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Acoustic Neuroma

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Moises A. Arriaga – One of the best experts on this subject based on the ideXlab platform.

  • hydroxyapatite cement cranioplasty in translabyrinthine Acoustic Neuroma surgery
    Otolaryngology-Head and Neck Surgery, 2002
    Co-Authors: Moises A. Arriaga, Douglas A Chen

    Objectives: Hydroxyapatite cement cranioplasty (HAC) after translabyrinthine resection of Acoustic Neuroma is a promising new technique for wound reconstruction. This study reviews the efficacy of HAC for the prevention of cerebrospinal fluid (CSF) leakage and the long-term wound outcomes of HAC versus abdominal fat graft (AFG) reconstruction. Methods: This retrospective study of l08 consecutive Acoustic Neuromas operated on by Pittsburgh Ear Associates uses chart review, telephone interview, and mail questionnaire data. Fifty-four patients received AFG dural repair, and 54 patients received HAC. Results: Seven AFG patients (12.5%) had CSF leaks versus 2 (3.7%) of the overall group of 54 HAC patients. However, none (0%) of the 47 HAC patients had CSF leakage with current HAC techniques. HAC also produced significantly less postauricular wound depression and superior cosmetic results in comparison with AFG. Although HAC patients experienced less postoperative discomfort, wound complications requiring medical or surgical intervention were extremely uncommon in both groups. Conclusion: HAC offers significant CSF leakage control and long-term cosmetic and comfort advantages over AFG alone. We recommend HAC as the standard closure technique for translabyrinthine Acoustic Neuroma surgery. (Otolaryngol Head Neck Surg 2002;126:512-7.)

  • facial function in hearing preservation Acoustic Neuroma surgery
    Archives of Otolaryngology-head & Neck Surgery, 2001
    Co-Authors: Moises A. Arriaga, Douglas A Chen

    Objective To determine if facial function is worse after hearing preservation Acoustic Neuroma surgery (retrosigmoid and middle fossa) than in translabyrinthine surgery. Design Retrospective medical record review. Setting Private neuro-otology subspecialty practice of patients operated on in a tertiary care hospital. Patients This study evaluated 315 consecutive Acoustic Neuroma surgical procedures between April 1989 and July 1998. A total of 209 translabyrinthine procedures and 106 hearing preservation surgical procedures were performed. The hearing preservation procedures were equally divided between retrosigmoid (n = 48) and middle fossa (n = 58) procedures. Methods Medical records were reviewed and tabulated for tumor size, surgical approach, and House-Brackmann facial function grade at short-, intermediate-, and long-term intervals. Results Postoperative facial function in hearing preservation surgical procedures at short- and long-term follow-up was not worse than facial function after translabyrinthine surgical procedures in comparably sized tumors. Conclusion Concern about postoperative facial function should not be the deciding factor in selecting hearing preservation vs nonhearing preservation Acoustic Neuroma surgery.

  • predicting long term facial nerve outcome after Acoustic Neuroma surgery
    Otolaryngology-Head and Neck Surgery, 1993
    Co-Authors: Moises A. Arriaga, William M. Luxford, James S Atkins, Jed A Kwartler

    Although anatomic preservation of the facial nerve is achieved in nearly 90% of reported cases after Acoustic Neuroma surgery, postoperative long-term facial function is of most concern to the patient. This study examines long-term facial nerve function in relation to the immediate postoperative function and the function at time of discharge from the hospital. Subjects included 515 patients who underwent primary Acoustic Neuroma removal at House Ear Clinic from 1982 through 1989 and who had normal preoperative facial function, an intact facial nerve after surgery, and a House-Brackmann facial nerve grade available immediately postoperatively, at time of hospital discharge, and at least 1 year postoperatively. Rate of acceptable facial function (House grades I-IV) differed significantly (p < or = 0.001) at the three postoperative time intervals: 85.2%, immediate; 73.6%, discharge; 93.8%, long-term. Of those with good immediate function (grades I-II), 98.6% had acceptable long-term function. Of those with poor immediate function (grades V-VI), 69.8% had acceptable long-term function. We conclude that facial nerve recovery after Acoustic Neuroma surgery is characterized by slight deterioration in the immediate postoperative period, but subsequent improvement in the long-term. Patients can be reliably counseled that acceptable function immediately after surgery is associated with a favorable long-term outcome; poor function immediately after surgery, despite an intact nerve, has a more guarded prognosis.

