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Treatment of acoustic tumours in elderly patients: is surgery warranted?

Published online by Cambridge University Press:  29 June 2007

Hans A. W. Ramsay  and
William M. Luxford
Hans A. W. Ramsay*
Affiliation:
Institute Research Fellow 1991–1992 and is a Clinical Teacher, University of Helsinki, Department of Otolaryngology, Helsinki, Finland
William M. Luxford
Affiliation:
The House Ear Institute and House Ear Clinic, Los Angeles, California. The Institute is an affiliate of the University of Southern California School of Medicine
*
Hans Ramsay, M.D., University Hospital/Korvaklinikka, Haartmaninkatu 4 E, SF-00290 Helsinki, Finland
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Abstract

Controversy regarding the best and safest treatment of acoustic tumours in elderly patients still exists. These patients may therefore end up having either microsurgical tumour removal, stereotactic radiosurgery or no treatment at all, depending on where the treatment decision is made. We evaluated the results of microsurgery for acoustic tumour removal in 65 patients who were 70 years of age or older. Surgery was performed between 1982 and 1989, using the translabyrinthine approach. Total tumour removal was achieved in 61 patients (94 per cent). No deaths due to surgery occurred. Other than one case of meningitis, there were no serious complications. Seven cases had post-operative CSF leaks, and three required surgery for correction of the problem. Facial nerve function pre-operatively, at the time of discharge and at one year or more post-operatively was compared to that in a younger age group. No differences between the groups were found. Nor was there any significant difference in mean operative time, blood loss, or hospital stay between the older and younger patients.

We believe that total microsurgical tumour removal is the treatment of choice in patients who are in good health, regardless of age. Partial removal is acceptable only if the tumour is adherent to the facial nerve or if vital-sign changes occur during surgery. Other forms of treatment are reserved for cases where surgery is contraindicated or refused by the patient.

Keywords

Cranial nerve neoplasmsvestibular schwannomaAgedMicrosurgeryRadiosurgery
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 4 , April 1993 , pp. 295 - 297
Copyright
Copyright © JLO (1984) Limited 1993

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