House Clinic and House Research Institute, Los Angeles, California, USA.
Otol Neurotol. 2011 Dec;32(9):1530-7. doi: 10.1097/MAO.0b013e3182355855.
To examine hearing preservation rates, facial nerve outcomes, and tumor recurrence rates in patients with neurofibromatosis Type 2 undergoing a primary middle cranial fossa approach for vestibular schwannoma removal.
Retrospective chart review.
Private practice tertiary neurotology referral center.
All patients with neurofibromatosis Type 2 undergoing attempted hearing preservation via a middle cranial fossa approach for removal of vestibular schwannoma from January 1, 2000, to June 1, 2010.
Primary middle cranial fossa approach for removal of vestibular schwannoma.
Preoperative, postoperative, and change in hearing thresholds, word recognition scores, and American Academy of Otolaryngology-Head and Neck Surgery hearing class, House-Brackmann facial nerve grade, and tumor recurrence.
Class A or B hearing according to the American Academy of Otolaryngology-Head and Neck Surgery was maintained in 50% of cases, whereas 63.6% had Class A, B, or C hearing, with an average word recognition score of 93.8% at an average follow-up period of 32.5 months. Facial nerve outcomes were excellent; 75% of cases maintained House-Brackmann Grade 1, whereas 94.3% had Grade 1 or 2 at an average of 25 months after surgery. Tumor growth within the surgical field was observed radiographically in 59% of cases.
In patients with neurofibromatosis Type 2, proactive treatment of smaller tumors provides a chance to maintain serviceable hearing and obtain tumor control for extended periods. When examining hearing outcomes, it is important to use word recognition scores, in addition to American Academy of Otolaryngology-Head and Neck Surgery hearing class, to better assess functionality. Although facial nerve outcomes tend to be favorable, the growth of new tumors, including facial schwannomas, may occur within the surgical field. Continued surveillance with serial magnetic resonance scans after surgery is mandatory.
研究 2 型神经纤维瘤病患者行原发中颅窝入路听神经瘤切除术的听力保留率、面神经结果和肿瘤复发率。
回顾性图表分析。
私人执业的三级神经耳科转诊中心。
所有于 2000 年 1 月 1 日至 2010 年 6 月 1 日接受尝试听力保留的 2 型神经纤维瘤病患者，通过中颅窝入路切除前庭神经鞘瘤。
原发中颅窝入路切除前庭神经鞘瘤。
术前、术后听力阈值、言语识别率以及美国耳鼻喉科学-头颈外科学会听力分级、House-Brackmann 面神经分级和肿瘤复发的变化。
50%的病例保持了美国耳鼻喉科学-头颈外科学会的 A 或 B 级听力，而 63.6%的病例有 A、B 或 C 级听力，平均言语识别率为 93.8%，平均随访时间为 32.5 个月。面神经结果良好；75%的病例保持 House-Brackmann 1 级，而 94.3%的病例在手术后平均 25 个月时保持 1 级或 2 级。在 59%的病例中，影像学观察到肿瘤在手术野内生长。
在 2 型神经纤维瘤病患者中，积极治疗较小的肿瘤为长期维持可利用听力和获得肿瘤控制提供了机会。在检查听力结果时，除了美国耳鼻喉科学-头颈外科学会听力分级外，使用言语识别率来更好地评估功能更为重要。尽管面神经结果往往较好，但新肿瘤的生长，包括面神经鞘瘤，可能会在手术野内发生。手术后必须进行连续磁共振扫描的随访。
