolaryngol Clin North Am 2002;35:393-404</ref> <ref>Tos M, Charabi S, Thomsen J. Clincial experience with vestibular schwannomas: epidemiology, symptomatology, diagnosis, and surgical results. Eur Arch Otorhinolaryngol 1998;255:1-6.</ref>  The incidence has been reported to range from 1 to 20 per million per year.<ref> Howitz MF, Johansen C, Tos M, Charabi S, Olsen JH. Incidence of Vestibular Schwannoma in Denmark, 1977-1995. Am J Otol 2000;21:690-694</ref> <ref>Tos M, Charabi S, Thomsen J. Clincial experience with vestibular schwannomas: epidemiology, symptomatology, diagnosis, and surgical results. Eur Arch Otorhinolaryngol 1998;255:1-6.</ref> <ref>Tos M, Stangerup SE, Cayé-Thomasen P, Tos T, Thomsen J. What is the real incidence of vestibular schwannoma? Arch Otolaryngol Head Neck Surg 2004;130:216-220</ref> A study of acoustic neuromas in a review of 24,000 brain MRIs reported a prevalence of 0.07%. When comparing the clinical incidence  
of acoustic neuromas to the prevalence of occult acoustic neuromas ascertained from histopathological studies of temporal bones, it can be concluded that the vast majority of tumors that exist are never clinically manifested.<ref>Thomsen J, Tos M. Acoustic neuroma: clinical aspects, audiovestibular assessment, diagnostic delay, and growth rate. Am J Otol 1990;11:12-19.</ref> <ref>Rosenberg SI. Natural history of acoustic neuromas. Laryngoscope 2000;110:497-508.</ref> Acoustic neuromas are most commonly diagnosed between the ages of 30 and 68.<ref>Strasnick B, Glasscock ME, Haynes D, McMenomey SO, Minor LB. The natural history of untreated acoustic neuromas. Laryngoscope1994;104:1115-1119.</ref> <ref>Hart RG, Davenport J. Diagnosis of acoustic neuroma. Neurosurgery 1981;9:450-463.</ref> Reported cases of acoustic neuroma in childhood are rare and in such patients other evidence of NF2 should be investigated. In a study of 146 cases of acoustic neuromas, the median age of cases was 52 years.<ref>Edwards CG, Schwartzbaum JA, Lönn S, Ahlbom A, Feychting M. Exposure to loud noise and risk of acoustic neuroma. Am J Epidemiol 2006;163:327-333.</ref> In a second study of 793 cases of Acoustic neuroma, the median age of the cases was 54 years. The sex ratio (females/males) for acoustic neuromas has been reported to be >1 <ref>Inskip PD, Tarone RE, Hatch EE, et al. Sociodemographic indicators and risk of brain tumours. Int J Epidemiol 2003;32:225-233.</ref> <ref>Howitz MF, Johansen C, Tos M, Charabi S, Olsen JH. Incidence of Vestibular Schwannoma in Denmark, 1977-1995. Am J Otol 2000;21:690-694.</ref> <ref>Chandler CL, Ramsden RT. Acoustic schwannoma. Br J Hosp Med 1993;49:336-343.</ref> <ref>Spoelhof GD. When to suspect acoustic neuroma. Am Fam Physician 1995;52:1768-1774.</ref>
of acoustic neuromas to the prevalence of occult acoustic neuromas ascertained from histopathological studies of temporal bones, it can be concluded that the vast majority of tumors that exist are never clinically manifested.<ref>Thomsen J, Tos M. Acoustic neuroma: clinical aspects, audiovestibular assessment, diagnostic delay, and growth rate. Am J Otol 1990;11:12-19.</ref> <ref>Rosenberg SI. Natural history of acoustic neuromas. Laryngoscope 2000;110:497-508.</ref> Acoustic neuromas are most commonly diagnosed between the ages of 30 and 68.<ref>Strasnick B, Glasscock ME, Haynes D, McMenomey SO, Minor LB. The natural history of untreated acoustic neuromas. Laryngoscope1994;104:1115-1119.