Ogunrinde O K, Lunsford L D, Flickinger J C, Kondziolka D
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pennsylvania.
J Neurosurg. 1994 Jun;80(6):1011-7. doi: 10.3171/jns.1994.80.6.1011.
Twenty patients with acoustic nerve tumors (mean diameter < or = 30 mm) and useful preoperative hearing were examined 2 years after stereotactic radiosurgery to determine the effectiveness of the surgery in the control of tumor growth and the preservation of cranial nerve function. Results showed tumor volume stabilization (12 cases) or reduction (seven cases) was achieved in a total of 19 patients (95%). Useful hearing (defined as Gardner and Robertson Class I or II) preservation was obtained in 100% of cases immediately postoperatively, 50% at 6 months, and 45% at both 1 and 2 years. Two years after stereotactic radiosurgery, facial nerve function was preserved in 90% of patients and 75% continued to have normal trigeminal nerve function. All patients returned to and maintained their preoperative functional status within 3 to 5 days after radiosurgery. These findings indicate that stereotactic radiosurgery with multiple isocenters and narrow radiation beams is a safe and effective management strategy for progressive acoustic nerve tumors. Auditory, facial, and trigeminal nerve function can be preserved in most patients. Prevention of further growth and preservation of cranial nerve function appear to be satisfactory goals in the current management of patients with acoustic neuromas.
对20例听神经瘤患者（平均直径≤30mm）且术前听力尚好者，在立体定向放射外科手术后2年进行检查，以确定该手术在控制肿瘤生长及保留颅神经功能方面的有效性。结果显示，19例患者（95%）实现了肿瘤体积稳定（12例）或缩小（7例）。术后即刻100%的病例保留了有用听力（定义为Gardner和Robertson I级或II级），6个月时为50%，1年和2年时均为45%。立体定向放射外科手术后2年，90%的患者保留了面神经功能，75%的患者三叉神经功能持续正常。所有患者在放射外科手术后3至5天内恢复并维持了术前功能状态。这些发现表明，采用多个等中心和窄辐射束的立体定向放射外科是治疗进展性听神经瘤的一种安全有效的管理策略。大多数患者的听觉、面神经和三叉神经功能可以得到保留。在当前听神经瘤患者的管理中，防止肿瘤进一步生长和保留颅神经功能似乎是令人满意的目标。
