Ebner F H, Tatagiba M
Klinik für Neurochirurgie, Alfried Krupp Krankenhaus Essen, Alfried Krupp Straßen 21, 45131, Essen, Deutschland.
Klinik für Neurochirurgie, Universitätsklinikum Tübingen, Tübingen, Deutschland.
Nervenarzt. 2019 Jun;90(6):578-586. doi: 10.1007/s00115-019-0721-7.
Vestibular schwannomas are primary benign tumors of the cerebellopontine angle originating either from the superior or the inferior vestibular nerve. Hearing deterioration is the leading symptom, which is why the widespread name for this tumor is acoustic neuroma. Due to the widespread availability of magnetic resonance imaging (MRI), the diagnosis of vestibular schwannoma is frequently made in an early stage of the disease. In these cases a wait and scan policy is recommended. If the tumor grows, the therapeutic options are stereotactic radiotherapy or microsurgical tumor operation. Young patient age, functional hearing ability, persistent dizziness, cystic tumor consistence and large space-occupying tumor size are in favor of surgery via the retrosigmoid, transmeatal approach. In experienced hands excellent results in terms of functional preservation of the facial nerve and the cochlear nerve and radical tumor resection can be obtained.
前庭神经鞘瘤是桥小脑角的原发性良性肿瘤，起源于前庭上神经或前庭下神经。听力减退是主要症状，这就是该肿瘤普遍被称为听神经瘤的原因。由于磁共振成像（MRI）的广泛应用，前庭神经鞘瘤常在疾病早期被诊断出来。在这些情况下，建议采取观察与扫描策略。如果肿瘤生长，治疗选择包括立体定向放射治疗或显微手术肿瘤切除。年轻患者、有功能性听力、持续性头晕、囊性肿瘤质地以及较大的占位性肿瘤大小有利于采用乙状窦后经耳道入路进行手术。在经验丰富的医生手中，可以在保留面神经和蜗神经功能以及彻底切除肿瘤方面取得优异成果。
