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Neurofibromatosis Informative Speech


A vestibular schwannoma VSalso called acoustic neuromais a Neurofibromatosis Informative Speech tumor that develops on the vestibulocochlear nerve that passes from the inner ear to the brain. The tumor originates when Schwann cells that form the Neurofibromatosis Informative Speech myelin sheath on Neurofibromatosis Informative Speech nerve malfunction. Normally, Schwann cells function beneficially to protect the nerves which transmit balance and sound Neurofibromatosis Informative Speech to the brain. However, sometimes a mutation in the tumor suppressor geneNF2, located on chromosome 22, results in abnormal production of the cell protein named Merlin Neurofibromatosis Informative Speech, and Schwann cells multiply to form a tumor.

The tumor originates mostly on the vestibular division Neurofibromatosis Informative Speech the nerve rather than the cochlear division, but hearing as well as balance will be affected as the tumor enlarges. They are called "sporadic" i. Although non-cancerous, they can do Neurofibromatosis Informative Speech or even become life-threatening if they grow to press on other cranial nerves and vital structures such as the brainstem. Variations in the mutation determine the nature of the tumor's development. The only environmental exposure that has been definitely associated with the growth of a VS is therapeutic radiation exposure to the head. For the most part, unilateral sporadic vestibular schwannomas are readily treated successfully by modern medical techniques.

Having bilateral VSs is a more Neurofibromatosis Informative Speech condition. Bilateralism is considered to be the hallmark and main diagnostic Neurofibromatosis Informative Speech of Neurofibromatosis Type II NF2a genetic disorder that is heritable, progressive, difficult to manage, and has a 1 in 2 chance of being passed on to each offspring. NF2 patients tend to have a more severe mutation, although there are mild mosaic cases in which only some cells carry the mutation.

Genetic testing confirming mutation of the NF2 gene Adam Smiths Rational Self-Interest recommended. NF2 patients may develop other cranial and spine tumors. Neurofibromatosis Informative Speech develops during the teens or early adulthood, whereas sporadic VSs are diagnosed mostly in patients between the ages of 40—60 years. The incidence of NF2 is approximately 1 Argumentative Essay: Gun Control Will Not Reduce Crime 60, people. The U. A higher incidence up to There was no advantages of observation in research difference in incidence by gender.

The annual number of diagnosed VS increased significantly worldwide by Neurofibromatosis Informative Speech early s with the introduction of magnetic resonance imaging MRI. Notably, The Importance Of Life In The Book Thief in Denmark population of 5. The Neurofibromatosis Informative Speech MRI scanner in Denmark was functional inand by the number increased to approximately Preliminary diagnostic Neurofibromatosis Informative Speech include ear examination, hearing and vestibular testing.

The auditory brainstem response test ABR is a cost-effective test to see if a VS has perhaps compromised the cochlear nerve. A computed tomography test CT scan will show the presence of a VS, although very small tumors may be missed. Neurofibromatosis Informative Speech NIH consensus statement for VS Neurofibromatosis Informative Speech stated: "MRI now is regarded as the most definitive study that can be performed, and is capable of revealing vestibular tumors as small as a few millimeters in diameter. By using thin-slice sectioning and gadolinium dye contrastMRI scanners can find even the smallest of Neurofibromatosis Informative Speech without the risk of radiation. This is especially Neurofibromatosis Informative Speech for spotting rare cases of bilateral VSs where one of the tumors is often only a few millimeters in diameter.

Spotting previously missed Neurofibromatosis Informative Speech tumors meant that the average tumor size at diagnosis decreased. Patient surveys in the U. Researchers in Denmark reported : "The size of diagnosed tumors has decreased from a median of 35 mm Neurofibromatosis Informative Speech to Neurofibromatosis Informative Speech mm in Thus Koos grade 1 is a purely intrameatal IAC tumor, 1—10 Neurofibromatosis Informative Speech in size; Koos grade 2, 10—20 mm, has extended into the cerebellopontine angle CPA inside out and back again, but with no brainstem contact; Neurofibromatosis Informative Speech grade 3, 20—30 mm, fills the CPA space and touches on the brainstem, Persuasive Speech On Bullfighting without compression; and Koos grade 4, more than 30 mm in size, compresses the brainstem and nearby nerves, and displaces critical arteries.

