Determining the Impact of Race and Ethnicity on Diagnosis and Management of Vestibular Schwannoma

Abstract

Objective:

While prior literature has demonstrated that patients of lower socioeconomic groups may have larger tumors on presentation and poorer outcomes, there is limited literature on the impact of race and ethnicity on management of vestibular schwannoma (VS). The objective of this study was to determine whether race and ethnicity impacted treatment choice and postoperative management of VS.

Methods:

Retrospective review of patients diagnosed with VS (ICD9 225.1, ICD10 D33.3, and ICD 10 H93.3) who presented to a tertiary care center between January 1, 2018 and October 31, 2023 was completed (IRB H-45412). Primary outcomes, including treatment choice, time to treatment, and postoperative management, were compared among different racial and ethnic groups.

Results:

Of the 78 patients diagnosed with VS, 46 (59.0%) patients were observed with serial imaging, 12 (15.4%) underwent radiation, and 14 (18.0%) pursued surgery initially. Treatment choice (P = .3917), time to treatment (P = .3310), and loss to follow up (P = .0579) were not significantly different between different races/ethnicities. In patients who pursued surgery, the duration of admission (P = .9300), need for rehabilitation (P = .6271), postoperative facial nerve paresis (P = .8233), and hospital readmission (P = .5680) did not differ significantly. The proportion of patients who qualified for hearing rehabilitation did not differ significantly (P = .3545). However, a significantly higher proportion of White patients chose to pursue hearing rehabilitation compared to the other groups ( P = .0096).

Conclusion:

Race and ethnicity did not significantly impact choice of treatment, management patterns, or postoperative course for patients with VS.