gms | German Medical Science

Since 1976 we have in Denmark performed nearly all surgery of VS by translabyrinthine approach and centralized all management of VS in our group.

Our long-term epidemiological studies show the increase of VS, and decrease of giant and large VS. The increase of mean incidence of VS is evident: In the period of 31.5 years (July 1976 –December 2007), during the period of translabyrinthine surgery 2199 VS were diagnosed in Denmark. In the first 7-year period the mean incidence was 7.6 VS/mill/year, in the fifth period (Jan.2002–Dec.2007) the mean incidence was 21.2 VS/mill/year. The mean incidence for the 31.5 years period is 13.2 VS/ mill/ year. In the 9½ -period, before the translabyrinthine surgery (1967-1976) 285 VS were diagnosed with a mean incidence of 5.4 VS/Mill/Year. The mean incidence will further increase.

The most important are the findings of only 1 intrameatal VS in each of the first two 7-years periods, with total 238 respectively 337 VS, in contrast to the last two six-years periods with finding of 166 and 218 intrameatal tumors respectively, indicating that many intrameatal VS do not grow and will presumably never become extrameatal VS. The reason of finding many intrameatal VS in contrast to the first two periods is the increase of number of the MR scanners in Denmark.

Based on these data we started in 1990 “wait and scan management” of intrameatal and small extrameatal VS. Today we have 770 intrameatal and small extrameatal VS on the wait and scan project. Within a mean observation of 5 years 17% of 336 intrameatal VS became extrameatal and only 32% of 522 small extrameatal VS grew more than 2 mm and will be operated.

The results of translabyrinthine and middle fossa surgery will be discussed and compared with the wait and management of VS.