Complicaciones y secuelas en la cirugía de los neurinomas del acústico. Complications and El Texto completo solo está disponible en PDF. Bibliografía . [1.]. Se realiza un estudio retrospectivo de pacientes afectos de neurinomas del acústico, a los que se practicó resección microquirúrgica de la lesión entre. El neurinoma del acústico es uno de los tumores intracraneales más frecuentes ( %, según algunas series) y constituye el 90% de los tumores del ángulo.
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Request PDF on ResearchGate | Complicaciones y secuelas en la cirugía de los neurinomas del acústico | Objective To evaluate the complications and. El schwannoma vestibular es un tumor benigno que se origina de las células formadoras de mielina del VIII par craneal. (vestibulococlear). Arriaga MA: Preservación de la audición en neurinomas del nervio acústico. Arriaga MA: Diagnostico y Manejo de los Neurinomas del Acústico in.
Determining which treatment to choose involves consideration of many factors including the size of the tumor, its location, the patient's age, physical health and current symptoms.
Hearing loss is both a symptom and concomitant risk, regardless of the treatment option chosen. Treatment does not restore hearing already lost, though there are a few rare cases of hearing recovery reported. A diagnosis of NF2 related bilateral acoustic neuromas creates the possibility of complete deafness if the tumors are left to grow unchecked.
Preventing or treating the complete deafness that may befall individuals with NF2 requires complex decision making. The trend at most academic U.
If this goal is successful, then treatment can also be offered for the remaining tumor. If hearing is not preserved at the initial treatment, then usually the second tumor, in the only-hearing ear, is just observed. If it shows continued growth and becomes life-threatening, or if the hearing is lost over time as the tumor grows, then treatment is undertaken.
This strategy has the highest chance of preserving hearing for the longest time possible. When a small tumor is discovered in an older patient, observation to determine the growth rate of the tumor may be indicated if serious symptoms are not present. There is now good evidence from large observational studies that suggest many small tumors in older individuals do not grow, thus allowing tumors with no growth to be observed successfully.
If the tumor grows, treatment may become necessary.
Another example of a group of patients for whom observation may be indicated includes patients with a tumor in their only hearing or better hearing ear, particularly when the tumor is of a size that hearing preservation with treatment would be unlikely. In this group of patients, MRI is used to follow the growth pattern.
Treatment is recommended if either the hearing is lost or the tumor size becomes life-threatening, thus allowing the patient to retain hearing for as long as possible.
Preservation of hearing is an important goal for patients who present with functional hearing. Many tumors can be entirely removed by surgery. Microsurgical techniques and instruments, along with the operating microscope, have greatly reduced the surgical risks of total tumor removal.
Subtotal removal is indicated when anything further risks life or neurological function. If the residual grows further, treatment will likely be required.
Periodic MRI studies are important to follow the potential growth rate of any tumor. Near total tumor removal is used when small areas of the tumor are so adherent to the facial nerve that total removal would result in facial weakness.
The approach used for each individual person is based on several factors such as tumor size, location, skill and experience of the surgeon, and whether hearing preservation is a goal.
Each of the surgical approaches has advantages and disadvantages in terms of ease of tumor removal, likelihood of preservation of facial nerve function and hearing, and post-operative complications. The incision for this approach is located behind the ear and allows excellent exposure of the internal auditory canal and tumor.
Since the incision goes directly through the inner ear, this results in permanent and complete hearing loss in that ear. Many patients with medium to large ANs have no functional hearing in the ear anyway, so this may not be an issue. Auris, nasus, larynx ; 24 3 : Sudden Deafness. Bethesda, MD. Systematic review of the evidence for the etiology of adult sudden sensorineural hearing loss.
The Laryngoscope ; 5 : Correa A, Pacheco A. Viral and epidemiologic studies of idiopathic sudden hearing loss. The Journal of Pediatrics ; 4 : Immune-mediated disorders associated with idiopathic sudden sensorineural hearing loss. The Annals of Otology, Rhinology, and Laryngology ; 6 : Increased frequencies of cochlin-specific T cells in patients with autoimmune sensorineural hearing loss.
Journal of Immunology ; 6 : Schindler A, Cesana BM, et al. Genetic and acquired prothrombotic risk factors and sudden hearing loss. The Laryngoscope ; 3 : Role of genetic and acquired prothrombotic risk factors in genesis of sudden sensorineural hearing loss. Acoustic trauma and cochlear microcirculation. An experimental and clinical study on pathogenesis and treatment of inner ear lesions after acute noise exposure. Advances in Oto-Rhino-Laryngology ; Differential vestibular dysfunction in sudden unilateral hearing loss.
Neurology ; 64 1 : Differential diagnosis and treatment of hearing loss. American Family Physician ; 68 6 : Sudden sensorlneural Hearing loss as a revealing symptom of vestibular Schwannoma. Acta Otolaryngol ; Reiss M, Reiss G. Praxis; 89 6 : Zur Differential diagnose der ein seitigen Schwerhorigkeit. Appropriateness of magnetic resonance imaging in sudden sensorineural hearing loss.
Causes of unilateral sensorineural hearing loss screened by highresolution fast spin echo magnetic resonance imaging: review of 1, consecutive cases. The American Journal of Otology ; 21 2 : Steroids, carbogen or placebo for sudden hearing loss: a prospective double-blind study. Oral steroid treatment of sudden sensorineural hearing loss: a ten year retrospective analysis. Long-term results of intratympanic prednisolone injection in patients with idiopathic sudden sensorineural hearing loss.
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Bethesda, MD. Acyclovir in the treatment of idiopathic sudden sensorineural hearing loss. Journal of Immunology ; 6 : The Consensus Development Panel. Guillain, G. The Acoustic Neuroma Association ANA does recommend that frequent cellular phone users use a hands free device to enable separation of the device from the head. Seuk Ky Kim, and M. Springfield, Ill.
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