Maria Feychting – One of the best experts on this subject based on the ideXlab platform.

  • Occupational exposures and risk of Acoustic Neuroma.
    Occupational and environmental medicine, 2010
    Co-Authors: Michaela Prochazka, Colin G Edwards, Maria Feychting, Judith A Schwartzbaum, Gun Nise, Anders Ahlbom, Nils Plato, Ulla M Forssen

    Acoustic Neuroma is a benign tumour accounting for approximately 6-10% of all intracranial tumours and occurs mainly in patients aged ≥50 years. Our aim was to investigate a wide range of occupational exposures, individual occupational titles and socioeconomic status (SES) as potential risk factors for Acoustic Neuroma. We conducted a population-based case-control study of 793 Acoustic Neuroma cases identified through the Swedish Cancer Registry and 101,762 randomly selected controls. Information on SES and occupation was obtained from censuses and linked to job-exposure matrices. Logistic regression was used to estimate ORs and calculate 95% CIs. An increased OR was seen for mercury exposure <10 years before the reference year (OR 2.9; 95% CI 1.2 to 6.8), and a more modest association for benzene exposure (OR 1.8; 95% CI: 1.0 to 3.2) ≥10 years before the reference year. We observed a threefold increased risk for females working as tailors and dressmakers ≥10 years before the reference year, and a more than threefold significantly elevated OR for those working as truck and conveyor operators <10 years before the reference year. We found no convincing evidence that SES is related to disease development. We observed an increased risk of Acoustic Neuroma associated with occupational exposure to mercury, benzene and textile dust. Men working as truck and conveyor operators <10 years before the reference year had the highest increased risk of Acoustic Neuroma, but it is unclear what in those occupations might contribute to disease development. Our study also suggested an association between Acoustic Neuroma and being a class teacher or policeman. However, these findings should be further investigated to exclude the possibility of detection bias.

  • occupational noise exposure and risk of Acoustic Neuroma
    American Journal of Epidemiology, 2007
    Co-Authors: Colin G Edwards, Judith A Schwartzbaum, Gun Nise, Ulla M Forssen, Anders Ahlbom, Stefan Lonn, Maria Feychting

    A small number of prior epidemiologic studies of occupational noise exposure based on self-report have suggested an association with Acoustic Neuroma. The goal of the present study was to further examine the association between noise exposure and Acoustic Neuroma by using an objective measure of exposure in the form of a job exposure matrix. A total of 793 Acoustic Neuroma cases aged 21–84 years were identified between 1987 and 1999 from the Swedish Cancer Registry. The 101,756 controls randomly selected from the study base were frequency matched to cases on age, sex, and calendar year of diagnosis. Occupational information, available for 599 of the cases and 73,432 of the controls, was obtained from censuses and was linked to a job exposure matrix based on actual noise measurements. All risk estimates were close to unity, regardless of noise exposure level or parameter. The overall odds ratio for exposure to � 85 dB of noise was 0.89 (95% confidence interval: 0.64, 1.23). Contrary to previous study results, the present findings did not demonstrate an increased Acoustic Neuroma risk related to occupational noise exposure even after allowing for a long latency period. The effect of nondifferential misclassification of exposure must be considered a potential cause of the negative findings. case-control studies; Neuroma, Acoustic; noise; risk factors

  • medical history cigarette smoking and risk of Acoustic Neuroma an international case control study
    International Journal of Cancer, 2007
    Co-Authors: Minouk J Schoemaker, Maria Feychting, Helle Collatz Christensen, Christoffer Johansen, Anthony J Swerdlow, Anssi Auvinen, Lars Klaeboe, Sigrid Lonn, Tiina Salminen

