Shelton C, Hitselberger W E
House Ear Institute, Los Angeles, Calif.
Laryngoscope. 1991 Sep;101(9):925-8. doi: 10.1288/00005537-199109000-00002.
Prior to the advent of microneurosurgery, the operative mortality for acoustic tumor removal was high and management often consisted of observation until sufficient symptoms warranted removal. The treatment of these tumors has evolved, and recent introduction of gadolinium-enhanced magnetic resonance imaging (MRI) allows the diagnosis of very small intracanalicular acoustic tumors before hearing has been significantly affected. For such tumors, some surgeons advocate the premicrosurgical philosophy of observation rather than removal. Our results of small acoustic tumor removal with attempt at hearing preservation were reviewed. From 1961 to June 1989, 39 acoustic tumors 0.5 cm or less were removed by the middle fossa approach. Measurable hearing was preserved in 67%, and facial function 1 year postoperatively was normal or nearly normal in 97%. There was no other permanent operative morbidity. Given our results, early surgical removal of small acoustic tumors is advocated.
在显微神经外科出现之前，听神经瘤切除手术的死亡率很高，治疗通常是观察，直到出现足够的症状才进行切除。这些肿瘤的治疗方法已经有所发展，最近引入的钆增强磁共振成像（MRI）能够在听力受到显著影响之前诊断出非常小的内耳道听神经瘤。对于这类肿瘤，一些外科医生主张采用观察而非切除的显微手术前理念。我们回顾了尝试保留听力的小型听神经瘤切除结果。从1961年至1989年6月，通过中颅窝入路切除了39例直径0.5厘米或更小的听神经瘤。67%的患者听力得以保留，术后1年97%的患者面部功能正常或接近正常。没有其他永久性手术并发症。基于我们的结果，主张早期手术切除小型听神经瘤。
