Mikrokirurško liječenje schwannoma vestibularnog živca

master's thesis

• Title (english): Microsurgical treatment of vestibucochlear schwannoma
• Author: Patricija Škreb
• Mentor: Goran Mrak (mentor)
• Committee member: Goran Augustin (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Goran Mrak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2023-09-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract

Schwannomi su primarno dobroćudne novotvorine podrijetla Schwannovih
stanica. Schwannomi vestibulokohlearnog živca čine do 85% tumora
pontocerebelarnog kuta te gotovo 8% svih intrakranijalnih tumora. Neposredna blizina
kritičnih anatomskim struktura i šarolika klinička prezentacija čine dijagnostiku i
liječenje ove bolesti izazovnima. Najviša pojavnost je između trećeg i petog desetljeća,
sa podjednakom zastupljenošću među oba spola, a najčešći i prvi simptom je
jednostrani gubitak sluha. Liječenje uključuje opservaciju, kontrolu rasta tumora
stereotaksijskom radiokirurgijom te kirurško odstranjenje tumora kroz jedan od
pristupa, ovisno o anatomskim varijacijama i veličini tumora: translabirintalni,
retrosigmoidni te pristup kroz srednju lubanjsku jamu. Potpuno uklanjanje tumora
moguće je postići isključivo mikrokirurškom tehnikom. Složenosti zahvata, osim
anatomskog smještaja, doprinosi važnost očuvanja strukture i funkcije drugih živaca
unutar unutarnjeg slušnog kanala (n. facialis, n. vestibulocochlearis), kao i priležećih
vitalnih moždanih struktura. Sve ovo čini operativno iskustvo neophodnim preduvjetom
za uspješno liječenje. Unatoč svojoj složenosti, mikrokirurško liječenje povezano je s
niskim morbiditetom i minimalnim mortalitetom. Cilj ovog rada je prikazati mikrokirurške
tehnike u liječenju schwannoma vestibulokohlearnog živca, kao i njihove prednosti te
nedostatke.

Abstract (english)

Schwannomas are primary benign tumors originating from the Schwann cells.
Vestibulocochlear schwannomas make up 85% of cerebellopontine angle tumors and
nearly 8% of all intracranial tumors. Specific anatomic localization and diverse clinical
presentation, makes diagnosis and treatment challenging. Peak incidence is between
the third and fifth decade of life, with no gender predominance. Unilateral hearing loss
is the most common first clinical sign of the disease. Therapy includes clinical
observation, tumor growth control via stereotactic radiosurgery and surgical removal
of the tumor mass via a number of different approaches, contingent upon anatomical
variations and tumor size: translabyrinthine, retrosigmoid, and the middle cranial fossa
approach. Total tumor removal is achievable solely by using the microsurgical
technique. In addition to anatomical localization, the need to preserve the surrounding
structures, as well as the function of the nerves passing through the region, with the
emphasis on the facial and vestibulocochlear nerve, is what makes this procedure even
more challenging. The outcome of the surgery has a direct impact on the quality of life
of the patient, thereby rendering surgical experience paramount. Despite its
complexity, microsurgical treatment is associated with low morbidity and negligible
mortality. The purpose of this paper is to provide an overview of microsurgical
techniques used in treatment of vestibulocochlear schwannomas, and discuss their
individual advantages and disadvantages.

• Keywords: kirurško liječenje; neurokirurgija; pontocerebelarni kut; schwannom; vestibulokohlearni živac
• Keywords (english): microsurgical treatment; neurosurgery; vestibulocochlear schwannoma
• Language: croatian
• URN:NBN: urn:nbn:hr:105:666809
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-04-18 12:00:39