Dornhoffer J L, Helms J, Hoehmann D H
Department of Otolaryngology, Julius-Maximilians University, Wuerzburg, Germany.
Otolaryngol Head Neck Surg. 1994 Sep;111(3 Pt 1):232-5. doi: 10.1177/01945998941113P111.
With the recent advent of magnetic resonance imaging and auditory brain stem response, it is now possible to diagnose acoustic tumors while they are still quite small. As a result, it is becoming obvious that the clinical presentation of these smaller lesions can be somewhat variant to what is considered typical for an acoustic neuroma. Likewise, although the sensitivity of auditory brain stem response for larger tumors is believed to be quite good, the sensitivity for smaller tumors has recently been questioned, particularly when the patient is first seen early in the course of the disease with only mild otologic complications. To assess auditory brain stem response results as well as clinical and audiologic presentations, we conducted a retrospective study of patients treated for small acoustic tumors (less than 1 cm). Of the 70 patients included in the study, auditory brain stem response was abnormal in 65 (93%), on the basis of wave V latency prolongation and interaural latency differences. This would indicate that auditory brain stem response is a valid screening test for acoustic tumors, even in early stages of development. The clinical presentation of patients with small acoustic tumors was similar to that reported for acoustic tumors in general, but with vertigo occurring more frequently in patients with smaller tumors. Several atypical patterns of hearing loss were also noted.
随着磁共振成像和听性脑干反应技术的近期出现，现在在听神经瘤还相当小时就能对其进行诊断。因此，越来越明显的是，这些较小病变的临床表现可能与通常认为的听神经瘤典型表现有所不同。同样，尽管人们认为听性脑干反应对较大肿瘤的敏感性相当高，但最近对较小肿瘤的敏感性提出了质疑，尤其是当患者在疾病早期首次就诊时仅伴有轻度耳科并发症的情况下。为了评估听性脑干反应结果以及临床和听力学表现，我们对治疗小型听神经瘤（小于1厘米）的患者进行了一项回顾性研究。在纳入研究的70例患者中，基于V波潜伏期延长和双耳潜伏期差异，65例（93%）的听性脑干反应异常。这表明听性脑干反应即使在听神经瘤的早期阶段也是一种有效的筛查测试。小型听神经瘤患者的临床表现与一般报道的听神经瘤相似，但较小肿瘤患者眩晕的发生率更高。还注意到了几种非典型的听力损失模式。
