Walch C, Unger F, Anderhuber W, Feichtinger K
HNO-Universitätsklinik, klinische Abteilung für Neurootologie, Karl-Franzens-Universität Graz.
Laryngorhinootologie. 2001 Jul;80(7):385-8. doi: 10.1055/s-2001-15710.
Stereotactic radiosurgery has proved to be an effective alternative to microsurgical resection in treatment of acoustic neuroma. Still, microsurgery is considered by many to be the therapy of choice. In case of recurrence microsurgical resection is much more difficult because of scarring and has a higher risk of complications. Therefore in cases of recurrence the role of radiosurgery needed to be evaluated.
From April 1992 to July 1997 135 patients suffering from acoustic neuroma were treated at the Neurosurgical Department of the University Medical School of Graz by means of the gamma-Knife. 12 patients had recurrence after a single or several microsurgical resections. The age distribution was between 38 and 71 years with a mean of 57 years. The diameter of the tumors varied between 10.5 and 31.2 mm.
In all 12 cases the tumors could be inactivated biologically in a mean follow-up period of 58.8 months by means of stereotactic radiosurgery. Tumor shrinkage was achieved in 3 cases (25%), central necrotic areas were observed in 8 cases (67%). No additional cranial nerve palsies occurred.
Stereotactic radiosurgery has proven to be a safe and effective treatment option instead of repeated microsurgery. Stereotactic radiosurgery should be considered as the therapy of choice in cases of recurrent acoustic neuromas.
立体定向放射外科已被证明是治疗听神经瘤的一种有效替代显微手术切除的方法。然而，许多人仍认为显微手术是首选治疗方法。在复发的情况下，由于瘢痕形成，显微手术切除要困难得多，且并发症风险更高。因此，在复发的情况下，需要评估放射外科的作用。
1992年4月至1997年7月，格拉茨大学医学院神经外科使用伽玛刀治疗了135例听神经瘤患者。12例患者在一次或多次显微手术切除后复发。年龄分布在38岁至71岁之间，平均年龄为57岁。肿瘤直径在10.5毫米至31.2毫米之间。
在所有12例病例中，通过立体定向放射外科，肿瘤在平均58.8个月的随访期内均可实现生物学灭活。3例（25%）实现了肿瘤缩小，8例（67%）观察到中央坏死区域。未出现额外的颅神经麻痹。
立体定向放射外科已被证明是一种安全有效的治疗选择，可替代重复的显微手术。对于复发性听神经瘤，应将立体定向放射外科视为首选治疗方法。
