Dugoročni rezultati transtemporalne kirurgije intrakanalikularnoga vestibularnog švanoma

Mislav Gjurić, Mislav Malić

Cilj istraživanja: Odrediti naše rezultate kod bolesnika operiranih transtemporalnim pristupom zbog intrakanalikularnog vestibularnog švanoma (VŠ). Materijali i metode: Retrospektivna analiza 152 bolesnika s intrakanalikularnim VŠ-om operiranih transtemporalnim putem i minimalnim trajanjem praćenja od 12 mjeseci nakon operacije. Rezultati: Kod svih 152 bolesnika, osim jednog, tumor je odstranjen u potpunosti. Niti jedan bolesnik nije više patio od napada vrtoglavice. Uspoređujući sluh prije i poslije operacije, predoperativno je 146 bolesnika imalo funkcionalan sluh (klasa A+B), dok je postoperativno takvih bolesnika bilo 84. U 58% bolesnika sluh je ostao funkcionalno sačuvan nakon operacije. Ukupno je 96% bolesnika godinu dana nakon operacije imalo normalnu ili gotovo normalnu funkciju živca (HB-I-II). Zaključci: Savjetovanje bolesnika s intrakanalikularnim VŠ-om treba se obavljati u specijaliziranom otoneurološkom centru koji raspolaže iskustvom i mogućnošću interdisciplinarnog liječenja. Rezultati sadašnje serije od 152 pacijenta s očuvanjem funkcionalnog sluha u 58% i funkcije facijalisa u 96% slučajeva potvrđuju vrhunsku kvalitetu u usporedbi s vodećim centrima u svijetu.

Aim of the study: To show the clinical outcome in patients with sporadic intracanalicular vestibular schwannoma (VS) removed by the extended middle cranial fossa approach (EMCF). Materials and methods: One hundred and fifty-two patients with intracanalicular VS were identified in a database, with a minimal follow-up of 12 months. Results: Complete VS removal was achieved in 151 of 152 patients. None of the patients who had been suffering from vertigo preoperatively had experienced vertigo attacks following the surgery. We were able to save functional hearing in 58 % of the patients who had preoperative class A or B hearing (N=146) according to the AAO-HNS classification. Postoperative normal or near-normal facial nerve outcome was achieved in 96 % of the patients. Conclusion: Patients with an intracanalicular VS should be referred to the specialized otoneurologic center where all treatment options should be offered and explained to the patient. Our results of the 152 patients show that with surgery, functional hearing and normal or near-normal facial nerve function can be achieved in 58% and 96 % of cases, respectively, which is comparable to the leading international centres.