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Acoustic neuroma and the eye
1Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, UK.
British Journal of Neurosurgery
|August 1, 1997
Summary
Acoustic neuroma surgery can cause significant ophthalmic complications, including corneal issues and nerve palsies. Early ophthalmologist involvement is crucial to prevent irreversible vision damage in patients undergoing acoustic neuroma treatment.
Area of Science:
- Ophthalmology
- Neurosurgery
- Neurology
Background:
- Acoustic neuroma (vestibular schwannoma) is a benign tumor arising from the Schwann cells of the vestibulocochlear nerve.
- Surgical resection is a primary treatment modality, carrying potential risks to adjacent cranial nerves and ocular structures.
- Ophthalmic complications following acoustic neuroma surgery require careful documentation and management.
Observation:
- This retrospective study analyzed 138 patients treated for acoustic neuroma over 12 years.
- Ophthalmic features before and after surgery were documented, involving multiple neurosurgical and ophthalmological specialists.
- Data included the incidence of lid surgery, keratopathy, corneal opacification, abscesses, optic atrophy, and cranial nerve palsies.
Findings:
- 44% of patients required lid surgery, 13% developed exposure keratopathy, and 9% had corneal opacification.
- Corneal complications were strongly correlated with preoperative trigeminal nerve (fifth cranial nerve) involvement.
- Postoperative oculomotor nerve (third cranial nerve) palsies occurred in 7% of patients.
Implications:
- Ophthalmic complications are common after acoustic neuroma surgery, necessitating proactive management.
- Preoperative assessment of trigeminal nerve function is vital for predicting corneal risks.
- Perioperative ophthalmological consultation is recommended to mitigate irreversible visual impairment.