J Neurol Surg B Skull Base 2019; 80(S 01): S1-S244
DOI: 10.1055/s-0039-1679746
Poster Presentations
Georg Thieme Verlag KG Stuttgart · New York

How Common Is Vestibular Schwannoma, Really? Reconciling Temporal Bone, Radiologic, and Population-Based Studies

John P Marinelli
1   Mayo Clinic School of Medicine, Rochester, Minnesota, United States
,
Brandon R. Grossardt
2   Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States
,
Christine M. Lohse
2   Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States
,
Matthew L. Carlson
3   Departments of Otolaryngology-Head and Neck Surgery and Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
06 February 2019 (online)

 

Background: Reported epidemiologic data surrounding vestibular schwannoma (VS) are controversial. Temporal bone studies have suggested that asymptomatic, incidentally diagnosed VS affects up to 2.4% (or 2,400 per 100,000 persons) of the population,[1] whereas magnetic resonance imaging (MRI) studies have reported VS to affect 0.0108% (or 11 cases per 100,000 persons).[2] Moreover, existing population-based data seem to consistently underestimate the prevalence of VS.[3]

Objective: For these reasons, the current study was conceived to determine the prevalence of sporadic VS in Olmsted County, Minnesota, in an attempt to reconcile temporal bone, radiologic, and population-based reports regarding VS.

Patients: All persons living in Olmsted County, Minnesota, on January 1, 2017, with a confirmed diagnosis of VS identified using the Rochester Epidemiology Project (REP) medical records-linkage system.

Main Outcome Measures: Prevalence of all sporadic VS and asymptomatic, incidentally diagnosed sporadic VS.

Results: Among the more than 159,000 persons living in Olmsted County on January 1, 2017, we identified 67 living with VS, resulting in a point prevalence of 42.0 per 100,000 persons ([Table 1]). The prevalence of VS was higher in older persons, reaching 212.4 per 100,000 in those aged 70 years and older ([Fig. 1]). The overall prevalence of asymptomatic, incidentally diagnosed VS was 7.5 per 100,000 persons, and 10.3 when restricted to those aged 20 years and older.

Conclusion: Using the unique infrastructure of the REP, the current study shows that sporadic VS affects over 40 people per 100,000, with prevalence reaching over 1 in every 500 persons aged 70 years and older. The prevalence of asymptomatic, incidentally diagnosed sporadic VS closely compares to past MRI studies ([Table 2]). Yet, the estimates of prevalence from temporal bone studies remain at least one order of magnitude greater than the current population-based study and past radiologic research. In this way, the current study demonstrates similarities between available population-based prevalence data and previous MRI studies while further substantiating the speculation that temporal bone studies systematically overestimate the prevalence of VS. Lastly, taken together, the currently available data suggest that asymptomatic, incidentally diagnosed VS likely affects between 5 and 20 people per 100,000 persons.

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