Acoustic neuroma staging: Difference between revisions

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| style="padding 5px 5px; background: #F5F5F5; " |Persistent and severe [[dizziness]] or [[Disequilibrium|imbalance]], disturbing daily life
| style="padding 5px 5px; background: #F5F5F5; " |Persistent and severe [[dizziness]] or [[Disequilibrium|imbalance]], disturbing daily life
|}
|}
=== Tumor size and stages ===
Numerous stage grading system ave been reported according to tumor size, but also for the first step description of the tumor size is more important and have measured by the maximum diameter (means the one measured in [[cerebellopontine angle]] (CPA) along the long axis) of the [[tumor]].<ref>{{Cite journal|last=Sterkers JM, Morrison GA, Sterkers O, El-Dine MM.|first=JM|date=1994|title=Preservation of facial, cochlear, and other nerve functions in acoustic neuroma treatment.|url=|journal=Otolaryngol Head Neck Surg|volume=|pages=|via=}}</ref><ref>{{Cite journal|last=Hitselberger WE, House WF|first=|date=1966|title=classification of acoustic neuromas|url=|journal=Arch Otolaryngol|volume=|pages=|via=}}</ref><ref>{{Cite journal|last=Koos WT, Day JD, Matula C, Levy DI|first=|date=|title=Neurotopographic considerations in the microsurgical treatment of small acoustic neurinomas|url=|journal=J Neurisurg|volume=|pages=|via=}}</ref>
{| style="border: 3px; font-size 190%; margin: 1px; width: 700px; align=“ left”"
! colspan="6" style="background: #5579FF; width: 600px:" | {{fontcolor|#FFF|Main grading systems for acoustic neuromas}}
|-
! style="background: #4479BA; " | {{fontcolor|#FFF| Tumor size (CPA Maximum diameter)}}
! style="background: #4479BA; " | {{fontcolor|#FFF| Sterker}}
! style="background: #4479BA; " | {{fontcolor|#FFF| House}}
! style="background: #4479BA; " | {{fontcolor|#FFF| Koos}}
! style="background: #4479BA; " | {{fontcolor|#FFF| Samii}}
! style="background: #4479BA; " | {{fontcolor|#FFF| Tumor Description}}
|-
! style="padding: 10px 10px; background: #ABCDEF; " | 0
(intracanalicular)
! style="padding: 10px 10px; background: #ABCDEF; " |Tube type
! style="padding: 10px 10px; background: #ABCDEF; " |intracanalicular
! style="padding: 10px 10px; background: #ace123; " |Grade I
! style="padding: 10px 10px; background: #eee000; " |T1
! style="padding: 10px 10px; background: #eee000; " |Confining to IAC
|-
! style="padding: 10px 10px; background: #ABCDEF; " | ≤10 mm
! rowspan="2" style="padding: 10px 10px; background: #ABCDEF; " | Small
! style="padding: 10px 10px; background: #ABCDEF; " | Grade 1
(Small)
! rowspan="3" style="padding: 10px 10px; background: #ace123; " | Grade II
! style="padding: 10px 10px; background: #eee000; " | T2
! style="padding: 10px 10px; background: #eee000; " | Superpassing IAC
|-
! style="padding: 10px 10px; background: #ABCDEF; " | ≤15 mm
! rowspan="2" style="padding: 10px 10px; background: #ABCDEF; " | Grade 2
(Medium)     
! rowspan="2" style="padding: 10px 10px; background: #eee000; " | T3a
! rowspan="2" style="padding: 10px 10px; background: #eee000; " | [[Tumor]] occupying [[Cerebellopontine angle|CPA]]
|-
! style="padding: 10px 10px; background: #ABCDEF; " | ≤20 mm
! rowspan="2" style="padding: 10px 10px; background: #ABCDEF; " | Mild
|-
! style="padding: 10px 10px; background: #ABCDEF; " | ≤3o mm
! style="padding: 10px 10px; background: #ABCDEF; " | Grade 3
(Moderately Large)
! style="padding: 10px 10px; background: #ace123; " | Grade III
! style="padding: 10px 10px; background: #eee000; " | T3b
! style="padding: 10px 10px; background: #eee000; " | [[Tumor]] occupying [[Cerebellopontine angle|CPA]] and contacting
the [[Brain stem|brainstem]] without compression
|-
! style="padding: 10px 10px; background: #ABCDEF; " | ≤40 mm
! style="padding: 10px 10px; background: #ABCDEF; " | Large
! style="padding: 10px 10px; background: #ABCDEF; " | Grade 4
(Large)
! rowspan="2" style="padding: 10px 10px; background: #ace123; " | Grade IV
! style="padding: 10px 10px; background: #eee000; " | T4a
! style="padding: 10px 10px; background: #eee000; " | [[Tumor]] compressing the [[Brain stem|brainstem]]
|-
! style="padding: 10px 10px; background: #ABCDEF; " | >40 mm
! style="padding: 10px 10px; background: #ABCDEF; " | Huge
! style="padding: 10px 10px; background: #ABCDEF; " | Grade 5
(Giant)
! style="padding: 10px 10px; background: #eee000; " | T4b
! style="padding: 10px 10px; background: #eee000; " | Sever [[Brain stem|brainstem]] displacement and deformation of fourth [[Ventricle (brain)|ventricle]] under [[tumor]] compression
|-
! colspan="6" style="padding: 10px 10px; background: #DCDCDC; " |Main grading systems for [[Acoustic neuroma|acoustic neuromas]]. The classifications on the left side (blue area) are mainly based on tumor size, while those on the right side (yellow area) are based on the [[Anatomy|anatomical]] relationship around the tumor. Koos classification (green area) combines the [[tumor]] size and anatomical relationship for larger tumors. IAC: Intracoustic canal
|}
<ref>{{Cite journal|last=Hao Wu, Liwei Zhang, Dongyi Han, Ying Mao, Jun Yang, Zhaoyan Wang, Wang Jia, Ping Zhong, Huan Jia|first=|date=2016|title=Summary and consensus in 7th International Conference on acoustic neuroma: An update for the management of sporadic acoustic neuromas|url=|journal=World Journal of Otorhinolaryngology-Head and Neck Surgery|volume=|pages=|via=}}</ref>


==References==
==References==

Revision as of 02:59, 18 January 2019

Template:Acoustic neuroma Diagnostic Study of Choice Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Acoustic neuroma staging have been reported in several articles. Standardization of main symptoms grading is another important staging for description of patients' status.

Diagnostic Study of Choice

Standardization of main symptoms grading 

For better description of patients' status then analyzing management strategy and outcome of the treatment, standardized grading for main symptoms have been made. Generally, the AAO-HNS Hearing Classification System, House-Brackmann Facial Nerve Grading System, Tinnitus Handicap Inventory and Dizziness Handicap Inventory are widely accepted and used for Acoustic neuroma.

Tinnitus grading system for acoustic neuromas
Grade Description

I

No tinnitus

II

Intermittent or mild tinnitus, can only be heard when the ambient noise is low

III

Persistent or moderate tinnitus, can be heard every day

IV

Persistent and severe tinnitus, interfere with work and sleep
Dizziness grading system for acoustic neuromas
Grade Description

I

No dizziness or imbalance

II

Occasional and mild dizziness or imbalance

III

Persistent or moderate vertigo or imbalance

IV

Persistent and severe dizziness or imbalance, disturbing daily life

References

Template:WikiDoc Sources

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