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Akustikusneurinome

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Schädelbasischirurgie

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Zusammenfassung

Das Akustikusneurinom (AKN) oder auch Vestibularisschwannom ist ein gutartiger sporadischer Tumor oder, im Falle des bilateralen AKN, eine Manifestation der Neurofibromatose Typ 2 (NF2). In Bezug auf die Entscheidungsfindung und die chirurgische Technik stellen bilaterale AKN bei NF2-Patienten im Vergleich zu sporadischen AKN eine komplexe Herausforderung dar. Die Strahlentherapie ist bei NF2 weniger effektiv, während die Therapie mit Biologika (Bevacizumab) eine Alternative zur Operation darstellt. Die Indikation zur Operation wird bei NF2 im Verlgeich zu sporadischen AKN deutlich konservativer gestellt. Wenn schließlich eine chirurgische Therapie durchgeführt wird, kann die Entscheidung zur weniger aggressiven Operation getroffen werden. Dabei sollte immer die Erhaltung des Hörvermögens berücksichtigt werden. Die Operation kann auch mit dem einzigen Ziel einer Dekompression des Gehörgangs oder des Tumors mit einer möglichen Loslösung des Nervus cochlearis durchgeführt werden. Eine starke Hirnstammkompression ist eine typische absolute Operationsindikation bei AKN.

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Authors and Affiliations

  1. Rigshospitalet, Neurokirurgisk klinik, Blegdamsvej 9, 2100, København Ø, Dänemark

    Dr. K. Fugleholm

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  1. Dr. K. Fugleholm
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Correspondence to K. Fugleholm .

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  1. Karlsruhe, Deutschland

    Alexander König

  2. Karlsruhe, Deutschland

    Uwe Spetzger

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Fugleholm, K. (2018). Akustikusneurinome. In: König, A., Spetzger, U. (eds) Schädelbasischirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54672-7_8

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  • DOI: https://doi.org/10.1007/978-3-662-54672-7_8

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