EVALUATION OF MONITORING OF PATIENTS WITH ACOUSTIC NEURINOMA
Keywords:vestibular schwannoma, sensorineural hypoacusis, magnetic resonance imaging
Objectives. In 1974, in the United States of America, ”Florida Ear and Sinus Center” initiated a ”Wait & Scan” approach for acoustic neurinoma. It consists of monitoring vestibular schwannoma patients, during several years, using magnetic resonance imaging. The aim of our study was to evaluate monitoring results of vestibular schwannoma patients.
Material and Methods. In the Otorhinolaryngology clinic of the Republican Clinical Hospital „Timofei Moșneaga”, Chișinău, Republic of Moldova, were monitored 6 patients with vestibular schwannoma. In order to establish the diagnosis in these patients, the following diagnostic methods were used: audiometry, brainstem auditory evoked potential test, vestibulometry and magnetic resonance imaging exam.
Results. In our study the following diagnoses were established: 1 case of intralabyrinthine vestibular schwannoma, 2 cases of intracanalicular vestibular schwannoma, 3 cases of 2nd grade vestibular schwannoma. Unilateral neurosensorial hypoacusis, in 5 cases, was the first symptom of this pathology. By American Academy of Otolaryngology - Head and Neck Surgery classification system, patients were distributed as follows: 4 cases of class D hypoacusis, 1 case of class C hypoacusis and, in 1 case, hearing was normal. According to the magnetic resonance imaging scan, two 2nd grade vestibular schwannoma patients showed tumor growth, while 2 cases of intracanalicular vestibular schwannoma were in stagnation.
Conclusion. It is strongly necessary to perform contrast magnetic resonance imaging scan in patients with unilateral neurosensorial hypoacusis of unknown ethiology, in order to establish the diagnosis. Also, following the study, it was established that tumors that exceed the internal auditory canal, show a higher growth rate than intracanalicular tumors.
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