Rahne T, Plößl S, Plontke S K, Strauss C
Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
Universitätsklinik und Poliklinik für Neurochirurgie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Germany.
HNO. 2018 Jan;66(Suppl 1):16-21. doi: 10.1007/s00106-017-0416-y.
Vestibular schwannoma (VS) is a benign tumor that develops in the internal auditory canal and the cerebellopontine angle, potentially diminishing hearing or balance. Most VS tumors arise from one of two vestibular branches: the superior or inferior vestibular nerve. Determining the specific nerve of origin could improve patient management in terms of preoperative counseling, treatment selection, and surgical decision-making and planning. The aim of this study was to introduce a novel scoring system that was designed to determine the nerve of origin.
The nerve of origin was predicted based on video head impulse assessments of all semicircular channels, together with cervical/ocular vestibular-evoked myogenic potential tests. The acquired data were entered into a scoring system developed to allocate the tumor origin. Finally, the nerve of origin was definitively determined intraoperatively.
The novel scoring system was applied to five consecutive patients undergoing surgical VS treatment. In one case, no determination was possible. In all other cases, the preoperatively predicted tumor origin was the same as the origin determined during surgery.
The scoring system predicts the nerve of origin and will be evaluated in a larger prospective cohort study of VS patients in the near future.
前庭神经鞘瘤（VS）是一种在内耳道和桥小脑角生长的良性肿瘤，可能会损害听力或平衡功能。大多数VS肿瘤起源于两个前庭分支之一：上前庭神经或下前庭神经。确定肿瘤的具体起源神经有助于在术前咨询、治疗选择以及手术决策和规划方面改善患者管理。本研究的目的是引入一种旨在确定起源神经的新型评分系统。
通过对所有半规管进行视频头脉冲评估以及颈/眼前庭诱发肌源性电位测试来预测起源神经。将获取的数据输入到为确定肿瘤起源而开发的评分系统中。最后，在手术中明确确定起源神经。
该新型评分系统应用于连续5例接受VS手术治疗的患者。其中1例无法确定。在所有其他病例中，术前预测的肿瘤起源与手术中确定的起源一致。
该评分系统可预测起源神经，在不久的将来将在更大规模的VS患者前瞻性队列研究中进行评估。
