Caye-Thomasen Per, Hansen Søren, Dethloff Thomas, Stangerup Sven-Eric, Thomsen Jens
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Gentofte University Hospital of Copenhagen, Denmark.
Laryngoscope. 2006 Jul;116(7):1131-5. doi: 10.1097/01.MLG.0000217528.37106.2D.
None of several previous reports on the growth pattern of vestibular schwannomas (VS) have dealt with the sublocalization and volumetric growth pattern of intracanalicular tumors. This paper reports such data from 196 patients.
All VS patients have been registered prospectively at one center in Denmark since 1975. Data on intracanalicular tumors were drawn from the database, yielding 196 patients with a diagnostic and at least one control magnetic resonance imaging scan. All images were retrieved and the tumor sublocalization, size, and growth rate determined.
The majority (50%) of the tumors was located centrally in the internal auditory canal (IAC), whereas 31% were porus-near and 19% fundus-near. Of the 196 tumors, 88 (45%) displayed growth, 20 (10%) shrinkage, and 88 (45%) remained unchanged. Thirty-eight (19%) tumors grew to extrameatal extension. Growth occurred only within 5 years after diagnosis. In the 88 growing tumors, the mean absolute growth rate was 111mm/year and the relative rate 114%/volume/year. The occurrence of IAC expansion at diagnosis was higher for tumors displaying subsequent shrinkage. Growth occurrence and rate, IAC expansion, and progression to extrameatal extension were not related to tumor sublocalization.
Most intracanalicular VS are located centrally in a nonexpanded IAC at diagnosis. Growth occurs within 5 years after diagnosis in up to 45% of the tumors, although only 19% extend into the cerebellopontine angle. IAC expansion, growth occurrence, and rate are not related to tumor sublocalization. These findings justify primary observation of all purely intracanalicular tumors, unless realistic hearing preservation is intended.
先前关于前庭神经鞘瘤（VS）生长模式的几份报告均未涉及内听道内肿瘤的亚定位和体积生长模式。本文报告了196例患者的此类数据。
自1975年以来，所有VS患者均在丹麦的一个中心进行前瞻性登记。内听道内肿瘤的数据来自数据库，共有196例患者进行了诊断性磁共振成像扫描且至少有一次对照扫描。检索了所有图像，并确定了肿瘤的亚定位、大小和生长率。
大多数（50%）肿瘤位于内听道（IAC）中央，而31%靠近内听道孔，19%靠近内听道底。在196例肿瘤中，88例（45%）有生长，20例（10%）缩小，88例（45%）保持不变。38例（19%）肿瘤生长至耳道外扩展。生长仅发生在诊断后的5年内。在88例生长的肿瘤中，平均绝对生长率为111mm/年，相对生长率为114%/体积/年。诊断时出现IAC扩张的情况在随后出现缩小的肿瘤中更高。生长的发生和速率、IAC扩张以及向耳道外扩展的进展与肿瘤亚定位无关。
大多数内听道内VS在诊断时位于未扩张的IAC中央。高达45%的肿瘤在诊断后5年内出现生长，尽管只有19%扩展至桥小脑角。IAC扩张、生长的发生和速率与肿瘤亚定位无关。这些发现证明对所有单纯内听道内肿瘤进行初步观察是合理的，除非有意实现现实的听力保留。