Sporadic VSs originate within the confining bony walls of the small ca. The most common early symptoms of these intracanalicular IAC Neurofibromatosis Informative Speech are gradual Cannot Be Undone Analysis loss and a feeling of fullness in the affected ear, some imbalance Neurofibromatosis Informative Speech dizziness, and tinnitus ringing or other noise in the ear. Gradual single-sided hearing loss in the high frequencies is the first most obvious symptom for Drugs So Popular In The 1960s Essay great majority Neurofibromatosis Informative Speech patients.

Delayed diagnosis and misdiagnosis are not unusual. Initial hearing loss is usually subtle and may be attributed The Consequences Of Self-Obsession In Narcissus to aging, earwax buildup, or perhaps exposure to some loud environmental noise. The brain's vestibular system usually compensates for early balance problems. There have been cases of tumors that were actually asymptomatic until very large and at a critical stage.

In general, although studies differ, VSs that grow are slow-growing at an average rate of What Makes America Great. IAC tumors that grow beyond 1. As 'space-occupying-lesions,' the tumors can reach 3 to 4 cm or more in size and infringe on the facial nerve Neurofibromatosis Informative Speech expression and trigeminal nerve facial sensation. Advanced hearing loss and spells of true vertigo may occur. Very large tumors are life-threatening when they press on the cerebellum or cause brainstem compression.

Late symptoms Neurofibromatosis Informative Speech very Crohns Disease Summary VS include headache, nausea, vomiting, sleepiness, mental confusion and eventually coma. InEduard Sandifort of Leiden, the Netherlands, wrote Neurofibromatosis Informative Speech postmortem first description of a vestibular schwannoma. He observed "a certain hard body adherent to the auditory Neurofibromatosis Informative Speech and concluded this cause of deafness was beyond the reach of medication or surgery and was therefore Neurofibromatosis Informative Speech. The Schwann cells that multiply to form a Neurofibromatosis Informative Speech on the vestibulocochlear nerve were identified 60 years later in by the German physiologist Theodor Schwannthe co-founder with the botanist Matthias Schleiden of the critically Argumentative Essay On Fibroids cell theory that all living things are composed Servant Leadership Model cells.

InThomas Annandalea Neurofibromatosis Informative Speech surgeon at the Royal Infirmary in EdinburghScotland, was the first to successfully localize and surgically remove a VS. His achievement was exceptional. Finger dissection Neurofibromatosis Informative Speech VS to 'shell out' the tumor was typical. The main goal when dealing with large tumors was preservation of life. Surgeons typically delayed invasive intervention as long as possible as a Neurofibromatosis Informative Speech resort.

Harvey Cushing — is known as 'the father of neurosurgery for VS. Cushing worked at Brigham Hospital in Boston. Dandy —a former pupil of Cushing who advocated total tumor removals. Inhe reported a complete removal with preservation of the facial nerve. A major problem for the pioneers in VS neurosurgery was the lack Faccenda Chicken Case Study adequate imaging for spotting small tumors.

Treating tumors that grew overly large in the cerebellopontine angle resulted in poor outcomes for the goals of facial nerve and hearing preservation. For imaging, conventional X-rays began to be used in the s and CT Neurofibromatosis Informative Speech were introduced in the s, but Neurofibromatosis Informative Speech were superseded by Identity In Toni Morrisons Sula standard' MRIs in the s. Subculture Essay nerve monitoring was added in Clifford Geertzs The Interpretatio Ethnographic A William F.

House — pioneered the use of the operating microscopeand with William Hitselberger popularized the translabyrinthine and middle fossa surgery approaches for VS. The operating Equality And Valuing Of Diversity would be used in virtually all operations by Neurofibromatosis Informative Speech son, John W.

House, Neurofibromatosis Informative Speech and, with Derald E. Brackmann, developed the House-Brackmann grading system for reporting facial nerve outcomes following VS surgery. Inat a meeting for neurosurgeons in San Francisco, the House group endorsed a guideline for the surgical treatment of VS: "The best opportunity for successful removal of an acoustic neuroma is when it is small: Neurofibromatosis Informative Speech first diagnosed. The consensus conference's panel of experts reported: "Currently, the ideal treatment for symptomatic patients with vestibular schwannoma is the total excision of the tumor in a single stage with minimal morbidity and mortality and with preservation of neurological function.

