Neurinomist

A neurinomist is a benign Tumeur nervous (noncancerous), developed at the expense of cells gliales called cells of Schwann, which manufacture the sheath of Myéline surrounding the Axone of a nerve: one also speaks about peripheral Gliome or Schwannome.

Neurinomists can create on the cranial nerves and rachidian, but the most frequent neurinomist (5 to 8% of the cerebral tumors) is the acoustic neurinomist .

Acoustic Neurinomist

In this case, the tumor is in fact a Schwannome vestibular nerve (the nerve of balance which forms, with the auditive nerve, the Nerf vestibulocochléaire or nerve VIII). Except extremely rare case of genetic cause, this tumor appears generally only on one side. While developing in the osseous channel which connects the ear to the brain, it compresses this nerve and involves the appearance of Vertige S or the disorders of balance. But it also causes a lesion of the auditive nerve, which passes in the same channel, outcome with a progressive Surdité and/or Acouphène S. These hearing disorders, since they reach generally one with dimensions, are often perceived more precociously and appear more awkward than the problems of balance, which are compensated by the other internal ear and also by the vision. This explains the traditional name of acoustic neurinomist (or neurinomist of acoustics). But this tumor can then cause a compression of the facial nerve (which also passes in the same channel) and induce problems of unilateral facial paralysis. In the long term, it will end up filling this channel, then will leave there (passage of a neurinomist of the type 1 with a neurinomist of the type 2) and will touch (stage 3) then to compress the brain (on the level of the cerebral Tronc) and the Cervelet (stage 4), which becomes very serious then and can result in death.

The symptomatic and clinical aspects are developed in the article Neurinome of acoustics.

The Imagery by magnetic resonance (IRM), painless, makes it possible to detect this type of tumor and to possibly carry out a prolonged monitoring, is before treatment, if the neurinomist remains of small size or slow evolution, that is to say after treatment, to take care of the risk of repetition.

Two types of treatments are possible:

the surgical treatment is essential in particular when the tumor is large, but it often presents the disadvantage of removing hearing and of threatening the integrity of the facial nerve. It must thus be practiced by specialized teams.
a treatment radiochirurgical using the Stéréotaxie and an irradiation with the Gamma rays ( gamma-knife ) is more suitable if the tumor is of small size: it makes it possible to avoid a difficult operation, as well as a long convalescence, and it minimizes the risks of after-effects. In France, the treatment by gamma-knife is not possible that in Marseilles (Hospital of Timone) and with the CHU of Lille.

External bonds

AFNA : French association for Neurinomes Acoustics
the voyage of the neurinomist

References

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