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Bilateral acoustic neuromas

V T Anand1, D P Byrnes, A P Walby

  • 1Department of Otolaryngology, Royal Victoria Hospital, Belfast, UK.

Clinical Otolaryngology and Allied Sciences
|October 1, 1993
PubMed
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Bilateral acoustic neuromas disproportionately affect young adults, often requiring multiple surgeries with significant risks of hearing loss and facial nerve complications. Management requires careful consideration of surgical timing and alternative treatments.

Area of Science:

  • Neurology
  • Otolaryngology
  • Neurosurgery

Background:

  • Bilateral acoustic neuromas (also known as vestibular schwannomas) are rare tumors.
  • Genetic predisposition, such as in neurofibromatosis type 2, is common in these patients.

Purpose of the Study:

  • To review the clinical course and management outcomes of 12 patients with bilateral acoustic neuromas.
  • To discuss guidelines for the care of these young patients, including surgical timing and alternative treatment options.

Main Methods:

  • Retrospective review of 12 patients diagnosed with bilateral acoustic neuromas.
  • Analysis of patient demographics, family history, surgical interventions, treatment outcomes, and complications.

Main Results:

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  • The mean age at diagnosis was 26.2 years, with equal sex incidence and a positive family history in 75% of patients.
  • Surgical complications included incomplete tumor removal, profound hearing loss, facial nerve palsy, and mortality from intracranial complications.
  • Observation and alternative treatments like radiosurgery and chemotherapy were considered.

Conclusions:

  • Bilateral acoustic neuromas present unique challenges due to their occurrence in young individuals and the potential for severe neurological and audiological deficits.
  • Multidisciplinary management is crucial, balancing the risks of surgery with the natural history of the tumors and the potential benefits of observation or alternative therapies.