Abram Steven, Rosenblatt Paul, Holcomb Stephen
Neuroscience Institute of Saint Thomas Hospital, 4220 Harding Road, Nashville, TN 37205, USA.
Otolaryngol Clin North Am. 2007 Jun;40(3):571-88, ix. doi: 10.1016/j.otc.2007.04.001.
Medical decision-making is based on benefit-to-cost analysis. Optimally, treatment obtains a high degree of benefit while minimizing the physical, social, and financial costs. The goals of the treatment of acoustic schwannomas are prohibiting tumor growth and alleviation of symptoms caused by damage to local structures. These symptoms-tinnitus, ataxia, and hearing loss--secondary to eighth nerve dysfunction, as well as symptoms arising from damage to adjacent structures such as the facial nerve, trigeminal nerve, or pons, can be caused by tumor growth or treatment. Determination of optimal therapy must also take into account an understanding of the natural history of the disease, because acoustic schwannomas are slow-growing benign tumors that when left untreated, usually enlarge over time and cause problems.
医疗决策基于效益成本分析。理想情况下，治疗应在将身体、社会和经济成本降至最低的同时，获得高度的效益。听神经瘤治疗的目标是抑制肿瘤生长并缓解因局部结构受损引起的症状。这些症状——耳鸣、共济失调和听力损失——继发于第八神经功能障碍，以及由肿瘤生长或治疗导致的邻近结构如面神经、三叉神经或脑桥受损引起的症状。确定最佳治疗方案还必须考虑对疾病自然史的了解，因为听神经瘤是生长缓慢的良性肿瘤，若不治疗，通常会随时间增大并引发问题。