</ref> <ref>Hart RG, Davenport J. Diagnosis of acoustic neuroma. Neurosurgery 1981;9:450-463.</ref> Reported cases of acoustic neuroma in childhood are rare and in such patients other evidence of NF2 should be investigated. In a study of 146 cases of acoustic neuromas, the median age of cases was 52 years.<ref>Edwards CG, Schwartzbaum JA, Lönn S, Ahlbom A, Feychting M. Exposure to loud noise and risk of acoustic neuroma. Am J Epidemiol 2006;163:327-333.</ref> In a second study of 793 cases of Acoustic neuroma, the median age of the cases was 54 years. The sex ratio (females/males) for acoustic neuromas has been reported to be >1 <ref>Inskip PD, Tarone RE, Hatch EE, et al. Sociodemographic indicators and risk of brain tumours. Int J Epidemiol 2003;32:225-233.</ref> <ref>Howitz MF, Johansen C, Tos M, Charabi S, Olsen JH. Incidence of Vestibular Schwannoma in Denmark, 1977-1995. Am J Otol 2000;21:690-694.</ref> <ref>Chandler CL, Ramsden RT. Acoustic schwannoma. Br J Hosp Med 1993;49:336-343.</ref> <ref>Spoelhof GD. When to suspect acoustic neuroma. Am Fam Physician 1995;52:1768-1774.</ref>
However, data from the Central Brain Tumor Registry of the United States (CBTRUS) do not support a female/male difference<ref>Propp JM, McCarthy BJ, Davis FG, Preston-Martin S. Descriptive epidemiology of vestibular schwannomas. Neuro-oncol 2006;8:1-11.</ref> Nevertheless,some of the studies that analyzed Swedish data, the sex ratio (females/males) of acoustic neuromas in the Nordic counties has been shown to be >1. This sex ratio may indicate that hormones play a role in the etiology of acoustic neuromas<ref>Schlehofer B, Blettner M, Wahrendorf J. Association between brain tumors and menopausal status. J Natl Cancer Inst 1992;84:1346-1349</ref> <ref>Howitz MF, Johansen C, Tos M, Charabi S, Olsen JH. Incidence of Vestibular Schwannoma in Denmark, 1977-1995. Am J Otol 2000;21:690-694.</ref> The tumor has been reported to be higher in whites than in non-whites<ref>Propp JM, McCarthy BJ, Davis FG, Preston-Martin S. Descriptive epidemiology of vestibular schwannomas. Neuro-oncol 2006;8:1-11.</ref> as well as being uncommon in individuals of African ancestry<ref>Chandler CL, Ramsden RT. Acoustic schwannoma. Br J Hosp Med 1993;49:336-343..</ref>
However, data from the Central Brain Tumor Registry of the United States (CBTRUS) do not support a female/male difference<ref>Propp JM, McCarthy BJ, Davis FG, Preston-Martin S. Descriptive epidemiology of vestibular schwannomas. Neuro-oncol 2006;8:1-11.</ref> Nevertheless,some of the studies that analyzed Swedish data, the sex ratio (females/males) of acoustic neuromas in the Nordic counties has been shown to be >1. This sex ratio may indicate that hormones play a role in the etiology of acoustic neuromas<ref>Schlehofer B, Blettner M, Wahrendorf J. Association between brain tumors and menopausal status. J Natl Cancer Inst 1992;84:1346-1349</ref> <ref>Howitz MF, Johansen C, Tos M, Charabi S, Olsen JH. Incidence of Vestibular Schwannoma in Denmark, 1977-1995. Am J Otol 2000;21:690-694.</ref> The tumor has been reported to be higher in whites than in non-whites<ref>Propp JM, McCarthy BJ, Davis FG, Preston-Martin S. Descriptive epidemiology of vestibular schwannomas. Neuro-oncol 2006;8:1-11.</ref> as well as being uncommon in individuals of African ancestry<ref>Chandler CL, Ramsden RT. Acoustic schwannoma. Br J Hosp Med 1993;49:336-343..</ref> According to some studies the incidence of acoustic neuromas has been
 
