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首页> 外文期刊>Neurosurgery >Early proactive management of vestibular schwannomas in neurofibromatosis type 2.
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Early proactive management of vestibular schwannomas in neurofibromatosis type 2.

机译：早期积极治疗2型神经纤维瘤病的前庭神经鞘瘤。

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OBJECTIVE: The treatment of patients with neurofibromatosis Type 2 has always been challenging for neurosurgeons and neurotologists. Guidelines for appropriate management of this devastating disease are controversial. METHODS: A retrospective study of 28 patients with neurofibromatosis Type 2 who underwent 40 middle fossa craniotomies for excision of their acoustic tumors is reported. Eleven patients underwent bilateral procedures. The study focused on hearing preservation and facial nerve results for this group of patients. The 16 male patients and 12 female patients ranged in age (at the time of surgery) from 10 to 70 years, with a mean age of 22.6 years. The mean tumor size was 1.1 cm (range, 0.5-3.2 cm), and the majority of tumors were less than 1.5 cm. RESULTS: Measurable hearing was preserved in 28 ears (70%), with 42.5% being within 15 dB pure-tone average and 15% speech discrimination score of preoperative levels. In 55% of cases there was no change in the hearing class, as defined by the American Academy of Otolaryngology-Head and Neck Surgery. Of the 11 patients who underwent bilateral operations, 9 (82%) retained some hearing bilaterally. After 1-year follow-up periods (mean, 12.8 mo), 87.5% of patients exhibited normal facial nerve function (House-Brackmann Grade I). CONCLUSION: Early surgical intervention to treat acoustic tumors among patients with neurofibromatosis Type 2 is a feasible treatment strategy, with high rates of hearing and facial nerve function preservation.
机译：目的：对神经外科医生和神经科医生而言，治疗2型神经纤维瘤病患者一直是一项挑战。适当处理这种破坏性疾病的指导方针是有争议的。方法：回顾性研究28例2型神经纤维瘤病患者，他们接受了40例中颅窝开颅手术，以切除其声学肿瘤。 11例患者接受了双侧手术。该研究集中于该组患者的听力保护和面神经结果。 16例男性患者和12例女性患者（手术时）的年龄为10至70岁，平均年龄为22.6岁。平均肿瘤大小为1.1厘米（范围0.5-3.2厘米），大多数肿瘤小于1.5厘米。结果：28耳（70％）的听力可保持，其中42.5％的平均纯音在15 dB以内，术前语音识别分数在15％以内。在55％的病例中，根据美国耳鼻咽喉头颈外科学会的定义，听力等级没有变化。在接受双侧手术的11例患者中，有9例（82％）保留了一些双侧听力。一年的随访期（平均12.8 mo）后，有87.5％的患者表现出正常的面神经功能（House-Brackmann I级）。结论：早期外科手术治疗2型神经纤维瘤病患者的听觉肿瘤是一种可行的治疗策略，具有较高的听力和保留面神经功能。

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