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Heyrnataugaslíðursæxli á Íslandi í 30 ár (1979 - 2009)

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Authors
Þorsteinn H Guðmundsson
Hannes Petersen
Issue Date
2013-06

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Other Titles
Acoustic neuroma in Iceland for 30 years (1979-2009).
Citation
Læknablaðið 2013, 99(6):289-92
Abstract
Heyrnartaugaslíðursæxli (acoustic neuroma (AN)) er æxli í 8. heilataug og á uppruna sinn frá taugaslíðursfrumum. Tilgangur rannsóknarinnar er að kanna nýgengið tímabilið 1979-2009 og varpa ljósi á faraldsfræðilega þætti er snúa að greiningu og meðferð. Rannsóknin var afturskyggn og náði til þeirra sem greinst höfðu árin 1979-2009. Gögnum frá Heyrnar- og talmeinastöð Íslands (HTÍ), Sjúkratryggingum Íslands (SÍ), háls-, nef- og eyrnadeild og heila- og taugaskurðdeild Landspítala (LSH) var safnað saman og athugaðir voru faraldsfræðilegir þættir sjúklingahópsins. Nýgengi heyrnartaugaslíðursæxla 1979-2009 er 1,24/100.000/ári og fer vaxandi. 10% æxla eru greind fyrir tilviljun, flest á síðasta þriðjungi tímabilsins, en á því tímabili eru æxlin minni við greiningu, það er fleiri meðalstór æxli finnast en færri stór og risastór. Helstu einkenni sjúklinga eru heyrnarskerðing (69%), jafnvægisleysi og/eða svimi (47%) og suð í eyrum (43%). 47 einstaklingar fóru í skurðaðgerð, 16 fengu gammahnífsgeislun og 30 eru undir eftirliti. Fylgikvillar aðgerðar, með tilliti til heyrnar og andlitslömunar, voru skráðir í 39 tilfellum. Heyrn-ar-leysi á aðgerðareyra var 69% (n=27) og 44% (n=17) hlutu óafturkræfa and-lits-lömun. Meðaleftirfylgni einstaklinga í eftirliti voru 3,5 ár og uxu 17% æxlanna. Nýgengi heyrnartaugaslíðursæxla á Íslandi er svipað og á hinum Norðurlöndunum. Tilfellum fer fjölgandi og fleiri æxli greinast fyrir tilviljun sem meðal annars má þakka segulómtækninni. Ef æxli eru smá er eftirlit raunhæfur kostur þar sem lágt hlutfall æxla stækkar innan nokkurra ára. Stærri æxli eru meðhöndluð með aðgerð eða gammahnífsgeislun en yfir helmingur aðgerðarsjúklinga missir heyrn eftir aðgerð.
Acoustic neuroma (AN) is a tumor of the 8th cranial nerve. The goal of this study was to find the incidence of AN in Iceland from 1979 - 2009 as well as investigate other epidemiological factors. The group of patients with the AN diagnosis was gathered retrospectively through medical records. We looked at several epidemiological factors including age and symptoms at diagnosis, and the treatment chosen for each individual. The incidence rate of AN in Iceland is 1.24/100,000. About 10% of diagnosed tumors were found incidentally. Most of those were found in the last 10 years of the investigation and in that period fewer large and giant tumors at diagnosis. Present complaints of patients at diagnosis were hearing loss (69%), dysequilibrium/dizziness (47%) and tinnitus (43%). Treatments were surgery (n=47), observation (n=30) and gamma knife radiosurgery (n=16). We had information concerning postoperative hearing loss and facial paralysis in 39 patients who underwent surgery. Loss of hearing postoperatively occurred in 69% (n=27) and 44% (n=17) had facial paralysis. For an average of 3.5 years, 17% of tumors followed by imaging grew. The incidence of AN is similar to that in Europe and is increasing. More tumors are found incidentally. Small tumors can be followed by regular imaging, at least for the short term. Larger tumors are treated by surgery or gamma knife radiosurgery. A high percentage of patients receiving surgery lost their hearing postoperatively.
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