Preoperative and Postoperative Growth Rates in Acoustic Neuromas Documented with CT Scanning

Abstract

Sequential computerized tomography (CT) allows us to determine the growth rate of acoustic neuromas. Prior to CT scanning, a variability in tumor growth rates was recognized on the basis of clinical signs. After incomplete tumor removal, some patients experienced rapid recurrence, whereas others lived many years without recurrence. We used CT scanning to study tumor growth rates in a heterogeneous group of 21 patients. Thirteen elderly patients were given annual scans after incomplete tumor removal, while eight patients who had not had surgery are likewise being followed up. Early detection and complete tumor removal with preservation of hearing and facial function remain the goal in vigorous and healthy patients. However, a large number of older, infirm patients with acoustic neuromas may not require surgery or be candidates for incomplete tumor removal. Because rapid tumor growth may necessitate total tumor removal even in older patients, a better understanding of the growth rates may permit us to take a more scientific approach in planning these patients' management.

Long-term follow-up of the residual intracanalicular tumours after subtotal removal of acoustic neurinomas

“…The growth rate appears to be different before and after surgery [12]. Silverstein et al [10], have reported that 80% of the patients who underwent subtotal removal, show no postoperative growth.…”

“…Several reports on the growth rate of AN have demonstrated slow growth prior to surgery [9,10,12]. The growth rate appears to be different before and after surgery [12].…”

“…Besides the age of the patient [9,10,12], size of the tumour [1][2][3] and yon Recklinghausen's disease [3], cellularity and vascularity are histopathological factors affecting growth rate. Small or intracanalicular tumours have slower growth [2,3].…”

Calidad de vida tras la cirugía del schwannoma vestibular

“…La pérdida de asociación entre tamaño tumoral y mejores resultados de CV, la dificultad para establecer el tamaño tumoral que es suficiente para amenazar la vida del paciente o justificar una cirugía, el conocimiento de que algunos tumores permanecen estáticos o presentan ritmos de crecimiento muy lentos [104][105][106] , y nuestro actual hallazgo de una relación débil pero inversa entre la CV y el tamaño tumoral, implica que la elección del tratamiento quirúrgico frente a otras opciones y establecer el momento para llevarlo a cabo, se convierta en un desafío. Además, nos obliga a no asumir de forma categórica, y a desechar la idea tradicional de que pacientes intervenidos con tumores más pequeños verán afectada su CV en menor grado que aquellos con tumores grandes.…”

Associação entre tamanho e potencial proliferativo em neurinomas do acústico

“…Geralmente tem cre s c i m e n t o lento, em média 1 a 5 mm por ano, e se originam na bainha do nervo vestibular perto da junção mielinoglial, próximo ao poro acústico interno. São tumore s bem circunscritos e encapsulados por epineuro [2][3][4] . Atualmente, a ressonância magnética (RM) e tomografia computadorizada (TC) são inadequadas para prever crescimento tumoral a não ser quando feitas de maneira seriada.…”