Selesnick S H, Jackler R K, Pitts L W
Department of Otolaryngology, University of California, San Francisco.
Laryngoscope. 1993 Apr;103(4 Pt 1):431-6. doi: 10.1002/lary.5541030412.
The application of magnetic resonance imaging (MRI) scanning in the diagnosis of acoustic neuroma (AN) has increased the relative incidence of smaller tumors and has impacted on the typical clinical presentation of AN patients. The charts of 126 patients treated at the University of California, San Francisco for newly diagnosed AN from 1986 to 1990 were reviewed. Twenty-four percent of tumors fell into the smallest size category (< 1 cm); this was a substantial improvement over earlier series. However, 16% of tumors remained undiagnosed until they achieved large size (> 3 cm). The incidence of hearing loss, dysequilibrium, headache, facial numbness, and diplopia all increased with increasing tumor size, while the incidence of vertigo decreased. Diagnosticians should not overemphasize "typical" symptom complexes, as substantial variability in clinical manifestations exists. An improved awareness by clinicians of the variability of AN presentation will improve diagnostic efficiency and continue the trend toward earlier diagnosis of these lesions.
磁共振成像（MRI）扫描在听神经瘤（AN）诊断中的应用增加了较小肿瘤的相对发病率，并对AN患者的典型临床表现产生了影响。回顾了1986年至1990年在加利福尼亚大学旧金山分校接受治疗的126例新诊断AN患者的病历。24%的肿瘤属于最小尺寸类别（<1 cm）；与早期系列相比，这有了显著改善。然而，16%的肿瘤在达到大尺寸（>3 cm）之前仍未被诊断出来。听力损失、平衡失调、头痛、面部麻木和复视的发生率均随肿瘤尺寸的增加而增加，而眩晕的发生率则下降。诊断医生不应过度强调“典型”症状组合，因为临床表现存在很大差异。临床医生提高对AN表现变异性的认识将提高诊断效率，并延续这些病变早期诊断的趋势。
