Vestibular schwannoma: 825 cases from a 25-year experience

Introduction: Acoustic nerve tumors have been recognized as a clinico-pathologic entity for at least 200 years, and they represent 90% of cerebellopontine angle diseases. Histologically, the tumors are derived from Schwann cells of the myelin sheath, with smaller tumors consisting of elongated palisade cells, while in large tumors, cystic degeneration can be found in the central areas, possibly due to deficient vascularization. We retrospectively reviewed 825 cases of vestibular schwannomas, reported between January 1984 and August 2006, in which the patients underwent surgery to remove the tumor. Objective: To evaluate signs, symptoms, aspects of clinical diagnosis, including the results of audiological and imaging studies, and surgical techniques and complications. Methods: A retrospective chart review. The medical records of all patients undergoing surgical treatment for schwannoma during the period indicated were reviewed. Results and Conclusion: Hearing loss was the first symptom reported in almost all cases, and tumor size was not proportional to the impairment of the auditory threshold. The surgical techniques allowed safe preservation of facial function. In particular, the retrolabyrinthine route proved useful in small tumors, with 50% preservation of hearing...

Schwanoma do espaço parafaríngeo: Relato de caso / Parapharyngeal schwannoma: A case report

Introdução: Os schwanomas são tumores raros que podemse originar de qualquer nervo periférico, cranial ou autonômico,sendo que cerca de 45% deles estão localizados na cabeça e/ou no pescoço. Podem ser únicos, múltiplos (neurofibromas),benignos e até malignizarem. Objetivo: relatar um caso deexérese transoral com boa evolução pós-operatória. Relato deCaso: paciente jovem com abaulamento faríngeo submetidoà ressecção transoral de schwannoma sem sequelas oucomplicações. Comentários finais: O diagnóstico baseia-se nahistória clínica, no exame físico e em exames complementarescomo a Ressonância Nuclear Magnética (RNM) e PAAF. O únicotratamento curativo é a excisão cirúrgica, embora o seguimentoeventualmente seja necessário.