Impact of Surgery on Long-Term Results of Hearing in Neurofibromatosis Type-2 Associated Vestibular Schwannomas
Impact of Surgery on Long-Term Results of Hearing in Neurofibromatosis Type-2 Associated Vestibular Schwannomas
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DOI：
10.3390/cancers11091376
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发表时间：
2019-09-01
期刊：
影响因子：
5.2
通讯作者：
Schuhmann, Martin Ulrich
中科院分区：
文献类型：
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作者：
Gugel, Isabel;Grimm, Florian;Schuhmann, Martin Ulrich
听力保护是治疗2型神经纤维瘤病(NF2)相关的前庭神经鞘瘤(VS)的主要目标，尤其是在儿童和青少年。在这项研究中，我们回顾了23名25岁以下患者的39个手术肿瘤(耳)的听力和体积测量数据集，并进行了21至167个月的随访。其他20种肿瘤在相容期间的听力数据也包括在内，这些肿瘤由于侵袭性较弱而没有接受手术，以供比较。手术在脑干听觉诱发电位(BAEP)引导下经乙状窦后入路进行。术后即刻，82%的耳保持功能性听力。非手术耳的平均听力得分较好。然而，在术后42个月的随访期内，两组患者的听力评分均逐渐恶化，且动态相似。手术病例听力未见明显加速损害。相反，两条听力衰退线之间的差距在随访期结束时往往会缩小。我们的结果表明，从长远来看，BAEP引导的手术不会导致额外的听力恶化，而且似乎可以减缓那些最初更具侵袭性的肿瘤的听力恶化。
Hearing preservation is a major goal in the treatment of neurofibromatosis type 2 (NF2) associated vestibular schwannoma (VS), particularly in children and adolescents. In this study, we retrospectively reviewed hearing and volumetry data sets of 39 operated tumors (ears) in 23 patients under the age of 25 and in a follow-up period of 21 to 167 months. Hearing data over a compatible period on 20 other tumors, which did not receive surgery due to their less aggressive nature, were included for comparison. Surgery was carried out via a retrosigmoid approach with the brainstem auditory evoked potential (BAEP) guide. Immediately after surgery, functional hearing was maintained in 82% of ears. Average hearing scores were better in the non-surgery ears. However, the hearing scores in both groups worsened gradually with a similar dynamic during the 42-month postoperative follow-up period. No accelerated impairment of hearing was evident for the operated cases. Rather, the gap between the two hearing deterioration lines tended to close at the end of the follow-up period. Our result suggested that the BAEP-guided surgery did not cause additional hearing deterioration in the long-term and seemed to slow down hearing deterioration of those tumors that were initially more aggressive.