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[听神经瘤术后复发的评估]

[Evaluation of the postoperative regrowth of the acoustic neurinomas].

作者信息

Tani S, Shinoda S, Koyama T, Tanaka H, Hashimoto T, Nakamura N, Abe T

机构信息

Department of Neurosurgery, Jikei University School of Medicine.

出版信息

No Shinkei Geka. 1993 Oct;21(10):909-13.

PMID:8413804
Abstract

Although recent advances in microsurgical removal of acoustic neurinomas has made it possible to preserve, morphologically, the cochlear nerve as well as the facial nerve, functional impairment of the facial nerve is often encountered following total removal of the tumor. In order to avoid such functional morbidity, a surgical procedure can be proposed in which the tumoral capsule attached to a functional structure such as the facial nerve is intentionally left. Along with this surgical procedure and postoperative course observation, postoperative regrowth of the tumor should be precisely evaluated. A few recent reports about this problem have been published since CT scan and MRI have become available. The authors reviewed 66 cases in which postoperative evaluation by high resolution CT scan of the acoustic neurinomas has been carried out in their department more than one year after surgery. Multiple factors such as age at onset, sex, preoperative period, tumor size, vascularity, extent of the tumor removal, residual site, and pathological findings on HE stain were studied in relation to the tumor regrowth. Four cases showed regrowth of the tumor, and one of these tumors was reoperated on. The percentage of regrowth was 7.5% among the tumors which were not totally removed. No significant risk factors for tumor regrowth were noticed in these cases, but tumor regrowth tended to be found in younger patients. The residual tumors which showed regrowth were always located in the internal auditory meatus. In this study, it is apparent that, percentagewise, tumor regrowth is not so prevalent.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

尽管近年来显微外科切除听神经瘤取得了进展,使得在形态上保留蜗神经和面神经成为可能,但在肿瘤全切后仍经常出现面神经功能障碍。为避免此类功能损害,可提出一种手术方法,即有意保留附着于面神经等功能结构的肿瘤包膜。随着这种手术方法及术后病程观察,应精确评估肿瘤的术后再生长情况。自从CT扫描和MRI问世以来,最近已有几篇关于此问题的报道发表。作者回顾了66例在其科室接受听神经瘤手术一年多后通过高分辨率CT扫描进行术后评估的病例。研究了多个因素,包括发病年龄、性别、术前病程、肿瘤大小、血管分布、肿瘤切除范围、残留部位以及HE染色的病理结果与肿瘤再生长的关系。有4例出现肿瘤再生长,其中1例再次手术。在未完全切除的肿瘤中,再生长的比例为7.5%。在这些病例中未发现肿瘤再生长的显著危险因素,但肿瘤再生长倾向于在年轻患者中出现。出现再生长的残留肿瘤总是位于内听道。在本研究中,显然从百分比来看,肿瘤再生长并不那么普遍。(摘要截选至250词)

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