General characteristics of the disease
Neuroma (or schwannoma) - a benign tumor that forms in the Schwann cells of spinal, cranial and peripheral nerves. Thus, neuroma - a neoplasm in cells that cover the nerves. They are rounded, sometimes lobed education in the form of capsules. It appears most frequently in the spine of the auditory nerve (vestibular portion), progress in the cerebellopontine angle (facial and auditory nerves), at least - in the spine V nerve (maxillary and mandibular, orbital nerves). And rarely neuromas occur in the roots of the glossopharyngeal and vagus nerves.
The percentage of disease neuroma - a relatively small at around 8% of all intracranial tumors and about 20% of all primary spinal structures. Subject to this disease are middle-aged and older, with women more likely to get sick. Since neuroma is a benign slow-growing tumors with, the cancer grows, it is very rare.
The most common are the following types of neuroma:
1. Morton's neuroma. This benign tumor is formed in the zone of the foot plantar nerve. In most cases there is a place of passage nerve third and fourth toes, sometimes between second and third fingers. Mainly affects one foot, very rarely - both.
2. The acoustic neuroma (is also known as vestibular schwannoma). In most cases, this tumor occurs in the vestibular branch of the auditory nerve, and its growth continues in the bridge-cerebellar angle. Neuroma increases in volume, resulting in a pressure on the brain stem and cerebellum. Direct contact with the formation of the facial nerve and sometimes even affects the lower cranial, and trigeminal nerve.
There are unilateral acoustic neuroma (about 95%) and bilateral (5%). The latter is usually caused by neurofibromatosis, and the first of its manifestations may be already in the second decade of life, in contrast to the one-sided, which most often faced by people aged 40-50 years.
3. neuromas spine. It is caused by a tumor of spinal nerve roots, and in most cases occurs in the thoracic and cervical spine, at least in the lumbar. It is considered the most common disease of the primary tumors in the spinal cord. It develops as extramedullary-intradural tumor in the Schwann cells.
Neuroma spinal roots can spread through the intervertebral foramen extradurally. This form neuroma is a type of "hourglass" and is characteristic of the cervical spine. The consequences are neuroma spine bone changes that are diagnosed normal spondylography.
Neuromas and other trigeminal nerve is the result of a tumor of the auditory nerve, and such species as sredostreniya neuroma - a subspecies of the tumor on the spine.
Histologically neuroma - a benign result of breeding Schwann cells (hence the second name of the disease, "schwannoma"), which form the myelin sheath of nerves, and it influences the process - has not been fully studied.
The symptoms neuromas
The first noticeable symptoms of acoustic neuroma is considered to be ringing in the ears, it complains about 60% of all patients, as well as hearing loss, especially noticeable during a telephone conversation. In most cases the auditory function is changing gradually, but in 10-20% of cases of immediate hearing loss. The lesions of the vestibular nerve may occur with a sharp turn of the head or the body, thus there is an unpleasant feeling of instability or loss of balance. Where the education is quite large, it can manifest hydrocephalus (fluid accumulation brain). However, as an epiphenomenon of possible faintly facial paralysis.
The main symptom of spinal neurinoma - a radicular pain caused by the development of the disease in the posterior sensory roots. Spinal neuromas develop slowly. Therefore, the correct diagnosis is established only after several years of pain if localization is seen in a broad lumbosacral. Narrow cervical reveals the disease at an early stage because there are signs of pressure on the spinal cord. In the presence of tumor in the side of the neck and a triangle in the supraclavicular area (which usually occur in the cervical spines or brachial plexus) possible pain in the neck or the shoulder belt.
Because peripheral neuromas occur for a long time and are asymptomatic, the tumor is detected as a subcutaneous volumetric education without painful symptoms.
Treatments neurinoma can pass a number of ways, regardless of the location of tumor formation.
1. Conservative treatment in this case involves the appointment of drugs such as mannitol in combination with corticosteroids, as well as control of water and electrolyte balance and diuresis. Also prescribe drugs that improve cerebral circulation.
2. The most common method - is surgical removal of the neuroma.
This method is radical removal. Treatment neuroma at the early stage is possible with microsurgical intervention. When this distance acoustic neuroma stored facial nerve function, and possibly hearing. In such cases, a translabirintny approach to treatment, but preservation of hearing - actually, if the size of the tumor did not exceed 2 cm.
3. The method of stereotactic radiosurgery is a certain alternative to the removal of neuromas, because in this case, is provided to control the growth of the tumor itself, with negative results are not high performance.
Radiosurgical treatment is indicated for the elderly, in the presence of somatic diseases, which does not allow for surgical treatment of neuromas, in the case of patients refuse surgery. This method is subject to the tumor is not more than 30 mm;
4. In the case of the slow growth of education, that is especially true for the elderly or people with severe comorbidities, expectant management should be applied which provides for CT or MRI and constant surveillance. Here it is used a palliative treatment for neuromas, ie bypass surgery, which can eliminate hydrocephalus.
Neuroma is not cancer, but if time does not pay attention to the symptoms, it can be very dangerous to human health, and its treatment will not bring positive results.