RESUMO
OBJECTIVES: To define anatomic parameters indicating or limiting the use of anterior and retrofacial accesses to sinus tympani (ST). MATERIAL: Anatomic study (30 temporal bones). MAIN OUTCOME MEASURE: The profundity of the ST, the distance between the sigmoid sinus and facial nerve (SS-F), the distance from posterior semicircular canal to the facial nerve, and the capacity of adequate visualization of the ST. RESULTS: Sinus tympani depth was significantly smaller (Assuntos
Nervo Facial/anatomia & histologia
, Procedimentos Cirúrgicos Otológicos/métodos
, Osso Temporal/cirurgia
, Membrana Timpânica/anatomia & histologia
, Membrana Timpânica/cirurgia
, Humanos
, Canais Semicirculares/anatomia & histologia
, Canais Semicirculares/cirurgia
, Osso Temporal/anatomia & histologia
RESUMO
The natural history of Vestibular Schwannomas (VS) is yet not totally known, but most of them have the tendency to slow growth, sometimes without any kind of symptoms during the individuals entire time. About 69% of diagnosed VS do not grow at all and 16% of these can even regress. Considering tumors that grow, about 70% have grown less than 2mm an year. Advanced radiological diagnosis, especially magnetic resonance imaging with gadolinium helps us diagnose small and less symptomatic tumors. Treatment of choice still is complete tumor resection. Surgical approaches have improved considerably and have helped preserve facial nerve function and hearing. Considering VSs natural history, there is a possibility for conservative treatment for these tumors, because their growth in the first year after diagnosis predicts tumor growth behavior in the next years. Surgery should be done in cases of tumor growth, patients desire or symptoms worsening. Moreover, in terms of postoperative sequelae, there is no difference between patients who underwent surgery immediately after diagnosis and those who underwent initial conservative treatment for these tumors.