Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
Dow University of Health and Sciences, Karachi, Pakistan.
J Pak Med Assoc. 2024 Mar;74(3 (Supple-3)):S109-S115. doi: 10.47391/JPMA.S3.GNO-13.
Vestibular Schwannoma (VS), previously known as acoustic neuroma, constitutes the majority of tumours found in the cerebellopontine angle (CPA). Most guidelines for managing CPA tumours have been developed by high-income countries (HICs). However, these guidelines often fall short in addressing the unique challenges encountered in low- and middle-income countries (LMICs), such as Pakistan. In LMICs, issues related to a limited healthcare workforce, inadequate infrastructure, and constrained financial resources hinder the effective implementation of these HIC-derived guidelines. Additionally, it has been observed that VS tends to present at a larger size in LMICs compared to HICs. Given that VS is the predominant type of CPA tumour and other types are covered under separate guidelines, this article aims to provide practical, contextspecific recommendations for the screening, diagnosis, and management of Vestibular Schwannoma in LMIC settings. Our focus is to bridge the gap in care strategies and adapt them to the resource constraints and clinical realities of LMICs.
前庭神经鞘瘤（VS），以前称为听神经瘤，是桥小脑角（CPA）中最常见的肿瘤。大多数管理 CPA 肿瘤的指南都是由高收入国家（HIC）制定的。然而，这些指南在解决低收入和中等收入国家（LMIC）中遇到的独特挑战方面往往存在不足，例如巴基斯坦。在 LMIC 中，与医疗保健劳动力有限、基础设施不足和财政资源有限相关的问题阻碍了这些源自 HIC 的指南的有效实施。此外，已经观察到 VS 在 LMIC 中比 HIC 中更倾向于呈现更大的尺寸。鉴于 VS 是 CPA 肿瘤的主要类型，而其他类型则涵盖在单独的指南下，本文旨在为 LMIC 环境中的前庭神经鞘瘤的筛查、诊断和管理提供实用的、具体情况的建议。我们的重点是弥合护理策略方面的差距，并将其调整为 LMIC 的资源限制和临床现实。