increasing. This may be due to several factors. Steady improvements in
diagnosis, such as the introduction of auditory brainstem response, CT, and MRI could
explain part of the increased incidence. Increased awareness among physicians
and patients of the symptoms of acoustic neuromas may have caused an increase in the
reporting of the tumor. Changes in classification or coding may also explain some
of the trend, whereby registries may have misclassified nonvestibular schwannomas as
acoustic neuromas. Or, there may be a true increase in the incidence of these
tumors. The trend may also lend support to the emerging hypotheses regarding an
environmental cause of these tumors. Established and hypothesized risk factors have been
reported extensively in the literature and include ionizing radiation exposure, cellular
telephone use, specific occupations, a possible hormonal cause, and loud noise exposure.


<div><div><div><div>'''Average annual incidence rates, overall and by gender and race, CBTRUS (1995–1999) and LACCSP (1995–1998)'''</div></div></div></div><div>
<div><div><div><div>'''Average annual incidence rates, overall and by gender and race, CBTRUS (1995–1999) and LACCSP (1995–1998)'''</div></div></div></div><div>

Revision as of 11:21, 22 April 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The true incidence of Acoustic neuromas has been difficult to estimate.[1] [2] The incidence has been reported to range from 1 to 20 per million per year.[3] [4] [5] A study of acoustic neuromas in a review of 24,000 brain MRIs reported a prevalence of 0.07%. When comparing the clinical incidence of acoustic neuromas to the prevalence of occult acoustic neuromas ascertained from histopathological studies of temporal bones, it can be concluded that the vast majority of tumors that exist are never clinically manifested.[6] [7] Acoustic neuromas are most commonly diagnosed between the ages of 30 and 68.[8] [9] Reported cases of acoustic neuroma in childhood are rare and in such patients other evidence of NF2 should be investigated. In a study of 146 cases of acoustic neuromas, the median age of cases was 52 years.[10] In a second study of 793 cases of Acoustic neuroma, the median age of the cases was 54 years. The sex ratio (females/males) for acoustic neuromas has been reported to be >1 [11] [12] [13] [14] However, data from the Central Brain Tumor Registry of the United States (CBTRUS) do not support a female/male difference[15] Nevertheless,some of the studies that analyzed Swedish data, the sex ratio (females/males) of acoustic neuromas in the Nordic counties has been shown to be >1. This sex ratio may indicate that hormones play a role in the etiology of acoustic neuromas[16] [17] The tumor has been reported to be higher in whites than in non-whites[18] as well as being uncommon in individuals of African ancestry[19] According to some studies the incidence of acoustic neuromas has been increasing. This may be due to several factors. Steady improvements in diagnosis, such as the introduction of auditory brainstem response, CT, and MRI could explain part of the increased incidence. Increased awareness among physicians and patients of the symptoms of acoustic neuromas may have caused an increase in the reporting of the tumor. Changes in classification or coding may also explain some of the trend, whereby registries may have misclassified nonvestibular schwannomas as acoustic neuromas. Or, there may be a true increase in the incidence of these tumors. The trend may also lend support to the emerging hypotheses regarding an environmental cause of these tumors. Established and hypothesized risk factors have been reported extensively in the literature and include ionizing radiation exposure, cellular telephone use, specific occupations, a possible hormonal cause, and loud noise exposure.

Average annual incidence rates, overall and by gender and race, CBTRUS (1995–1999) and LACCSP (1995–1998)
Gender
Race
Type of Tumor Total Number of Tumors (N) Overall Rate (CI) Male Female White Nonwhite
CBTRUS, 1995–1999
Nerve sheath 2,811 1.08 (1.04–1.12) 1.10 (1.04–1.16) 1.07 (1.02–1.13) 1.13 (1.08–1.17) 0.56 (0.48–0.63)
Vestibular schwannoma 1,424 0.55 (0.52–0.58) 0.56 (0.52–0.60) 0.55 (0.51–0.58) 0.58 (0.55–0.61) 0.23 (0.18–0.28)
LACCSP, 1995–1998
Nerve sheath 352 1.11 (0.99–1.22) 1.15 (0.97–1.32) 1.07 (0.91–1.23) 1.21 (1.08–1.36) 0.68 (0.50–0.87)
Vestibular schwannoma 256 0.82 (0.71–0.92) 0.83 (0.68–0.99) (0.66–0.94)0.80 0.89 (0.77–1.01) 0.51 (0.36–0.67)
Rates are per 100,000 person-years and are age adjusted to the year 2000 U.S. standard population.
Abbreviations: CBTRUS, Central Brain Tumor Registry of the United States; CI, confidence interval; LACCSP, Los Angeles County Cancer Surveillance Program.

