Document Detail


Neuro-otological findings after radiosurgery for acoustic neurinomas.
MedLine Citation:
PMID:  8906059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the neuro-otological complications in patients after radiosurgery for acoustic neurinomas. DESIGN: Inception cohort, retrospective study. SETTING: University hospital. PATIENTS: A consecutive sample of 46 patients with acoustic neurinomas who underwent unilateral gamma knife radiosurgery at the University of Tokyo, Japan, between June 1990 and June 1994 were followed up by otolaryngologists for more than 3 months. INTERVENTION: Gamma knife stereotactic radiosurgery. MAIN OUTCOME MEASURES: Neuro-otological examinations including pure tone audiometry, auditory brain stem response, and caloric test. RESULTS: Tumor growth occurred in 2 patients (4.3%). Seven (18%) of the 38 patients with preserved hearing of any extent became deaf within 1 year. In cases of gradual hearing loss, the average deterioration rate was approximately 8 dB per year. Abnormalities of auditory brain stem response preceded deafness in 2 patients. Caloric response, preserved before treatment in 13 patients, disappeared 4 to 13 months after treatment (median, 8 months) in 9 (69%) of them, whereas their hearing was preserved. Delayed facial palsy and persistent trigeminal neuropathy occurred in 10 (22%) and 7 (15%) of the 46 patients, respectively. Severe facial palsy tended to persist. CONCLUSIONS: The rates of neuro-otological complications of radiosurgery are almost comparable with those previously reported from other institutions. The deafness within 1 year after treatment might be attributed to a lesion in the cochlear nerve. Hearing loss did not parallel vestibular function loss. The persistent severe facial palsy contrasts with previously reported findings. Considering the serious facial nerve complications that occurred in some of our patients, further study to disclose the risk factors for neurological dysfunction would be needed for radiosurgery to become a true, safe alternative to microsurgery.
Authors:
K Ito; H Kurita; K Sugasawa; T Okuno; M Mizuno; T Sasaki
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  122     ISSN:  0886-4470     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1996-12-04     Completed Date:  1996-12-04     Revised Date:  2006-03-28    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1229-33     Citation Subset:  AIM; IM    
Affiliation:
Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Audiometry, Pure-Tone
Caloric Tests
Cranial Nerve Diseases / etiology
Evoked Potentials, Auditory, Brain Stem
Facial Paralysis / etiology*
Female
Hearing Disorders / etiology*
Humans
Male
Middle Aged
Neuroma, Acoustic / complications,  surgery*
Postoperative Complications
Radiosurgery*
Retrospective Studies
Trigeminal Nerve

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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