Acoustic neuroma staging
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Acoustic neuroma Microchapters | |
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Diagnosis | |
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Treatment | |
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Case Studies | |
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Acoustic neuroma staging On the Web | |
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American Roentgen Ray Society Images of Acoustic neuroma staging | |
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Risk calculators and risk factors for Acoustic neuroma staging | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Acoustic neuroma may be classified into three subtypes based on tumor size and into six subtypes based on tumor location.
Staging
Standardization of main symptoms grading
For better description of patients' status then analyzing management strategy and outcome of the treatment, standardized grading for main symptoms have been made. Generally, the AAO-HNS Hearing Classifi- cation System,6 House-Brackmann Facial Nerve Grading System,7 Tinnitus Handicap Inventory8 and Dizziness Handicap Inventory9 are widely accepted and used for Acoustic neuroma.
| Tinnitus grading system for acoustic neuromas | |
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| Grade | Description |
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I |
No tinnitus |
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II |
Intermittent or mild tinnitus, can only be heard when the ambient noise is low |
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III |
Persistent or moderate tinnitus, can be heard every day |
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IV |
Persistent and severe tinnitus, interfere with work and sleep |
| Dizziness grading system for acoustic neuromas | |
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| Grade | Description |
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I |
No dizziness or imbalance |
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II |
Occasional and mild dizziness or imbalance |
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III |
Persistent or moderate vertigo or imbalance |
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IV |
Persistent and severe dizziness or imbalance, disturbing daily life |
Tumor size and stages
Numerous stage grading system ave been reported according to tumor size, but also for the first step description of the tumor size is more important and have measured by the maximum diameter (means the one measured in cerebellopontine angle (CPA) along the long axis) of the tumor.
| Main grading systems for acoustic neuromas | |||||
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| Tumor size (CPA Maximum diameter) | Sterker | House | Koos | Samii | Tumor Description |
| 0
(intracanalicular) |
Tube type | intracanalicular | Grade I | T1 | Confining to IAC |
| ≤10 mm | Small | Grade 1
(Small) |
Grade II | T2 | Superpassing IAC |
| ≤15 mm | Grade 2
(Medium) |
T3a | Tumor occupying CPA | ||
| ≤20 mm | Mild | ||||
| ≤3o mm | Grade 3
(Moderately Large) |
Grade III | T3b | Tumor occupying CPA and contacting
the brainstem without compression | |
| ≤40 mm | Large | Grade 4
(Large) |
Grade IV | T4a | Tumor compressing the brainstem |
| >40 mm | Huge | Grade 5
(Giant) |
T4b | sever brainstem displacement and deformation of fourth ventricle under tumor compression | |
| Main grading systems for acoustic neuromas. The classifications on the left side (blue area) are mainly based on tumor size, while those on the right side (yellow area) are based on the anatomical relationship around the tumor. Koos classification (green area) combines the tumor size and anatomical relationship for larger tumors. | |||||