Benović radomir, živković Nenad, stanić Milenko služba neurohirurgije, Kliničko bolnički centar Zemun, Beograd
ApstraktNajčešći tumori pontocerebelarnog ugla su vestibularni Švanomi i meningiomi. Znatno ređe se javljaju holestatomi, astrocitomi, metastaze, meduloblastomi, hondrosarkomi, hordomi, lipomi, horoidni pleksus papilomi, teratomi. Cilj ovog rada je utvrditi zastupljenost tumora prema polu, rasprostranjenost tumora prema starosnim grupama, učestalost tumora prema histološkom tipu i odnos veličine tumora, simptomatologije i prognoze bolesti. U periodu od 2006. do 2010. godine u KBC Zemun na odeljenju neurohirurgije ispitivano je i lečeno 38 pacijenta sa intrakranijalnim ekspanzivnim procesima u PCU. Prema dobijenim rezultatima najučestaliji tumor je Švanom i nešto je prisutniji u ženskoj populaciji. dominantni simptomi bolesti su oštećenje VIII, kao i parcijalne lezije V nerva i cerebelarna simptomatologija, dok je najređe ledirana donja grupa nerava, kao i sam facijalis. Metod lečenja pacijenata sa tumorima ove regije je mikrohirurška ekstirpacija, a kao uzroci letalnog ishoda izdvajaju se infekcije i hematomi lože tumora posle ekstirpacije. dominantni neurološki deficit ,postoperativno, je paraliza i pareza facijalisa.
AbstractThe most common tumor in the cerebellopontine angle (CPa) are vestibular schwannomas and meningiomas. The purpose of this study is to present proportional representation according to gender and age, incidence of histological type, as well as relation between tumor magnitude, clinical symptoms and prognosis. a group of 38 patients with PCa expansion were examined and treated in time interval from 2006 until 2010 at clinical-hospital center "KBC ZemunBelgrade". Gender proportion was 22 female (57,1%) and 16 male (42,9%). Middle-aged patients (from 30 to 60 years) were predominant in age proportion 20(52,6%). The most frequent tumor in the study was vestibular schwannoma (63,1%) followed by meningioma (31,6%). The rest were various histological type tumors like cholestatoma, plexus papilloma, glioma etc. (5,3%). Tumor magnitude proportion showed that the most of the scwanoma (over 95%) were grades III and IV (according to Koss classification). The leading admission symptoms were: deferent degrees of hearing loss, cerebellar disorders and trigeminal lesions. The analysis of postoperative results for 38 patients have shown: mortality rate of 13,2%, complete lesion of facial nerve(39,4%), partial lesion(33,3%) and (27,3%) without lesion of facial nerve. Lesions of lower group of cranial nerves (IX, X and XI) had 3 patients (9%) and pyramid deficit had 6(17,3%) patients.This study showed that typical PCa vestibular schwannoma is predominantly in female and elder population presented. recommended treatment is surgical (total or subtotal extirpation), followed by adjuvant therapy for elder patients. The most frequent causes of lethal outcome are infections and hematomas in tumor bed. The leading neurological deficit after tumor extirpation is total or partial lesion of facial nerve.