Schwager K
Klinik für Hals-Nasen-Ohren-Krankheiten, Kopf-, Hals- und Plastische Gesichtschirurgie, Klinikum Fulda gAG, Akademisches Lehrkrankenhaus der Philipps-Universität Marburg, Pacelliallee 4, 36043, Fulda, Germany.
HNO. 2011 Jan;59(1):22, 24-30. doi: 10.1007/s00106-010-2190-y.
Acoustic neuroma/vestibular schwannoma treatment has changed considerably since the 1990s, when surgical treatment was recommended in all cases of schwannoma, whereas nowadays a more differentiated approach is taken. The three classical approaches (translabyrinthine, transtemporal, and suboccipital) still have their surgical value; however, greater importance is apportioned to radiotherapy (radiosurgery, gamma- and cyber-knife). Magnetic resonance imaging in particular has changed diagnostics and how tumor growth is followed. Electrophysiological monitoring of facial and auditory nerves has helped lower postoperative morbidity. New issues have been raised regarding quality of life. Neuropsychological investigations for cognitive and mnestic performance following procedures in the cerebellopontine angle have highlighted problem areas receiving hitherto little attention. Finally, the therapy of this benign lesion should be planned individually, taking the patient's age as well as their professional and personal status into consideration.
自20世纪90年代以来，听神经瘤/前庭神经鞘瘤的治疗方法发生了很大变化。当时，所有神经鞘瘤病例都建议进行手术治疗，而如今则采取了更为差异化的方法。三种经典手术方法（经迷路入路、经颞入路和枕下入路）仍具有手术价值；然而，放射治疗（放射外科、伽玛刀和射波刀）变得更为重要。特别是磁共振成像改变了诊断方式以及对肿瘤生长的监测方式。对面神经和听神经的电生理监测有助于降低术后发病率。生活质量方面出现了新的问题。对桥小脑角手术后认知和记忆表现的神经心理学调查突出了一些此前很少受到关注的问题领域。最后，对于这种良性病变的治疗应根据患者的年龄以及职业和个人状况进行个体化规划。
