neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2020-22-3-102-109neurosurgery-919Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWВнутриканальные вестибулярные шванномы. Наблюдение, радиохирургия или микрохирургия – что выбрать?Intracanalicular vestibular schwannomas. Observation, radiosurgery or microsurgery – what to choose?https://orcid.org/0000-0002-1572-5798ИльяловС. Р.IlyalovS. R.

Ильялов Сергей Рустамович

249031 Обнинск, ул. Королева, 4

4 Koroleva St., Obninsk 249031

sergeyilyalov@gmail.comhttps://orcid.org/0000-0002-0976-4547ГолановА. В.GolanovA. V.

125047 Москва, ул. 4-я Тверская-Ямская, 16

164th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-6510-7883БановС. М.BanovS. M.

125047 Москва, ул. 4-я Тверская-Ямская, 16

164th Tverskaya-Yamskaya St., Moscow 125047

Центр высокоточной радиологии Gamma Clinic (ООО «Гамма Медтехнологии»)РоссияGamma Clinic High-Precision Radiology Centre (Gamma Medtechnology Ltd)Russian FederationФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. Н.Н. Бурденко» Минздрава РоссииРоссияN.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaRussian Federation202028092020223102109Copyright © Ильялов С.Р., Голанов А.В., Банов С.М., 20202020Ильялов С.Р., Голанов А.В., Банов С.М.Ilyalov S.R., Golanov A.V., Banov S.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/919

В обзоре описана эпидемиология вестибулярных шванном (ВШ), их классификация, патогенез основных клинических симптомов мелких опухолей, расположенных во внутреннем слуховом проходе (внутриканально), принципы диагностики и различные варианты лечения. Анализируются достоинства и недостатки основных вариантов ведения пациентов с внутриканальными ВШ: наблюдения, радиохирургических и микрохирургических вмешательств. Наблюдение целесообразно при отсутствии признаков роста ВШ, при исходно не нарушенном или при полностью утраченном слухе со стороны опухоли. Радиохирургия дает пациенту шанс на сохранение слуха, в том числе функционального, и позволяет контролировать рост ВШ более чем в 90 % случаев. В настоящее время недостаточно данных, чтобы рекомендовать микрохирургическое вмешательство как метод первого выбора при лечении внутриканальных ВШ.

The review examines the epidemiology of vestibular schwannomas (VS), classification, the pathogenesis of the main clinical symptoms of small tumors located in the internal auditory canal (intracanalicular), the principles of diagnosis and various treatment options. The main directions of curation of patients with intracanalicular VS are analyzed: observation, radiosurgery and microsurgery. The main advantages and disadvantages of the methods used are considered: observation is advisable in the absence of VS growth, with initially safe hearing or with completely lost hearing. Radiosurgery has a high chance of preserving hearing, including functional, and provides control of VS growth in more than 90 %. There is currently insufficient data to recommend microsurgery as the first choice in the treatment of intracanalicular VS.

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The authors declare that there are no conflicts of interest present.