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The incidence rate of sporadic vestibular schwannoma (VS) has commonly been quoted as one in 100,000. However, since the advent of screening for asymmetrical hearing loss and increased availability of modern MRI scanning, more recent studies have shown the incidence is likely to be higher. The authors conducted a systematic review to more accurately characterise the incidence of sporadic VS. The study was conducted according to PRISMA guidelines and registered with PROSPERO. Articles in Chinese, English, German, Italian or Spanish, of population-based studies on incidence of sporadic VS, from January 2010 to August 2020, searched through PubMed, Scopus and Embase, were included. Studies that included cases of Neurofibromatosis Type 2 were excluded. Among 424 citations, six were included. Included studies were of populations from Denmark, the Netherlands, Taiwan, and the United States. Across all the six studies, incidence rates of sporadic VS ranged between 3.0 and 5.2 per 100,000 person years. Median age was 60 years at diagnosis. Highest rates were found in patients older than 70 years with a peak incidence of 20.6 per 100,000 person years. At diagnosis, tumours were intracanicular in 48% to 72%. Two studies showed modest increase in incidence over the study period. One study (United States) showed the rate of asymptomatic incidentally diagnosed VS via neuroimaging to be 1.3 per 100,000 person years. The authors point out that the higher-than-previously-quoted rate (more than five-fold in all age groups and more than 20-fold in patients above 70 years old) is likely due to increased availability of MRI and its modern techniques allowing detection of smaller intracanicular VS tumours that were previously undetectable. They helpfully estimate the lifetime prevalence of sporadic VS to exceed one in 500.

Global Incidence of Sporadic Vestibular Schwannoma: A Systematic Review.
Marinelli JP, Beeler CJ, Carlson ML, et al.
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Richard (Wei Chern) Gan

Royal Brisbane and Women's Hospital, Australia.

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