［第22回前庭研究会］聴神経鞘腫の神経学的所見と外科的治療法
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概要
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On the basis of the clinical experiences with seventy-three cases of solitary acoustic neurinoma, the subjective symptoms and objective neurological findings in this tumor were analyzed and its diagnosis and treatment discussed.<BR>There are still only few cases properly diagnosed at their early stage.<BR>The accurate analysis of the auditory and vestibular functions is most essential for its early diagnosis. Diminished corneal reflex and disturbed gustatory sensation should be of great importance as the signs of the adjacent cranial nerves. No definite correlation is found between the pressure and protein content of the cerebrospinal fluid, although the latter increases in considerable amount in the majority of the cases.<BR>Serial vertebral angiograms with subtraction technique can offer many profits to the diagnosis and to the operative practice. The anterior inferior cerebellar artery then holds the key.<BR>Both of the operative results and the follow-up study lead to the conclusion that the best results are obtained by the total removal.<BR>With the increasingly small mortality rate in the total removal, the preservation of the facial nerve should be aimed for this benign tumor. The accessoryfacial anastomosis can only prevent the atrophy and keep the tone of the facial muscles, but is unable to give any favors to the facial expression.<BR>The earlier diagnosis and earlier surgery should be emphasized, and the ideal treatment with radical removal preserving the facial nerve could be achieved by the more mutual cooperation of neurosurgeon, neurologist and otologist.
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