mise à jour du 9 janvier 2003
Br J Ophthalmol
1999; 83; 1392-1389
Ocular complications of acoustic neuroma surgery
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.
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%).
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