Zusammenfassung
Primäres Ziel der Behandlungsstrategie von Vestibularisschwannomen ist der Erhalt
bzw. die Optimierung der Lebensqualität unter bestmöglicher Erhaltung der
Nervenfunktionen. Einfluss auf das Management von Vestibularisschwannomen haben
in erster Linie Tumorgröße, Tumorlage, Wachstumstendenz, Alter und
Komorbiditäten sowie audiovestibuläre Symptome, d. h. Gleichgewichts- und
Hörstörungen.
Abstract
Vestibular schwannomas are benign neoplasms originating from the Schwann cells of
the vestibular vestibular nerve of the vestibulocochlear nerve, and rarely from
the pars cochlearis. These are tumors that are in contact with the nerve but do
not bind the fibers. Benign neoplasms of the Schwann cells of the auditory and
equilibrium nerves can also occur primarily in the inner ear and are referred to
as intralabyrinthine schwannomas (ILS). Vestibular schwannomas represent 6–7 %
of all intracranial and 90 % of cerebellopontine angle tumors. Bilateral
occurrence occurs in < 5 % of cases, and then corresponds to type 2
neurofibromatosis. The first symptom is often a unilateral hearing loss. It may
then lead to balance disorders, tinnitus, facial paralysis and other
impairments. Diagnosis is audiological, vestibular and imaging. Magnetic
resonance imaging currently represents the gold standard. Management chooses
between an observational strategy and surgery, depending on tumor size, age, and
other factors. The possible access routes offer different advantages and
disadvantages; the potential complications include the liquorrhoea. Radiation
therapy is possible in special cases, and drug therapies are also being tested.
In the rehabilitation of the hearing function, in addition to a CROS or BICROS
restoration, the cochlear implant has been used with good success. The impact on
quality of life is largely determined by hearing impairment, balance disorders,
tinnitus, and possibly headache, which must be considered in patient
consultation and long-term care.
Schlüsselwörter
Vestibularisschwannom - Akustikusneurinom - Schwindel - Tinnitus - Hörminderung
Key words
Vestibular schwannoma - acoustic neuroma - dizziness - tinnitus - hearing loss
