Early Diagnosis of Acoustic Neurinoma : Clinical Experience of 108 Cases
スポンサーリンク
概要
- 論文の詳細を見る
The majority of acoustic neurinoma cases, especially schwannoma, commence with disturbances of the peripheral vestibular system. The patient, however, often complains of tinnitus, hearing loss, unusual sensation of the tip of tongue, and slight loss of balance, but not vertigo, because the vestibular dysfunctions are compensated by the central nervous system. The disease is not always detected at this early stage and is diagnosed only when the acoustic neurinoma has grown to compress the brain stem and cerebellum.<BR> Since acoustic neurinoma develops in the internal auditory canal, “early diagnosis” must be established while the symptoms and signs remain within the 7th and 8th cranial nerves. Problems concerning the early diagnosis of acoustic neurinoma are discussed based on results of our investigation of 108 cases, which are grouped into Stages 0 to IV.<BR> Concerning the Stage 0 cases, the following seven points as disclosed by Sakata12) were noted: 1) severe disturbance or no reaction to caloric stimulation; 2) severe sensory neural deafness; 3) disturbance of taste over the anterior two-thirds of the tip of the tongue; 4) spontaneous nystagmus to the opposite side; 5) elevation of protein in CSF; 6) enlargement of the meatus acousticus internus (Stenvers view); and 7) facial paresis.<BR> Concerning all of the Stage I to IV cases, the following points were noted: 1) only slight disturbance of caloric nystagmus was recognized in 2 cases; 2) nearly normal hearing was found in 3 cases; 3) elevation of the CSF protein was only 46 mg/dl at minimum; 4) no differences between right and left sides for taste were found in 4 cases; 5) nystagmus appeared in all but 2 cases of bilateral acoustic neurinoma; and 6) it is instructive that hearing loss appeared in the form of sudden deafness in 7 of the total 108 cases.<BR> Early diagnosis at ambulatory and bedside examinations is obtained not by the complex and expensive instruments available but by practical and functional analysis of symptoms and signs.
- 日本脳神経外科学会の論文
- 1979-07-15