小听神经瘤听力保留手术的预后因素
Prognostic Factors for Hearing Preservation Surgery in Small Vestibular Schwannoma.
作者信息
Concheri Stefano, Deretti Alessandra, Tealdo Giulia, Zanoletti Elisabetta
机构信息
Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padova, 35128 Padova, Italy.
出版信息
Audiol Res. 2023 Jul 3;13(4):473-483. doi: 10.3390/audiolres13040042.
OBJECTIVE
to evaluate recent contributions to the literature on prognostic factors of hearing preservation in small vestibular schwannoma microsurgery.
METHODS
review of the most recent studies.
RESULTS
factors such as tumor size, preoperative hearing status, tumor growth rate, tumor origin, surgical approach, radiological characteristics, results of preoperative neurophysiological tests, preoperative symptoms and demographic features have been investigated and some of them reported to be significant in the prediction of hearing preservation.
CONCLUSIONS
tumor size and preoperative hearing status are the most impactful factors and play a key role in patient selection for hearing preservation surgery. Other features such as fundal extension, tumor origin and impaired ABR could have prognostic value on hearing preservation. Tumor growth rate, preoperative impedance, cVEMPs and age have also recently been found to be significant, but more studies are needed. The role of preoperative tinnitus, vertigo and gender is lacking and controversial, whereas the differences between available surgical approaches have been smoothed out in recent years.
目的
评估近期关于小型前庭神经鞘瘤显微手术听力保留预后因素的文献贡献。
方法
回顾最近的研究。
结果
已对肿瘤大小、术前听力状况、肿瘤生长速率、肿瘤起源、手术入路、放射学特征、术前神经生理学测试结果、术前症状和人口统计学特征等因素进行了研究，其中一些因素据报道在听力保留预测中具有重要意义。
结论
肿瘤大小和术前听力状况是最具影响力的因素，在听力保留手术的患者选择中起关键作用。其他特征如基底扩展、肿瘤起源和听觉脑干反应受损可能对听力保留具有预后价值。肿瘤生长速率、术前阻抗、颈肌前庭诱发肌源性电位和年龄最近也被发现具有重要意义，但还需要更多研究。术前耳鸣、眩晕和性别的作用尚不明确且存在争议，而近年来现有手术入路之间的差异已趋于平缓。
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