Oliveira Penido Norma de, Tangerina Rodrigo P, Macoto Kosugi Eduardo, Cesário de Abreu Carlos Eduardo, Brandão Vasco Matheus
PhD in Medicine. Affiliated Professor - Unifesp-Epm.
M. S. in Sciences - UNIFESP/EPM.
Braz J Otorhinolaryngol. 2007 Nov-Dec;73(6):867-871. doi: 10.1016/S1808-8694(15)31189-7.
The natural history of Vestibular Schwannomas (VS) is yet not totally known, but most of them have the tendency to slow growth, sometimes without any kind of symptoms during the individuals entire time. About 69% of diagnosed VS do not grow at all and 16% of these can even regress. Considering tumors that grow, about 70% have grown less than 2mm an year. Advanced radiological diagnosis, especially magnetic resonance imaging with gadolinium helps us diagnose small and less symptomatic tumors. Treatment of choice still is complete tumor resection. Surgical approaches have improved considerably and have helped preserve facial nerve function and hearing. Considering VSs natural history, there is a possibility for conservative treatment for these tumors, because their growth in the first year after diagnosis predicts tumor growth behavior in the next years. Surgery should be done in cases of tumor growth, patients desire or symptoms worsening. Moreover, in terms of postoperative sequelae, there is no difference between patients who underwent surgery immediately after diagnosis and those who underwent initial conservative treatment for these tumors.
前庭神经鞘瘤（VS）的自然病史尚未完全明确，但大多数肿瘤有生长缓慢的趋势，有时在个体的整个病程中都没有任何症状。约69%的已诊断VS根本不生长，其中16%甚至会消退。在有生长的肿瘤中，约70%每年生长小于2mm。先进的放射学诊断，尤其是钆增强磁共振成像有助于我们诊断小的、症状较轻的肿瘤。首选的治疗方法仍然是完整切除肿瘤。手术方法有了很大改进，有助于保留面神经功能和听力。考虑到VS的自然病史，对这些肿瘤进行保守治疗是有可能的，因为它们在诊断后第一年的生长情况可预测未来几年的肿瘤生长行为。在肿瘤生长、患者有意愿或症状恶化的情况下应进行手术。此外，就术后后遗症而言，诊断后立即接受手术的患者与最初对这些肿瘤进行保守治疗的患者之间没有差异。
