González-Orús Álvarez-Morujo Ricardo José, Alvarez-Palacios Itziar, Martin-Oviedo Carlos, Scola-Yurrita Bartolomé, Arístegui-Ruiz Miguel Ángel
Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España.
Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España.
Acta Otorrinolaringol Esp. 2014 Sep-Oct;65(5):275-82. doi: 10.1016/j.otorri.2014.01.002. Epub 2014 Jun 13.
Vestibular schwannoma (VS) is a benign, slow-growing tumour originating in the 8th cranial nerve. The treatment includes microsurgery, stereotactic radiotherapy and conservative management of tumours with periodic radiological tests.
This was a retrospective study of patients with VS following conservative management in a tertiary hospital between 1993 and 2013. A total of 73 patients were enrolled in our protocol. The mean age at diagnosis was 59.7 years. The average size was 11.9mm (4-27mm); 58.9% of the tumours were intracanalicular and 41.1%, extracanalicular. The mean follow-up period was 35.75 months.
In 87.7% of patients there was no evidence of tumour growth. A total of 9 tumours (12.3%) increased in size. The average growth rate was 0.62mm/year. The percentage of extracanalicular tumours that grew (20%) was higher than that of intracanalicular tumours (7%). Seven patients (9.5%) experienced significant changes in their symptoms and 6 of these (8.2%) experienced a loss of useful hearing. Six patients (8.2%) left follow-up and underwent surgery.
Periodic monitoring of vestibular schwannomas with magnetic resonance imaging represents an option for management, because most small tumours experience little or no growth over time.
前庭神经鞘瘤（VS）是一种起源于第8颅神经的良性、生长缓慢的肿瘤。治疗方法包括显微手术、立体定向放射治疗以及通过定期影像学检查对肿瘤进行保守治疗。
这是一项对1993年至2013年在一家三级医院接受保守治疗的VS患者的回顾性研究。共有73例患者纳入我们的研究方案。诊断时的平均年龄为59.7岁。平均大小为11.9毫米（4 - 27毫米）；58.9%的肿瘤位于内听道内，41.1%位于内听道外。平均随访期为35.75个月。
87.7%的患者没有肿瘤生长的证据。共有9个肿瘤（12.3%）增大。平均生长速率为0.62毫米/年。内听道外肿瘤生长的百分比（20%）高于内听道内肿瘤（7%）。7例患者（9.5%）症状出现显著变化，其中6例（8.2%）有用听力丧失。6例患者（8.2%）中断随访并接受了手术。
通过磁共振成像定期监测前庭神经鞘瘤是一种治疗选择，因为大多数小肿瘤随着时间推移生长很少或不生长。
