Principles of diagnosis and treatment of vestibular schwannoma: a literature review

S. A. Lysenko, N. M. Lysenko, Y. V. Stoika, Y. O. Botanevych
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Abstract

Background. Vestibular schwannoma is a formation of Schwann cells in the vestibulocochlear zone. Despite the benign nature of the tumor, it carries risks for life, as its massiveness poses a threat to intracranial structures and their functional capacity. The purpose of the study is to conduct an analysis of modern information on the diagnosis and methods of treatment of schwannoma. Materials and methods. A literature search using keywords was conducted in Web of Science, Scopus, PubMed, Elsevier, and Springer databases. Results. In most cases, vestibular schwannoma is diagnosed after a number of symptoms are detected such as dizziness, hearing loss, etc. According to modern research, magnetic resonance imaging and audiogram are the most informative and at the same time gold standard for diagnosis, and verification is carried out based on pathohistology. Most schwannomas are clinically stable; however, when analyzing the information, the main approaches in the presence of such a diagnosis were determined. The safest and most non-invasive one is observation, with control of the dynamics of the clinical picture and the size of the formation. However, there are several surgical techniques for complete tumor removal. The most common of them is access through the middle cranial fossa, which, unfortunately, has several limitations. Translabyrinthine and retrosigmoid approaches are also used. The choice of treatment depends on the size, growth and symptoms of the patients. Radiotherapy is one of the relatively new methods of treatment, it is sometimes combined with a surgery. Conclusions. Thus, vestibular schwannoma requires active monitoring and the use of other treatment methods. In the presence of clinical indications, a combination of different types of treatment allows achieving positive therapeutic outcomes. A perspective for future research is the study of targeted gene therapy.
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前庭分裂瘤的诊断和治疗原则:文献综述
背景。前庭裂隙瘤是由前庭蜗区内的许旺细胞形成的。尽管这种肿瘤是良性的,但由于其肿块对颅内结构及其功能能力构成威胁,因此具有生命危险。本研究旨在对有关裂隙瘤诊断和治疗方法的现代信息进行分析。材料和方法。使用关键词在 Web of Science、Scopus、PubMed、Elsevier 和 Springer 数据库中进行文献检索。结果。在大多数情况下,前庭分裂瘤是在发现头晕、听力下降等一系列症状后被诊断出来的。根据现代研究,磁共振成像和听力图是信息量最大的诊断方法,同时也是诊断的金标准,并根据病理组织学进行验证。大多数裂隙瘤临床症状稳定,但在分析相关信息时,确定了诊断裂隙瘤的主要方法。最安全、最无创的方法是观察,控制临床表现的动态和形成的大小。不过,也有几种手术技术可以彻底切除肿瘤。其中最常见的是通过中颅窝进入,但不幸的是,这种方法存在一些局限性。经迷路和蛛网膜后入路也可使用。治疗方法的选择取决于肿瘤的大小、生长情况和患者的症状。放射治疗是相对较新的治疗方法之一,有时会与手术相结合。结论因此,前庭分裂瘤需要积极监测并采用其他治疗方法。在有临床指征的情况下,联合使用不同类型的治疗方法可以取得积极的治疗效果。未来研究的一个方向是研究靶向基因疗法。
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