Tshaj tawm neuroma

Mob acoustic neuroma yog lub qog hlwb qeeb ntawm cov hlab ntsha uas txuas lub pob ntseg mus rau lub hlwb. Cov hlab ntsha no hu ua vestibular cochlear hlab ntsha. Nws nyob tom qab pob ntseg, muaj cai nyob hauv lub hlwb.

Lub ntsiab lus ntawm cov leeg hlwb yog benign. Qhov no txhais tau hais tias nws tsis kis mus rau lwm qhov ntawm lub cev. Txawm li cas los xij, nws muaj peev xwm ua rau kev puas tsuaj ntau qhov tseem ceeb thaum nws loj tuaj.

Acoustic neuromas tau sib txuas nrog cov caj ces tsis zoo neurofibromatosis hom 2 (NF2).

Acoustic neuromas tsis muaj qhov tshwm sim.

Cov tsos mob sib txawv, raws li qhov loj thiab qhov chaw nyob ntawm qog. Vim tias cov kabmob loj hlob zoo li maj mam, cov tsos mob feem ntau pib tom qab hnub nyoog 30 xyoo.

Cov tsos mob tshwm sim suav nrog:

• Qhov txawv txav ntawm txav mus los (txav dua tshiab)
• Hnov tsis hnov ​​lus hauv lub pob ntseg uas cuam tshuam uas ua rau nws hnov ​​lus nyuaj nyuaj
• Ringing (tinnitus) hauv pob ntseg cuam tshuam

Cov tsos mob tshwm sim tsawg yog:

• Nyuaj rau kev nkag siab kev hais lus
• Kiv taub hau
• Mob taub hau
• Poob ntawm kev tshuav
• Loog ntawm lub ntsej muag lossis ib lub pob ntseg
• Mob hauv lub ntsej muag lossis pob ntseg
• Lub cev tsis muaj zog ntawm lub ntsej muag lossis lub ntsej muag asymmetry

Tus kws kho mob tej zaum yuav xoom xaim ntawm lub hlwb kev xav raws li koj li keeb kwm kho mob, kuaj koj lub paj hlwb, lossis kev ntsuam xyuas.

Feem ntau, kev kuaj lub cev yog qhov qub thaum kuaj mob qog. Qee zaum, cov cim hauv qab no tej zaum yuav muaj:

• Txo cov kev xav ntawm ib sab ntawm lub ntsej muag
• Drooping rau ntawm ib sab ntawm lub ntsej muag
• Tsis taug kev mus

Qhov kev ntsuas tau txiaj ntsig zoo tshaj plaws los txheeb xyuas lub suab mob hlwb yog qhov MRI ntawm lub hlwb. Lwm yam kev kuaj mob txhawm rau kuaj cov qog thiab qhia nws txhawm rau ntawm lwm qhov ua rau kiv taub hau lossis mob pob ntsug xws li:

• Hnov cov lus ntsuas
• Kev ntsuas ntawm qhov sib npaug thiab sib npaug (electronystagmography)
• Kev ntsuam xyuas ntawm lub rooj sib hais thiab lub hlwb kev ua haujlwm (lub hlwb auditory evoked teb)

Txoj kev kho yog nyob ntawm qhov loj thiab qhov chaw ntawm qog, koj hnub nyoog, thiab koj kev noj qab haus huv tag nrho. Koj thiab koj tus kws kho mob yuav tsum txiav txim siab saib cov qog ntshav tsis kho, siv hluav taws xob tiv thaiv nws kom tsis txhob loj hlob, lossis sim tshem nws.

Ntau lub acoustic neuromas yog qhov me me thiab loj hlob qeeb. Cov hlav me me uas muaj ob peb lossis tsis muaj tsos mob tuaj yeem saib xyuas kev hloov pauv, tshwj xeeb tshaj yog cov neeg laus. Kev ntsuas MRI ib txwm yuav ua tiav.

