Related Experiment Videos
Recurrence after incompletely resected acousticus neurinomas.
S Sakaki1, K Nakagawa, T Hatakeyama
1Department of Neurological Surgery, Ehime University School of Medicine, Japan.
Medical Journal of Osaka University
|March 1, 1991
Summary
Complete removal of acoustic neurinoma significantly reduces recurrence risk. Residual tumors in the internal auditory meatus are a primary concern for recurrence after incomplete excision.
Area of Science:
- Neurosurgery
- Neuro-oncology
- Radiology
Background:
- Acoustic neurinomas (vestibular schwannomas) are tumors that arise from the nerve sheath of the vestibulocochlear nerve.
- High recurrence rates are observed following incomplete surgical excision, but the precise mechanisms remain unclear.
- Postoperative imaging via computed tomography (CT) or magnetic resonance imaging (MRI) is crucial for monitoring tumor remnants.
Observation:
- A 10-year review of 51 patients undergoing acoustic neurinoma resection analyzed recurrence patterns.
- Tumor resection was categorized as total (43%), nearly total (33%), or subtotal (24%).
- Recurrence rates were 29% for nearly total and 25% for subtotal resections, with no recurrences after total resection.
Findings:
- Recurrence was exclusively linked to residual tumor in the internal auditory meatus following nearly total resection.
- No recurrences were observed from residual tumor near the brain stem.
- Complete tumor resection is associated with a zero recurrence rate.
Implications:
- Total resection of acoustic neurinomas is recommended whenever feasible through neurosurgical and neuro-otological techniques.
- Careful postoperative surveillance with CT or MRI is essential for patients with residual tumor fragments in the internal auditory meatus, particularly when nerve preservation influences resection extent.
- Understanding recurrence sites informs surgical strategy and follow-up protocols to improve patient outcomes.