Strasnick B, Glasscock M E, Haynes D, McMenomey S O, Minor L B
Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk 23507.
Laryngoscope. 1994 Sep;104(9):1115-9. doi: 10.1288/00005537-199409000-00011.
The emergence of magnetic resonance imaging with gadolinium has dramatically enhanced our ability to accurately detect the presence of acoustic tumors as small as 2 mm in diameter. Early diagnosis and improved surgical techniques continue to reduce the morbidity associated with surgical removal of these lesions. There exists, however, a select group of patients in whom no treatment may be the most appropriate management. Since 1979, a total of 51 patients with radiographic evidence of an acoustic neuroma have been prospectively followed for tumor growth and progression of symptoms. Patients were chosen for this conservative approach on the basis of age, medical condition, tumor size, audiometric data, and patient preference. This study reveals that a significant number of patients with acoustic tumors can be safely followed with regular imaging studies and may never require treatment. Discussed are tumor growth rates, epidemiology, and the impact of these factors on patient management.
钆增强磁共振成像的出现极大地提高了我们准确检测直径小至2毫米的听神经瘤的能力。早期诊断和改进的手术技术继续降低与手术切除这些病变相关的发病率。然而，有一部分特定的患者，不进行治疗可能是最合适的处理方式。自1979年以来，共有51例有听神经瘤影像学证据的患者被前瞻性地随访观察肿瘤生长及症状进展情况。根据年龄、身体状况、肿瘤大小、听力测定数据和患者偏好，选择患者采用这种保守方法。这项研究表明，相当数量的听神经瘤患者可以通过定期影像学检查安全地随访观察，可能永远不需要治疗。文中讨论了肿瘤生长速度、流行病学以及这些因素对患者管理的影响。
