Wigand M E, Haid T, Goertzen W, Wolf S
Department of Otorhinolaryngology, University of Erlangen-Nuremberg, Germany.
Acta Otolaryngol. 1992;112(2):237-41. doi: 10.1080/00016489.1992.11665411.
With the aim of preserving hearing, 20 acoustic neurinomas in 17 patients with neurofibromatosis 2 were intentionally submitted to an incomplete (80%) tumour removal. In 12 cases this was an operation on the last hearing ear with total deafness of the contralateral ear. If an auditus existed in both ears the better hearing ear was selected for the primary intervention. Early audiological controls evidenced residual hearing in 19 of the 20 cases operated on by the enlarged middle fossa approach, which was utilized inspite of the tumour diameters being between 1 and 6 cm in the cerebello-pontine angle. The oncologic and functional follow-up over 1 to 7 years showed different patterns of slow progression of hearing loss and of persistent auditory function over 2 to 7 years. Facial nerve function was excellent in 16 of the 18 controlled cases. Continued CT or MRT imaging revealed no signaling in 2 cases, constant tumour sizes in 10 cases and slow progression in 3 cases. With regard to the importance of an auditory communication in the younger adult, the described treatment modality appears to be the first choice method.
为了保留听力，对17例2型神经纤维瘤病患者的20个听神经瘤有意进行了不完全（80%）肿瘤切除。其中12例是对最后一只听力耳进行手术，对侧耳完全失聪。如果双耳都有听力，则选择听力较好的耳朵进行初次干预。早期听力检查显示，采用扩大中颅窝入路手术的20例患者中有19例保留了残余听力，尽管小脑脑桥角的肿瘤直径在1至6厘米之间。1至7年的肿瘤学和功能随访显示，听力损失进展缓慢以及2至7年持续存在听觉功能的模式各不相同。18例接受检查的病例中有16例面神经功能良好。持续的CT或磁共振成像显示，2例无信号，10例肿瘤大小稳定，3例进展缓慢。鉴于听觉交流对年轻成年人的重要性，所述治疗方式似乎是首选方法。
