Vestibularisschwannome – ein Update zu Krankheitsbild und mikrochirurgischer Behandlung

Ebner, Florian; Tatagiba, Marcos

doi:10.1007/s00115-019-0721-7

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…Total surgical removal of the tumor is usually providing a definite cure (4, 5). Concurrently, VS surgery implies an increased risk of additional harm to the CN (e.g., facial palsy) (5)(6)(7)(8)(9)(10). Observation or radiosurgery are further treatment strategies and in recent years complete VS resection has been discouraged in large VS (11).…”

Section: Introductionmentioning

confidence: 99%

“…The underlying rationale for this recommendation is to preserve CN function and QoL assuming a linear relationship between them. In fact, several studies report a deterioration of QoL by VS surgery (12)(13)(14) relating to hearing, vestibular and facial function (6)(7)(8). Radiosurgery or observation has been suggested to affect CN function and QoL to a lesser extent.…”

Section: Introductionmentioning

confidence: 99%

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Trading mental and physical health in vestibular schwannoma treatment decision

et al. 2023

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ObjectiveObservation, radiotherapy and surgery are treatment options in vestibular schwannomas (VS). Decision making differs between centers and is usually based on tumor characteristics (e.g., size) and the expected physical health (PH) outcome (i.e., hearing and facial function). However, mental health (MH) is often under-reported. The objective of the present study was to ascertain the impact of VS treatment on PH and MH.MethodsPH and MH were assessed in a prospective cross-sectional study including 226 patients with unilateral sporadic VS before and after surgical removal (SURG). Quality-of-life (QoL) was estimated by self-rating questionnaires: general Short-Form Health Survey (SF-36), Penn Acoustic Neuroma Quality-of-Life Scale (PANQOL), Dizziness Handicap Inventory (DHI), Hearing Handicap Inventory (HHI), Tinnitus Handicap Inventory (THI), and Facial Disability Index (FDI). QoL changes over time as well as predictive factors were accessed by multivariate analyses of covariance (MANCOVA).ResultsIn total, 173 preoperative and 80 postoperative questionnaires were analyzed. There was a significant PH deterioration related to facial function (FDI, PANQOL-face) after surgery. In line with facial rehabilitation, however, FDI improved within the first five years after surgery and did not differ compared to the preoperative patient cohort, eventually. In contrast, MH (i.e., PANQOL-anxiety) and general health (i.e., PANQOL-GH) improved with surgery and correlated with the extent-of-resection.ConclusionPhysical and mental health is significantly influenced by VS surgery. While PH might decrease after surgery, MH potentially increases when patient is cured. Practitioners should take MH into account before advising an incompletely VS treatment (e.g., subtotal resection, observation or radiosurgery).

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trading mental and physical health in vestibular schwannoma treatment decision

et al. 2023

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“…8,9 Clinical presentation is most associated with hearing deficits due to anatomic origin. 11 In advanced tumors, patients may present with ipsilateral hearing loss, hydrocephalus, hypesthesia, and brainstem compression ultimately leading to death. However, modern imaging and operative advancements have made tumors in the this area easier to diagnose and treat.…”

Section: Introductionmentioning

confidence: 99%

“…8 Surgical intervention is indicated in cases of tumor growth in patients with low surgical risk (i.e., young age) and decreased quality of life that will be ameliorated with intervention. 11 The retrosigmoid transmeatal approach is utilized with favorable outcomes with experienced surgeons. 11,12 The retrosigmoid approach was classically associated with a postoperative cerebrospinal fluid (CSF) leak rate of 2 to 10% potentially due to the pneumatization of the petrous apex air cells; however, reconstructive techniques such as fat obliteration, cranioplasty, and eustachian tube packing have reduced the incidence of such CSF leakage complications.…”

Section: Introductionmentioning

confidence: 99%

“…11 The retrosigmoid transmeatal approach is utilized with favorable outcomes with experienced surgeons. 11,12 The retrosigmoid approach was classically associated with a postoperative cerebrospinal fluid (CSF) leak rate of 2 to 10% potentially due to the pneumatization of the petrous apex air cells; however, reconstructive techniques such as fat obliteration, cranioplasty, and eustachian tube packing have reduced the incidence of such CSF leakage complications. 13 PitNETs that have no direct connection to the normal pituitary gland and reside outside the sella turcica are called ectopic PitNETs.…”

Section: Introductionmentioning

confidence: 99%

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High-Grade Ectopic Pituitary Adenoma within the Cerebellopontine Angle: A Case Report

et al. 2023

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Ectopic pituitary tumors are neoplasms with no connection to the pituitary gland and are commonly deposited in other areas of the anterior skull base. A 32-year-old female presented with a three-month history of right sided facial weakness, sensorineural hearing loss, diplopia, and severe headaches. Physical examination revealed a mid-dilated sluggishly reactive right pupil with slight limitation in all gazes, as well as right-sided orbicularis weakness, lagophthalmos, and decreased facial sensation. An MRI of the head without contrast revealed a 3.7 x 1.8 x 2.6 cm mildly enhancing mass in the right internal acoustic meatus and along the petrous ridge. The case was brought before the institution’s tumor board, where concern for higher grade pathology, such as hemangiopericytoma, was discussed. Per patient preference, surgical biopsy of the tumor was performed. Immunohistochemical staining revealed a WHO grade II neuroendocrine tumor, with cells staining positive for synaptophysin, chromogranin, and CD56, with a Ki-67 index of 8%. In addition to the ectopic location, this pituitary tumor was noted to be aggressive in nature based on its high Ki-67 index. Surgical excision or radiologic therapy of tumors involving the CPA are appropriate treatments in most cases.

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46/w mit Schwindel und progredienter einseitiger Hörminderung

Ebner

Hohenhorst

2020

DGNeurologie

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Vestibularisschwannome – ein Update zu Krankheitsbild und mikrochirurgischer Behandlung

Cited by 7 publications

References 27 publications

Trading mental and physical health in vestibular schwannoma treatment decision

Trading mental and physical health in vestibular schwannoma treatment decision

High-Grade Ectopic Pituitary Adenoma within the Cerebellopontine Angle: A Case Report

46/w mit Schwindel und progredienter einseitiger Hörminderung

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