Management of vestibular schwannoma during pregnancy: A systematic review

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-02-01 DOI:10.1016/j.neuchi.2025.101643

Younis Al-Mufargi , Asma AlHosni , Salim Al-kalbani , Tariq Al-Saadi

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引用次数: 0

Abstract

Objective

This systematic review evaluates the management strategies for vestibular schwannoma (acoustic neuroma) during pregnancy, a rare but significant clinical condition, by synthesizing findings from case reports.

Methods

A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases. Relevant case reports were included based on predefined inclusion and exclusion criteria. Data were extracted on patient demographics, tumor characteristics, clinical symptoms, management strategies, and outcomes.

Results

Thirty-seven cases were included, with a mean patient age of 28.72 years and a mean gestational age at diagnosis of 26.63 weeks. Hearing loss was the most common symptom (92.3%), followed by facial numbness (53.8%) and headache (41%). Tumor sizes ranged from 2.0 to 6.5 cm, with larger tumors associated with increased neurological symptoms. Surgical intervention was performed post-delivery in 78.9% of cases, while 21.1% underwent surgery during pregnancy. Seizures showed a statistically significant difference with the timing of surgery, with one case occurring during pregnancy and none post-delivery (p = 0.05). Most cases were managed conservatively, with surgery deferred until postpartum unless neurological decline or tumor growth warranted earlier intervention.

Conclusions

The management of vestibular schwannoma during pregnancy requires a multidisciplinary approach, balancing maternal and fetal health. Conservative management is generally preferred, with surgical intervention reserved for cases with significant symptoms. Hormonal changes during pregnancy may exacerbate tumor growth, underscoring the need for early diagnosis and careful monitoring. Further research is needed to optimize management guidelines and improve outcomes.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.