小的散发前庭神经鞘瘤的早期手术和确定性治愈。
Early surgery and definitive cure in small sporadic vestibular schwannoma.
机构信息
Department of Neurosciences, Section of Otolaryngology, Azienda Ospedale-Università Padova, Padua, Italy.
Department of Neurosciences, Academic Neurosurgery, University of Padua, Padua, Italy.
出版信息
Acta Otorhinolaryngol Ital. 2022 Oct;42(5):481-486. doi: 10.14639/0392-100X-N2322.
OBJECTIVE
To report surgical outcomes of a cohort of small sporadic vestibular schwannoma and discuss the role of early surgery.
METHODS
Retrospective descriptive analysis of 234 consecutive patients with small vestibular schwannoma operated on with translabyrinthine or hearing preservation surgical approaches. Outcome measures were control of disease, postoperative facial nerve function, complications and hearing outcome.
RESULTS
A translabyrinthine approach was performed in 59% of cases, hearing preservation surgery in 40% and transmeatal approach in 1%, respectively. Complete resection was achieved in 100% of cases. Overall, postoperative major and minor complications were 8.5% in the series, with complete recovery and no sequalae. Facial nerve function at one year postoperatively was House-Brackmann scale (HB) 1-2 in 95% of cases. The rate of hearing preservation was 70% A-B-C classes of Tokyo classification and 77% AB classes of AAOHNS classification.
CONCLUSIONS
Early surgery in small vestibular schwannoma is a valid option, due to good functional outcomes, low morbidity and definitive cure. Early surgery is associated with better outcomes when considered in relation to non-surgical treatments reported in the literature.
目的
报告小散发性前庭神经鞘瘤患者队列的手术结果，并讨论早期手术的作用。
方法
对 234 例连续接受经迷路或听力保护手术的小前庭神经鞘瘤患者进行回顾性描述性分析。结果测量包括疾病控制、术后面神经功能、并发症和听力结果。
结果
经迷路入路占 59%，听力保护手术占 40%，经耳道入路占 1%。100%的病例达到了完全切除。总的来说，该系列的术后主要和次要并发症为 8.5%，完全恢复，无后遗症。术后 1 年面神经功能为 House-Brackmann 量表（HB）1-2 级的占 95%。根据东京分类的 A-B-C 级和 AAOHNS 分类的 AB 级，听力保护率为 70%。
结论
对于小的前庭神经鞘瘤，早期手术是一种有效的选择，因为它具有良好的功能结果、低发病率和明确的治愈率。与文献中报道的非手术治疗相比，早期手术与更好的结果相关。
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