Yog tias tsis kho, qee lub acurstic neuromas tuaj yeem:

• Ua rau cov hlab ntshav koom nrog hauv kev hnov ​​lus thiab sib npaug
• Tso lub siab rau cov ntaub so ntswg nyob ze
• Ua rau lub siab leeg ua lub luag haujlwm rau qhov txav thiab qhov zoo nyob hauv lub ntsej muag
• Ua rau lub cev tsim ntawm cov kua (hydrocephalus) hauv lub hlwb (nrog cov qog loj heev)

Tshem ib qho acoustic neuroma feem ntau ua rau:

• Cov hlav loj dua
• Cov qog uas ua rau cov tsos mob
• Cov hlav uas tau loj hlob sai
• Cov qog uas nias rau lub hlwb

Kev phais mob lossis ib hom kev kho hluav taws xob yog ua tiav kom tshem lub qog thiab tiv thaiv lwm qhov kev puas tsuaj. Ua raws li hom kev phais ua, qee zaum hnov ​​lus zoo tuaj yeem khaws cia.

• Txoj kev phais mob kom tshem tawm cov leeg neuroma hu ua microsurgery. Lub koob tsom kab tshwj xeeb thiab me me, cov twj paj nruag siv tau siv. Cov txheej txheem no muaj kev cia siab dua.
• Stereotactic radiosurgery tsom mus rau high-powered x-rays ntawm thaj chaw me me. Nws yog ib hom kev khomob hluav taws xob, tsis yog phais mob. Nws tuaj yeem siv los txo qis lossis nres qhov kev loj hlob ntawm cov qog uas nyuaj rau tshem tawm nrog kev phais. Nws kuj tseem tuaj yeem kho neeg mob uas tsis tuaj yeem phais neeg, xws li cov neeg laus lossis cov neeg mob hnyav.

Tshem tawm ntawm lub suab acurstic tuaj yeem ua kev puas tsuaj. Qhov no yuav ua rau tsis hnov ​​lus zoo lossis tsis muaj zog hauv cov leeg ntsej muag. Qhov kev puas tsuaj no feem ntau tshwm sim thaum lub qog loj.

Qhov acoustic neuroma tsis yog mob qog nqaij hlav. Cov qog tsis kis mus rau lwm qhov ntawm lub cev. Txawm li cas los xij, nws yuav txuas ntxiv mus ntxiv thiab nias ntawm cov qauv hauv pob txha taub hau.

Cov neeg uas mob qog me me thiab cov qog qeeb yuav tsis xav tau kev kho mob.

Hnov tsis hnov ​​lus zoo ua ntej kev kho mob tsis zoo yuav rov qab tuaj tom qab kev phais mob lossis duab hluav taws xob. Thaum muaj cov qog ua haujlwm me, hnov ​​pob ntseg uas tshwm sim tom qab kev phais mob yuav rov qab tuaj.

Cov neeg feem coob uas mob qog yuav tsis muaj qhov ua rau lub ntsej muag tsis muaj zog tom qab phais tas. Txawm li cas los xij, cov neeg muaj qog nqaij hlav loj yuav ua rau muaj qee qhov tsis muaj zog ntawm lub ntsej muag tom qab kev phais mob.

Cov tsos mob ntawm lub paj puas tsuaj xws li tsis hnov ​​lus lossis tsis muaj zog ntawm lub ntsej muag tuaj yeem ncua sijhawm tom qab hluav taws xob.

Feem ntau, kev phais mob lub hlwb tuaj yeem tshem tawm cov qog.

Hu rau koj tus kws khomob yog koj muaj:

• Hnov khoom uas hnov ​​dheev lossis rov mob loj tuaj
• Pob ntseg hauv ib lub pob ntseg
• Kiv taub-hau (ib hom)

Vestibular schwannoma; Tumour - lub suab; Cerebellopontine lub kaum pob qog; Lub qog ntxaib; Hnov tsis hnov ​​lus - hnov ​​mob; Tinnitus - Suab

• Kev phais mob hlwb - tso tawm
• Stereotactic radiosurgery - tso tawm

• Nruab nrab hauv lub paj hlwb thiab lub paj hlwb peripheral

Arriaga MA, Brackmann DE. Neoplasms ntawm posterior fossa. Hauv: Flint PW, Francis HW, Haughey BH, li al, eds. Cummings Otolaryngology: Taub Hau Thiab Caj DabCov. 7 tus ed. Philadelphia, PA: Elsevier; 2021: chap 179.

DeAngelis LM. Cov qog ntawm cov hlab hauv nruab nrab. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 180.

Wang X, Mack SC, Taylor MD. Cov noob caj noob ces ntawm cov qog hlwb hlav hlwb. Hauv: Winn HR, ed. Youmans thiab Winn Neurological phaisCov. 7 tus ed. Philadelphia, PA: Elsevier; 2017: cha 205.