RESUMO
CONCLUSIONS: This study showed that patients with acoustic tumor (AT) with hearing loss in the contralateral side had severe mood disturbances. It is important for physicians to provide patients who have better hearing in the tumor side with adequate information regarding the possibility of profound bilateral hearing loss and how to communicate with others in such situations. OBJECTIVES: We examined the pretreatment status as regards neurosis and/or depression of patients with an AT using the Cornell Medical Index (CMI) and Self-rating Depression Scale (SDS) and clarified the relationship with the patients' background. METHODS: We enrolled 30 patients with unilateral AT between 1997 and 2010. At the time of diagnosis, we examined each patient's psychological condition, sex, age, laterality, tumor size, hearing level on bilateral side, facial paresis, headache, and canal paresis. RESULTS: In all, 20.0% of AT patients were diagnosed with neurosis using the CMI and 26.7% had depression according to the SDS. χ(2) analysis showed that patients with AT with hearing deterioration on the contralateral side had mental illness significantly more often than those with normal hearing on the contralateral side. Multivariable regression analysis revealed that the pretreatment status of hearing level on the contralateral side significantly affected the patients' psychological condition.
Assuntos
Transtorno Depressivo/etiologia , Perda Auditiva Unilateral/psicologia , Neuroma Acústico/psicologia , Adulto , Estudos de Casos e Controles , Índice Médico de Cornell , Transtorno Depressivo/diagnóstico , Feminino , Perda Auditiva Unilateral/diagnóstico , Perda Auditiva Unilateral/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neuroma Acústico/patologia , Neuroma Acústico/cirurgia , Testes Psicológicos , Qualidade de Vida , Fatores de Risco , Autoavaliação (Psicologia)RESUMO
We operated on three patients with juvenile nasopharyngeal angiofibroma in the past 3 years. The endoscopic transnasal approach was utilized in all the cases, and in one case it was accompanied with a Caldwell-Luc procedure. All the tumors were located around the sphenopalatine foramen, but also had involved and enlarged the pterygoid canal. All the cases underwent preoperative selective embolization, but it was difficult to embolize the branch of the internal carotid artery. A partial resection of the middle turbinate facilitated the manipulation of the sphenopalatine foramen and the pterygoid canal. Endoscopic management of juvenile nasopharyngeal angiofibroma should be considered as a first-choice option for tumors at the early stage.
