Kaiser Permanente-Southern California, San Diego, 5893 Copley Drive, San Diego, CA 92111, USA.
Otolaryngol Clin North Am. 2023 Jun;56(3):521-531. doi: 10.1016/j.otc.2023.02.011. Epub 2023 Apr 3.
Stereotactic radiosurgery (SRS) is a valid option for most patients undergoing treatment of small- and medium-sized vestibular schwannoma. Predictors of hearing preservation are the same for observation or surgery: when pretreatment hearing is normal, the tumor is smaller, and when a cerebrospinal fluid fundal cap exists. Hearing outcomes are poor when hearing loss exists pre-treatment. Rates of facial and trigeminal neuropathy are higher post-treatment after fractionated plans than single-fraction SRS. Subtotal resection and adjuvant radiation appears to offer patients with large tumors optimal outcomes for hearing, tumor control, and cranial nerve function versus gross total resection.
立体定向放射外科（SRS）是大多数接受小和中型前庭神经鞘瘤治疗的患者的有效选择。听力保护的预测因素对于观察或手术相同：当预处理听力正常时，肿瘤较小，并且当存在脑脊液眼底帽时。当预处理存在听力损失时，听力结果较差。与单次 SRS 相比，分割计划治疗后面部和三叉神经神经病的发生率更高。与全切除相比，次全切除和辅助放疗似乎为大型肿瘤患者提供了最佳的听力、肿瘤控制和颅神经功能结果。
