Vestibularisschwannome sind seltene, benigne Schwannome von Kleinhirnbrückenwinkel, innerem Gehörgang oder Innenohr. Die häufigsten Symptome sind eine Hörstörung mit oder ohne Tinnitus sowie Gleichgewichtsstörungen. Aufgrund der zunehmenden Detektion kleinerer Tumoren im MRT und des wachsenden Anteils von fast asymptomatischen Patienten ist ein Umdenken von der reinen Bildgebung zu einer genauen Analyse der Hör- und Gleichgewichtsfunktion nötig.
Abstract
Vestibular (vestibulocochlear) schwannomas are rare, benign schwannomas of the cerebellopontine angle, the internal auditory canal, or the inner ear. They can occur with or without clinical symptoms. The most common symptoms are unilateral or side-differentiated hearing loss with or without tinnitus and balance disorders. Initial symptomatology is nonspecific in the basic functional diagnosis, raising the question of when a hearing or balance disorder should be thought of as a differential diagnosis of vestibular schwannoma and what diagnostic pathway is appropriate. This concerns not only the confirmation of the diagnosis and the recording of all dysfunctions of the involved cranial nerves in the initial basic diagnostics, but also the procedure in the course and follow-up diagnostics – especially in patients who are subject to an observation strategy. Today, imaging alone is no longer sufficient for differentiated and individualized patient counseling. Due to the increasing detection of smaller tumors on MRI and the growing proportion of nearly asymptomatic patients, a shift in thinking from pure imaging monitoring to a detailed analysis of auditory and vestibular function is timely. In this educational article, diagnostic pathways for a sufficient patient consultation will be compiled. Ultimately, functional examination techniques from follow-up and progression diagnostics will also be included.
Schlüsselwörter
Vestibularisschwannom - Hörerhalt - mikrochirurgische Tumorresektion - audiologische Basisdiagnostik - vestibuläre Basisdiagnostik
Keywords
vestibular schwannoma - hearing preservation - microsurgical tumor resection - hearing diagnostics - vestibular diagnostics
