Rosenberg S I, Silverstein H, Gordon M A, Flanzer J M, Willcox T O, Silverstein J
Ear Research Foundation, Sarasota, FL 34239.
Otolaryngol Head Neck Surg. 1993 Sep;109(3 Pt 1):482-7. doi: 10.1177/019459989310900316.
A conservative approach to the management of acoustic neuromas in elderly patients has been used since 1971. Elderly patients without symptoms of brain stem compression are initially treated by observation and yearly radiographic imaging. A translabyrinthine radical-subtotal resection is performed if brain stem compression is present or if tumor is growing rapidly. Twenty-three patients, ages 65 to 86 years, had initial nonsurgical management of their tumors. Growth rates could be determined for 16 patients. Thirteen patients not requiring surgery had an average tumor growth rate of 0.6 mm/yr. Three patients with an average growth rate of 6.8 mm/yr eventually required surgery. No patient whose tumor was < 15 mm at initial evaluation has experienced brain stem symptoms or demonstrated rapid tumor growth. Twenty-four patients ages 65 to 86 years underwent planned subtotal tumor excision. Eighteen patients followed postoperatively for more than 1 year demonstrated an average rate of regrowth of tumor of 0.7 mm/yr.
自1971年以来，对于老年听神经瘤患者一直采用保守的治疗方法。没有脑干受压症状的老年患者最初采用观察和每年进行影像学检查的方式进行治疗。如果出现脑干受压或肿瘤快速生长，则进行经迷路根治性次全切除术。23名年龄在65至86岁之间的患者最初对其肿瘤进行了非手术治疗。可以确定16名患者的肿瘤生长速度。13名不需要手术的患者肿瘤平均生长速度为每年0.6毫米。3名平均生长速度为每年6.8毫米的患者最终需要进行手术。初次评估时肿瘤<15毫米的患者均未出现脑干症状或肿瘤快速生长的情况。24名年龄在65至86岁之间的患者接受了计划性肿瘤次全切除术。18名术后随访超过1年的患者肿瘤平均复发率为每年0.7毫米。
