• Yoshinori Higuchi, Shiro Ikegami, Kentaro Horiguchi, Kyoko Aoyagi, Osamu Nagano, Toru Serizawa, Yosuke Tajima, Toyoyuki Hanazawa, Iwao Yamakami, and Yasuo Iwadate.
• Departments of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. Electronic address: yhiguchi@faculty.chiba-u.jp.
• World Neurosurg. 2021 Apr 1; 148: e406-e414.

ObjectiveThe relationship between quantitative posturography results and growth of vestibular schwannomas (VSs) during conservative management has not been studied. We aimed to clarify the relationship between the presence of disequilibrium based on posturographic measurement and VS growth.MethodsThis retrospective, single-center study included 53 patients with VSs (Koos stage I or II) managed conservatively after initial diagnosis. Radiographic progression was considered present if 20% volumetric growth was observed over the imaging interval. Posturography was performed at initial diagnosis, and sway velocity (SV) and sway area were calculated. Tumor growth-free survival was estimated using the Kaplan-Meier method.ResultsMean follow-up period was 2.87 ± 2.58 years, up to tumor growth detection or last follow-up magnetic resonance imaging. Tumor growth incidence was 40.8% and 61.2% at 2 and 5 years, respectively. Cerebellopontine angle extension and SV with eyes open were related to tumor growth. Tumor growth-free survival of patients with cerebellopontine angle extension and patients with intracanalicular tumor at 2 years was 37.3% and 76.4%, respectively. Tumor growth-free survival of patients with SV >2.06 cm/second and patients with SV ≤2.06 cm/second at 2 years was 30.8% and 68.9%, respectively. The Cox hazard model demonstrated a significant risk for future tumor growth with SV >2.06 cm/second (relative risk, 2.475; 95% confidence interval, 1.11-5.37, P = 0.027).ConclusionsWe demonstrated a positive correlation between SV with eyes open and future tumor growth. Posturographic data are objective and quantitative; thus, SV may be a potential predictor of future growth of VSs.Copyright © 2021 Elsevier Inc. All rights reserved.

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