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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >The changing landscape of vestibular schwannoma diagnosis and management: A cross‐sectional study
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The changing landscape of vestibular schwannoma diagnosis and management: A cross‐sectional study

机译：前庭施瓦南瘤诊断与管理的变化景观：横截面研究

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Objectives To assess the current state of the diagnosis and management of vestibular schwannoma (VS) as well as treatment trends, and to evaluate the role of treatment setting and various specialists in treatment plan. Methods Patients diagnosed with VS completed a voluntary and anonymous survey. The questionnaires were distributed through Acoustic Neuroma Association website, Facebook page, and e‐mail newsletters from January to March 2017. Results In total, 789 VS patients completed the survey. Of those, 414 (52%) underwent surgery; 224 (28%) underwent radiotherapy; and 121 (15%) were observed. General otolaryngologists diagnosed 62% of responders, followed by primary care (11%) and neurotologists (10%). Patients who underwent surgery were significantly younger and had larger tumors compared to those treated with radiation or observation. The ratio of patients having nonsurgical versus surgical resection changed from 1:2 to 1:1 for the periods of 1979 through 2006 versus 2007 through 2017, respectively. Neurosurgeons (40%) and neurotologists (38%) were the most influential in treatment discussion. Neurotologists ( P ??0.001) and general otolaryngologists ( P =?0.04) were more influential than neurosurgeons for the decision process in patients with smaller tumors. Patients treated at academic versus nonacademic private institutions reported similar tumor sizes ( P =?0.27), treatment decisions ( P =?0.09), and decision satisfaction ( P =?0.78). Conclusion There is a continuing trend toward nonsurgical management, with approximately half of the patients opting for nonsurgical management. In this cohort, the patients commonly presented with otologic symptoms and otolaryngologists made the most diagnoses. Neurotologists and neurosurgeons were the most influential in treatment discussion. Level of Evidence NA Laryngoscope , 130:482–486, 2020
机译：目的评估前庭施瓦新瘤（VS）和治疗趋势的诊断和管理的当前状态，并评估治疗计划的作用和治疗计划中的各种专家。方法诊断患有VS的患者完成了一项自愿和匿名调查。从2017年1月至3月，通过声神经瘤协会网站，Facebook页面和电子邮件通讯分发了调查问卷。结果总共有789例VS患者完成了调查。其中414（52％）接受手术; 224（28％）接受放射治疗;观察到121（15％）。一般耳鼻喉科医生诊断出62％的响应者，其次是初级护理（11％）和神经外科医生（10％）。接受手术的患者对辐射或观察治疗的人相比，手术的显着较小，肿瘤较大。非术语与手术切除患者的比例分别从1979年至2006年期间的1：2至1：1改为2007年至2017年。神经外科医生（40％）和神经外科医生（38％）是治疗讨论中最有影响力的。神经监测者（p？0.001）和一般耳鼻喉科医生（p = 0.04）比神经外部更有影响力，对于较小的肿瘤患者的决策过程。在学术与非遗传性私营机构治疗的患者报告了类似的肿瘤尺寸（P = 0.27），治疗决策（P = 0.09），以及决定满足（P = 0.78）。结论非技术管理有持续趋势，约有一半的患者选择非本地管理。在这种队列中，通常呈现出耳科症状和耳鼻喉科医生的患者最多诊断出来。神经外科医生和神经外科医生是治疗讨论中最有影响力的。证据水平na喉镜，130：482-486,2020

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