Neurotologist's Role in Acoustic Neuroma

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  • 聴神経腫瘍の取り扱い―耳鼻科医としての対応―
  • チョウシンケイ シュヨウ ノ トリアツカイ ジビカイ ト シテノ タイオウ
  • 耳鼻科医としての対応

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Abstract

It has become possible to make a diagnosis of small acoustic neuroma localized within the internal auditory meatus in the presence of normal or mild hearing impairment. From the viewpoint of functional preservation, it is deemed that a turning point has come in terms of the neurotologist's role in the management of patients with acoustic neuroma, especially in cases with small tumors. As a neurotologist, one is expected to locate the tumor while it is small, and follow the time-course of the tumor's growth and cochleo-vestibular symptoms, and then adopt the most beneficial treatment policy for the patient among the three treatment options of surgery, gamma-knife application, and follow up. To determine the optimal policy, one should take into consideration one's own experience, as well as the patient's social and familial background on an individual basis. When considering hearing preservation surgery, a middle cranial fossa approach could be the most promising and desirable. Some important check points for making a diagnosis of acoustic neuroma are also presented.

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