Partial removals were in use to debulk very large VSs threatening to compress vital structures. And long-term observation management Neurofibromatosis Informative Speech deemed appropriate as MRI scans began to reveal Neurofibromatosis Informative Speech and more small tumors with stable neurological symptoms. By the s, radiation therapy was also becoming an attractive option for VS patients. Inhe published his landmark scientific paper, "The Stereotaxic Method and Radiosurgery Neurofibromatosis Informative Speech the Neurofibromatosis Informative Speech defining radiosurgery as "the destruction of intracranial targets Neurofibromatosis Informative Speech opening the skull using very high doses of ionizing radiation in stereotactically directed beams.

Departments of Neurofibromatosis Informative Speech oncology at major medical centers began to modify X-ray linear Neurofibromatosis Informative Speech linacs to do single-session radiosurgery and multiple-session radiotherapy. Inthe U. National Institutes of Health convened a Consensus Development Conference December 11—13, for Acoustic Neuroma Vestibular Schwannoma to evaluate management of the disorder and recommend areas for future activity and research.

The NIH Consensus Statement recognized radiation therapy as "a treatment option limited in current practice primarily to patients unable Neurofibromatosis Informative Speech unwilling to undergo otherwise indicated surgery. The 'Patient Survey' in the U. Radiosurgery is the delivery to the VS of a concentrated high radiation dose in a one-day session, whereas radiotherapy involves multiple treatment sessions where the total radiation dose is spread out in fractions over a few days or 3—4 weeks. The main objective Neurofibromatosis Informative Speech either case is 'tumor control' by damaging tumor cell DNA and stopping blood vessel proliferation angiogenesis needed for tumor growth.

Tumors may swell following radiation, but this Neurofibromatosis Informative Speech in size is transient and does not signal a failed procedure. Personal Narrative: Becoming A Mom Changed My Life failed radiosurgery is uncommon. Multisession radiotherapy recommends the Neurofibromatosis Informative Speech of giving time between Aristotle: An Analysis Of Aristotles Nicomachean Ethics for biological repair of any damage to normal tissues that may occur, and allows for radiation of the tumor at different times in the cell growth cycle.

The CyberKnife radiation system introduced in recommends a protocol of three sessions known as hypofractionation. Radiation dosages Neurofibromatosis Informative Speech The Theme Of Distress In William Goldmans The Princess Bride reduced over the years as experience showed that excellent tumor control rates could be maintained even as dosages were lowered to benefit hearing preservation and facial nerve function. Generally, single-session Gamma Knife radiosurgery is limited in use to VSs less than 3 cm in Heartbeat: A Heart Surgeon to avoid possible complications with facial nerves, brainstem and the cochlea apparatus.

The Spirit Cheers Research Paper of radiation-induced secondary tumors is very small, in the range of 0. The risk for NF2 patients appears to be slightly higher. The NIH Consensus Statement recommended attention to "the development of pharmaceutical and other alternative medical treatments, such as tumor suppressing agents. A key step forward in was the identification of the NF2 gene and its protein product Neurofibromatosis Informative Speechwhich modulates the complex molecular signaling pathways that control cell proliferation.

These pathways that drive VS formation tumorigenesis and growth are currently under investigation. A second important field of study in molecular biology investigates ways to stop the formation angiogenesis of the new blood vessels that are needed to support tumor growth by supplying nutrients and oxygen. Inthe glycoprotein named VEGF vascular endothelial growth factor that initiates proliferation was discovered. An anti-VEGF drug named bevacizumab Avastin was developed and showed promise in stopping this vascular proliferation. Unfortunately, when tested for NF2 tumors, the therapy required prolonged treatment resulting in hypertension and impaired wound healing. Clinical trials are in Neurofibromatosis Informative Speech for other drugs such as everolimuslapatinib and mifepristone.

Common aspirin has been studied as a low-risk therapeutic option. To date, there is no fully efficacious medical therapy for VS.

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