Acoustic neuroma (vestibular schwannoma) therapy from an oto-rhino-laryngological perspective.
Summary of "Acoustic neuroma (vestibular schwannoma) therapy from an oto-rhino-laryngological perspective."
Acoustic neuroma/vestibular schwannoma treatment has changed considerably since the 1990s, when surgical treatment was recommended in all cases of schwannoma, whereas nowadays a more differentiated approach is taken. The three classical approaches (translabyrinthine, transtemporal, and suboccipital) still have their surgical value; however, greater importance is apportioned to radiotherapy (radiosurgery, gamma- and cyber-knife). Magnetic resonance imaging in particular has changed diagnostics and how tumor growth is followed. Electrophysiological monitoring of facial and auditory nerves has helped lower postoperative morbidity. New issues have been raised regarding quality of life. Neuropsychological investigations for cognitive and mnestic performance following procedures in the cerebellopontine angle have highlighted problem areas receiving hitherto little attention. Finally, the therapy of this benign lesion should be planned individually, taking the patient's age as well as their professional and personal status into consideration.
Affiliation
Klinik für Hals-Nasen-Ohren-Krankheiten, Kopf-, Hals- und Plastische Gesichtschirurgie, Klinikum Fulda gAG, Akademisches Lehrkrankenhaus der Philipps-Universität Marburg, Pacelliallee 4, 36043, Fulda, Deutschland, k.schwager@klinikum-fulda.de.
Journal Details
This article was published in the following journal.
Name: HNO
ISSN: 1433-0458
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21069273
- DOI: http://dx.doi.org/10.1007/s00106-010-2190-y
Medical and Biotech [MESH] Definitions
Neuroma, Acoustic
A benign SCHWANNOMA of the eighth cranial nerve (VESTIBULOCOCHLEAR NERVE), mostly arising from the vestibular branch (VESTIBULAR NERVE) during the fifth or sixth decade of life. Clinical manifestations include HEARING LOSS; HEADACHE; VERTIGO; TINNITUS; and FACIAL PAIN. Bilateral acoustic neuromas are associated with NEUROFIBROMATOSIS 2. (From Adams et al., Principles of Neurology, 6th ed, p673)
Vestibulocochlear Nerve Diseases
Pathological processes of the VESTIBULOCOCHLEAR NERVE, including the branches of COCHLEAR NERVE and VESTIBULAR NERVE. Common examples are VESTIBULAR NEURITIS, cochlear neuritis, and ACOUSTIC NEUROMA. Clinical signs are varying degree of HEARING LOSS; VERTIGO; and TINNITUS.
Ear
The hearing and equilibrium system of the body. It consists of three parts: the EXTERNAL EAR, the MIDDLE EAR, and the INNER EAR. Sound waves are transmitted through this organ where vibration is transduced to nerve signals that pass through the ACOUSTIC NERVE to the CENTRAL NERVOUS SYSTEM. The inner ear also contains the vestibular organ that maintains equilibrium by transducing signals to the VESTIBULAR NERVE.
Saccule And Utricle
Two membranous sacs within the vestibular labyrinth of the INNER EAR. The saccule communicates with COCHLEAR DUCT through the ductus reuniens, and communicates with utricle through the utriculosaccular duct from which the ENDOLYMPHATIC DUCT arises. The utricle and saccule have sensory areas (acoustic maculae) which are innervated by the VESTIBULAR NERVE.
Hair Cells, Vestibular
Sensory cells in the acoustic maculae with their apical stereocilia embedded in a gelatinous OTOLITHIC MEMBRANE. These hair cells are stimulated by the movement of otolithic membrane, and impulses are transmitted via the VESTIBULAR NERVE to the BRAIN STEM. Hair cells in the saccule and those in the utricle sense linear acceleration in vertical and horizontal directions, respectively.
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