최근 5년간 경험한 청신경종양 25례의 임상분석

Abstract

Background and Objectives: For the past 10 years with the development of imaging techniques, acoustic tumors (AT) have been detected before significant symptoms could develop. The development of MRI scan and improved awareness by otolaryngologists of the changing clinical presentation of AT have increased the relative incidence of small AT. The objective of this study is to review symptomatology, diagnostic approach and surgical treatment of AT which were experienced for the last 5 years, and to make an effective diagnostic work-up with management. Patients and Methods: From March 1995 through March 2000, 25 patients with AT (including 4 patients with neuro fibro mato sis type П) were diagnosed and treated at Ajou University Hospital. We analysed tumor size, chief complaints, pure tone audiogram (PTA), speech discrimination score (SDS), auditory evoked response (ABR), caloric test, surgical approach, hearing preservation, and facial nerve preservation. Patients were grouped by tumor size, which was recommended from AANR (American Acoustic Neuroma Registry) in 1996. Results: The most common symptom of AT was progressive unilateral hearing loss. But sudden hearing loss and dizziness were chief complaints in the cases with small tumors (group IC, 0). Hearing was relatively well preserved with small tumors, but was impaired in large tumors. ABR showed normal response in 3 cases with small tumors. In caloric test, 3 cases didn’t show unilateral vestibular weakness, and 2 of these cases were confirmed as AT from inferior vestibular nerve during operation. Hearing preservation was done in 4 of 10 cases with hearing conservation surgeries. Facial nerve was well preserved with small tumors, especially less than 2 cm, but its postoperative function was not good with large tumors. Conclusion: These data provide patients with small tumor showed good hearing and facial nerve functions. So it is very important to detect small AT earlier with systematized diagnostic approach. (J Clinical Otolaryngol 2000;11:241–248)