References

  1. ↑ Ho SY, Kveton JF. Acoustic neuroma assessment and management. Otolaryngol Clin North Am 2002;35:393-404
  2. ↑ Tos M, Charabi S, Thomsen J. Clincial experience with vestibular schwannomas: epidemiology, symptomatology, diagnosis, and surgical results. Eur Arch Otorhinolaryngol 1998;255:1-6.
  3. ↑ Howitz MF, Johansen C, Tos M, Charabi S, Olsen JH. Incidence of Vestibular Schwannoma in Denmark, 1977-1995. Am J Otol 2000;21:690-694
  4. ↑ Tos M, Charabi S, Thomsen J. Clincial experience with vestibular schwannomas: epidemiology, symptomatology, diagnosis, and surgical results. Eur Arch Otorhinolaryngol 1998;255:1-6.
  5. ↑ Tos M, Stangerup SE, Cayé-Thomasen P, Tos T, Thomsen J. What is the real incidence of vestibular schwannoma? Arch Otolaryngol Head Neck Surg 2004;130:216-220
  6. ↑ Thomsen J, Tos M. Acoustic neuroma: clinical aspects, audiovestibular assessment, diagnostic delay, and growth rate. Am J Otol 1990;11:12-19.
  7. ↑ Rosenberg SI. Natural history of acoustic neuromas. Laryngoscope 2000;110:497-508.
  8. ↑ Strasnick B, Glasscock ME, Haynes D, McMenomey SO, Minor LB. The natural history of untreated acoustic neuromas. Laryngoscope1994;104:1115-1119.
  9. ↑ Hart RG, Davenport J. Diagnosis of acoustic neuroma. Neurosurgery 1981;9:450-463.
  10. ↑ Edwards CG, Schwartzbaum JA, Lönn S, Ahlbom A, Feychting M. Exposure to loud noise and risk of acoustic neuroma. Am J Epidemiol 2006;163:327-333.
  11. ↑ Inskip PD, Tarone RE, Hatch EE, et al. Sociodemographic indicators and risk of brain tumours. Int J Epidemiol 2003;32:225-233.
  12. ↑ Howitz MF, Johansen C, Tos M, Charabi S, Olsen JH. Incidence of Vestibular Schwannoma in Denmark, 1977-1995. Am J Otol 2000;21:690-694.
  13. ↑ Chandler CL, Ramsden RT. Acoustic schwannoma. Br J Hosp Med 1993;49:336-343.
  14. ↑ Spoelhof GD. When to suspect acoustic neuroma. Am Fam Physician 1995;52:1768-1774.
  15. ↑ Propp JM, McCarthy BJ, Davis FG, Preston-Martin S. Descriptive epidemiology of vestibular schwannomas. Neuro-oncol 2006;8:1-11.
  16. ↑ Schlehofer B, Blettner M, Wahrendorf J. Association between brain tumors and menopausal status. J Natl Cancer Inst 1992;84:1346-1349
  17. ↑ Howitz MF, Johansen C, Tos M, Charabi S, Olsen JH. Incidence of Vestibular Schwannoma in Denmark, 1977-1995. Am J Otol 2000;21:690-694.
  18. ↑ Propp JM, McCarthy BJ, Davis FG, Preston-Martin S. Descriptive epidemiology of vestibular schwannomas. Neuro-oncol 2006;8:1-11.
  19. ↑ Chandler CL, Ramsden RT. Acoustic schwannoma. Br J Hosp Med 1993;49:336-343..

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