Doherty Joni K, Friedman Rick A
House Clinic and House Ear Institute, Los Angeles, California 90057, USA.
Curr Opin Otolaryngol Head Neck Surg. 2006 Oct;14(5):305-13. doi: 10.1097/01.moo.0000244186.72645.d4.
The present review examines the various mainstream treatment options, benefits and risks, and controversies involved in developing a management algorithm for treatment of vestibular schwannoma.
Advances in microsurgery and radiosurgery have made tremendous contributions to management of vestibular schwannoma; however, considerable controversy still exists. The auditory and facial nerve functional outcomes have improved with use of intraoperative monitoring for vestibular schwannoma removal and with lower radiosurgery doses; however, risks to the facial and auditory nerves still exist. Observing vestibular schwannomas for growth with serial magnetic resonance imaging is an increasingly popular option for small vestibular schwannomas that allows patients to enjoy hearing and facial function.
The risks and benefits of each treatment option must be weighed for each patient, and management decisions regarding vestibular schwannomas should be individualized for each patient depending on tumor anatomy, patient preferences, and symptoms.
本综述探讨了为前庭神经鞘瘤制定治疗算法所涉及的各种主流治疗选择、益处和风险以及争议。
显微手术和放射外科的进展为前庭神经鞘瘤的治疗做出了巨大贡献；然而，仍存在相当大的争议。通过在切除前庭神经鞘瘤时使用术中监测以及降低放射外科剂量，听觉和面部神经功能结果有所改善；然而，面部和听觉神经的风险仍然存在。对于小型前庭神经鞘瘤，通过连续磁共振成像观察其生长情况是一种越来越受欢迎的选择，这能让患者保留听力和面部功能。
必须为每位患者权衡每种治疗选择的风险和益处，并且关于前庭神经鞘瘤的管理决策应根据肿瘤解剖结构、患者偏好和症状为每位患者个体化制定。
