Vestibularisschwannome sind seltene, benigne Schwannome von Kleinhirnbrückenwinkel,
innerem Gehörgang oder Innenohr. Die häufigsten Symptome sind eine Hörstörung mit
oder ohne Tinnitus sowie Gleichgewichtsstörungen. Aufgrund der zunehmenden Detektion
kleinerer Tumoren im MRT und des wachsenden Anteils von fast asymptomatischen Patienten
ist ein Umdenken von der reinen Bildgebung zu einer genauen Analyse der Hör- und Gleichgewichtsfunktion
nötig.
Abstract
Vestibular (vestibulocochlear) schwannomas are rare, benign schwannomas of the cerebellopontine
angle, the internal auditory canal, or the inner ear. They can occur with or without
clinical symptoms. The most common symptoms are unilateral or side-differentiated
hearing loss with or without tinnitus and balance disorders. Initial symptomatology
is nonspecific in the basic functional diagnosis, raising the question of when a hearing
or balance disorder should be thought of as a differential diagnosis of vestibular
schwannoma and what diagnostic pathway is appropriate. This concerns not only the
confirmation of the diagnosis and the recording of all dysfunctions of the involved
cranial nerves in the initial basic diagnostics, but also the procedure in the course
and follow-up diagnostics – especially in patients who are subject to an observation
strategy. Today, imaging alone is no longer sufficient for differentiated and individualized
patient counseling. Due to the increasing detection of smaller tumors on MRI and the
growing proportion of nearly asymptomatic patients, a shift in thinking from pure
imaging monitoring to a detailed analysis of auditory and vestibular function is timely.
In this educational article, diagnostic pathways for a sufficient patient consultation
will be compiled. Ultimately, functional examination techniques from follow-up and
progression diagnostics will also be included.
Schlüsselwörter
Vestibularisschwannom - Hörerhalt - mikrochirurgische Tumorresektion - audiologische
Basisdiagnostik - vestibuläre Basisdiagnostik
Keywords
vestibular schwannoma - hearing preservation - microsurgical tumor resection - hearing
diagnostics - vestibular diagnostics