    Acoustic Neuroma (vestibular schwannoma) is a benign tumor of the vestibulocochlear nerve. Its recorded incidence is increasing but risk factors for this tumor have scarcely been investigated. We conducted a population-based case-control study of risk factors for Acoustic Neuroma in the UK and Nordic countries, including 563 cases and 2,703 controls. Tumor risk was analyzed in relation to medical history and cigarette smoking. Risk of Acoustic Neuroma was significantly raised in parous compared with nulliparous women (OR = 1.7, 95% CI: 1.1-2.6), but was not related to age at first birth or number of children. Risk was not associated with a history of allergic disease, past head injury, past diagnosis of a neoplasm or birth characteristics, but was significantly raised for past diagnosis of epilepsy (OR = 2.5, 95% CI: 1.3-4.9). Tumor risk was significantly reduced in subjects who had ever regularly smoked cigarettes (OR = 0.7, 95% CI: 0.6-0.9), but the reduction applied only to current smokers (OR = 0.5, 95% CI: 0.4-0.6), not ex-smokers (OR = 1.0, 95% CI: 0.8-1.3). The reduced risk of Acoustic Neuroma in smokers and raised risk in parous women might relate to sex hormone levels, or smoking might suppress tumor growth, but effects of parity and smoking on timing of diagnosis of the tumor are also a potential explanation. The raised risk in relation to past diagnosis of epilepsy might be a surveillance artefact or imply that epilepsy and/or antiepileptic medication use predispose to Acoustic Neuroma. These findings need replication by other studies and possible mechanisms need to be clarified.

Joachim Schuz – One of the best experts on this subject based on the ideXlab platform.

  • environmental risk factors for sporadic Acoustic Neuroma interphone study group germany
    European Journal of Cancer, 2007
    Co-Authors: Brigitte Schlehofer, Klaus Schlaefer, Maria Blettner, Gabriele Berg, Eva Bohler, I Hettinger, K Kunnagrass, Jurgen Wahrendorf, Joachim Schuz

    The only known risk factor for sporadic Acoustic Neuroma is high-dose ionising radiation. Environmental exposures, such as radiofrequency electromagnetic fields and noise are under discussion, as well as an association with allergic diseases. We performed a population-based case-control study in Germany investigating these risk factors in 97 cases with Acoustic Neuroma, aged 30 to 69 years, and in 194 matched controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in multiple logistic regression models. Increased risks were found for exposure to persistent noise (OR=2.31; 95% CI 1.15-4.66), and for hay fever (OR=2.20; 95% CI 1.09-4.45), but not for ionising radiation (OR=0.91; 95 % CI 0.51-1.61) or regular mobile phone use (OR=0.67; 95% CI 0.38-1.19). The study confirms results of recently published studies, although the pathogenetic mechanisms are still unknown.

  • cellular telephone use and risk of Acoustic Neuroma
    American Journal of Epidemiology, 2004
    Co-Authors: Helle Collatz Christensen, Joachim Schuz, Michael Kosteljanetz, Hans Skovgaard Poulsen, J. Thomsen, Christoffer Johansen

    Despite limited evidence, cellular telephones have been claimed to cause cancer, especially in the brain. In this Danish study, the authors examined the possible association between use of cellular telephones and development of Acoustic Neuroma. Between 2000 and 2002, they ascertained 106 incident cases and matched these persons with 212 randomly sampled, population-based controls on age and sex. The data obtained included information on use of cellular telephones from personal interviews, data from medical records, and the results of radiologic examinations. The authors obtained information on socioeconomic factors from Statistics Denmark. The overall estimated relative risk of Acoustic Neuroma was 0.90 (95% confidence interval: 0.51, 1.57). Use of a cell phone for 10 years or more did not increase Acoustic Neuroma risk over that of short-term users. Furthermore, tumors did not occur more frequently on the side of the head on which the telephone was typically used, and the size of the tumor did not correlate with the pattern of cell phone use. The results of this prospective, population-based, nationwide study, which included a large number of long-term users of cellular telephones, do not support an association between cell phone use and risk of Acoustic Neuroma.