Criteria of objectification diagnostics and indicators of quality of vestibular schwannoma surgical treatment

Abstract

The article is sanctified to the problem of standardization and objectification diagnosis and the development of indicators of the quality of surgical treatment of patients with vestibular schwannomas (VS).Purpose. Objectification and standardization of diagnostic criteria and indicators of the quality of surgical treatment of patients with VS accordance to international standards.Materials and methods. Locations retro prospective analysis of complex examination results and treatment of 227 patients with VS were in The State institution Institute of neurosurgery named after acad. A.P. Romodanov of AMN of Ukraine for the period from 2005 to the present. In our series of supervisions of ВШ more often (in two times) diagnosed for women by age 60 from 40 to (to 40% of all supervisions) with an average duration of history about 4 years. All observations of this study verified histologically.Results. System multivariate analysis of clinical manifestations and symptoms of VS on a large array of data has allowed us to develop and implement a standardized integrated circuit otoneurological examination of patients to improve the effectiveness of early diagnosis of tumors of the cerebellopontine angle. Worked out a range of quality indicators of surgical treatment of patients with VS. Scale provides objective evidence and indicators required to assess the initial condition of the patients, the dynamic control of neurological disorders during the treatment and / or evaluation of the completed rehabilitation course. The scale is evaluated 11 clinical signs expressed by rank. The boundaries of the total score range corresponding to: neurological disorders (focal neurological deficit) of mild severity score 0-8; neurological disorders moderate severity 9-24 points; focal neurological deficits heavy severity of 25-41 points. This system allows to forecast the flow of disease and potential answer for rehabilitation events.Conclusions. Offered numerical score of surgery quality indicators for VS should be integrated into the overall scheme of assessment examination of the patient with the assistance of objective instrumental methods of examination. This evaluation is required in the preoperative period and in dynamics.In some cases, such an assessment is not only the clinical but also the expert value, objectifies and justify the cost of treatment and the amount of the insurance policy, determines the patient’s social adaptation. The proposed scale of assessment of the quality indicators of surgical treatment of patients with VS brings a solution to the international standards.