MG Mulhern, PM Aduriz-Lorenzo, D Rawluk, L
Viani, P Eustace, P Logan
University of Toronto,
Department of Ophthalmology, The Toronto
Hospital ,
399 Bathurst Street,
Toronto,Ontario, Canada
An acoustic neuroma is a benign tumour
derived from the Schwann cells of the
vestibulocochlear nerve sheath. The vestibular
portion of the nerve arises within the internal
auditory meatus, and it is here that the tumour
occurs most often. Lesions which produce
symptoms do so by distortion of the 8th nerve
complex or by displacement of the adjacent
brainstem.
The ophthalmic sequelae of tumour resection
can ultimately lead to a dry exposed anaesthetic
eye, which may (i) require lifelong
supplementation with lubricants, (ii) undergo
recurrent episode of neurotrophic ulceration, or
(iii) painlessly progress onto corneal
perforation and iris prolapse. This study seeks
to quantify the ophthalmic complications
(corneal and visual), highlight the "at risk"
groups, and outline the management modalities
required after acoustic neuroma resection.
[...]
PATIENT SYMPTOMATOLOGY
At the research review, 57 of the patients
were questioned to determine if they had any
ophthalmic symptoms after surgery; 19 (33.4%)
were asymptomatic, while the following symptoms
were reported by the othersÑ dryness
(33.4%), crocodile tears (7%), epiphora (5.3%),
poor acuity (3.5%), reduced visual field
secondary to brow ptosis (1.7%) and secondary to
tarsorrhaphy (1.7%), aberrant regeneration
induced lid closure on yawning (1.7%), and
miscellaneous (12.3%).
