{"id":72,"date":"2012-04-17T21:46:41","date_gmt":"2012-04-17T12:46:41","guid":{"rendered":"\/sawamura\/wp\/?p=72"},"modified":"2026-01-15T17:32:58","modified_gmt":"2026-01-15T08:32:58","slug":"acoustictumor","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/braintumors\/acoustictumor\/","title":{"rendered":"\u8074\u795e\u7d4c\u816b\u760d\uff08\u524d\u5ead\u795e\u7d4c\u9798\u816b\uff09"},"content":{"rendered":"\n<h5 class=\"wp-block-heading\"><a href=\"\/sawamura\/contact_yamamoto\/\" title=\"\">\u8074\u795e\u7d4c\u816b\u760d\uff08\u524d\u5ead\u795e\u7d4c\u9798\u816b\uff09\u306b\u95a2\u3057\u3066\uff0c\u6a2a\u6d5c\u5e02\u7acb\u5927\u5b66\u306e\u5c71\u672c\u54f2\u54c9\u5148\u751f\u304c\u5fa1\u76f8\u8ac7\u306b\u306e\u308a\u307e\u3059\uff0c\u76f8\u8ac7\u3057\u305f\u3044\u65b9\u306f\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u304f\u3060\u3055\u3044<\/a><\/h5>\n\n\n\n<p>\u5c71\u672c \u54f2\u54c9\uff08\u3084\u307e\u3082\u3068 \u3066\u3064\u3084\uff09<br>\u3000\u6a2a\u6d5c\u5e02\u7acb\u5927\u5b66\u9644\u5c5e\u75c5\u9662 \u8133\u795e\u7d4c\u5916\u79d1 \u8a3a\u7642\u79d1\u90e8\u9577<br>\u3000\u6a2a\u6d5c\u5e02\u7acb\u5927\u5b66 \u8133\u795e\u7d4c\u5916\u79d1 \u4e3b\u4efb\u6559\u6388<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u6b63\u78ba\u306b\u306f\uff0c<strong><span style=\"color: #000080;\">\u524d\u5ead\u795e\u7d4c\u9798\u816b<\/span><\/strong> vestibular schwannoma \u3068\u3044\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u805e\u3053\u3048\u306e\u795e\u7d4c\uff08\u8778\u725b\u795e\u7d4c\uff09\u3067\u306f\u306a\u304f\u3066\uff0c\u30d0\u30e9\u30f3\u30b9\u306e\u795e\u7d4c\uff08\u524d\u5ead\u795e\u7d4c\uff09\u304b\u3089\u767a\u751f\u3059\u308b\u304b\u3089\u3067\u3059<\/li>\n\n\n\n<li>\u8133\u816b\u760d\u306e6%\u304f\u3089\u3044\u3092\u5360\u3081\u308b\u826f\u6027\u816b\u760d\u3067\uff0c\u3068\u3066\u3082\u591a\u3044\u3082\u306e\u3067\u3059<\/li>\n\n\n\n<li>\u75c7\u72b6\u306f\uff0c<span style=\"color: #000080;\"><strong>\u8074\u529b\u4f4e\u4e0b\uff08\u7247\u65b9\u306e\u8033\u3067\uff0c\u7a81\u7136\u3042\u308b\u3044\u306f\u3086\u3063\u304f\u308a\u805e\u3053\u3048\u304c\u60aa\u304f\u306a\u308b\uff09\uff0c\u8033\u9cf4\u308a\uff0c\u3081\u307e\u3044\uff08\u6642\u306b\u306f\u767a\u4f5c\u6027\u306e\u6fc0\u3057\u3044\u3081\u307e\u3044\uff09\uff0c\u3075\u3089\u3064\u304d\uff0c\u9854\u3068\u820c\u306e\u3057\u3073\u308c<\/strong><\/span>\u3067\u3059<\/li>\n\n\n\n<li>\u826f\u6027\u816b\u760d\u3067\u3059\u304b\u3089<span style=\"color: #000000;\">\u6cbb\u7642\u3092\u6025\u3050\u5fc5\u8981\u306f\u3042\u308a\u307e\u305b\u3093\uff0c\u3042\u308f\u3066\u306a\u3044\uff01<\/span><\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u9078\u629e\u80a2\u306f\uff13\u3064<\/strong><\/span><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">\uff0c<span style=\"color: #ff0000;\"><strong>\u4f55\u3082\u3057\u306a\u3044\u3067\u69d8\u5b50\u3092\u898b\u308b\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\uff0c\u958b\u982d\u624b\u8853\u3067\u53d6\u308b<\/strong><\/span><\/span><\/span>\u3067\u3059<\/li>\n\n\n\n<li>\u305d\u308c\u305e\u308c\u306b\u5229\u70b9\u3068\u6b20\u70b9\u304c\u3042\u308b\u306e\u3067\uff0c\u500b\u3005\u306e\u60a3\u8005\u3055\u3093\u306e\u5e74\u9f62\u3084\u8074\u529b\u3084\u751f\u6d3b\uff0c\u3059\u3079\u3066\u542b\u3081\u3066\u8003\u3048\u307e\u3059<\/li>\n\n\n\n<li>\u3053\u306e3\u3064\u306e\u9078\u629e\u80a2\u3092\u614e\u91cd\u306b\u3044\u308d\u3044\u308d\u8abf\u3079\u305f\u308a\u610f\u898b\u3092\u805e\u3044\u3066\uff0c\u3088\u304f\u3088\u304f\u8003\u3048\u307e\u3059<\/li>\n\n\n\n<li>\u6cbb\u7642\u306b\u95a2\u3057\u3066\u8fd1\u5e74\u3067\u306f\uff0c\u8133\u5916\u79d1\u3067\u306e\u958b\u982d\u624b\u8853\u3088\u308a\u3082\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u307b\u3046\u304c\u5727\u5012\u7684\u306b\u591a\u304f\u306a\u3063\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li><strong><span style=\"color: #ff0000;\">\u307b\u3069\u3093\u3069\u304c\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u6cbb\u308b<\/span><\/strong><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">\u306e\u3067\uff0c\u958b\u982d\u624b\u8853\u306f\u3088\u307b\u3069\u5927\u304d\u306a\u3082\u306e\u3057\u304b\u3057\u307e\u305b\u3093<\/span><\/span><\/li>\n\n\n\n<li>\u624b\u8853\u6cbb\u7642\u3092\u7a4d\u6975\u7684\u306b\u8003\u3048\u308b\u304b\u3069\u3046\u304b\u306e\u5927\u307e\u304b\u306a\u76ee\u5b89\u306f\uff0c<span style=\"color: #ff0000;\"><span style=\"color: #000000;\"><span style=\"color: #000080;\"><strong>\u816b\u760d\u306e\u5927\u304d\u3055\u304c3cm\u524d\u5f8c<\/strong><\/span><\/span><\/span>\u304f\u3089\u3044\u306e\u6642\u3067\u3059<span style=\"color: #ff0000;\"><span style=\"color: #000000;\"><br><\/span><\/span><\/li>\n\n\n\n<li>\u8074\u795e\u7d4c\u816b\u760d\u306e\u5834\u5408\uff0c<strong><span style=\"color: #ff0000;\">\u540d\u533b\u3068\u306f\u624b\u8853\u306e\u4e0a\u624b\u306a\u5916\u79d1\u533b\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/span><\/strong>\uff0c\u4e0d\u8981\u306a\u624b\u8853\u3092\u52e7\u3081\u306a\u3044\u5916\u79d1\u533b\u3067\u3059<\/li>\n\n\n\n<li>\u6cbb\u7642\u306e\u76ee\u7684\u306f<strong><span style=\"color: #ff0000;\">\u8074\u529b\u306e\u6e29\u5b58<\/span><\/strong><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">\u3068<\/span><\/span><strong><span style=\"color: #ff0000;\">\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u3092\u51fa\u3055\u306a\u3044<\/span><\/strong>\u3053\u3068\u306b\u6ce8\u76ee\u3067\u3059<\/li>\n\n\n\n<li>\u4eca\u3069\u304d\uff0c\u547d\u3092\u306a\u304f\u3059\u3088\u3046\u306a\u816b\u760d\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u307e\u305a\u306f\uff0c\u4f55\u3082\u3057\u306a\u3044\u3067\u7d4c\u904e\u89b3\u5bdf\u3092\u3059\u308b\u3053\u3068\u3092\u8003\u3048\u307e\u3057\u3087\u3046<\/li>\n\n\n\n<li>\u7d4c\u904e\u89b3\u5bdf\u306e\u305f\u3081\u306eMRI\u691c\u67fb\u306f\uff0c\u534a\u5e74\u304b1\u5e74\u306b1\u56de\u3082\u3059\u308c\u3070\u5341\u5206\u3067\u3059<\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u691c\u67fb\u306b\u4f59\u5206\u306a\u533b\u7642\u8cbb\u3092\u304b\u3051\u306a\u3044<\/strong><\/span>\u3053\u3068\u3082\u30dd\u30a4\u30f3\u30c8\u3067\u3059<\/li>\n\n\n\n<li>\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3067\uff0c<span style=\"color: #000080;\"><strong>\u5f37\u3044\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u304c\u6b8b\u308b\u53ef\u80fd\u6027\u306f1%\u7a0b\u5ea6\u3042\u308b\u3044\u306f0%<\/strong><\/span>\u3068\u5831\u544a\u3055\u308c\u3044\u3066\u3044\u308b\u306e\u3067\uff0c3cm\u4ee5\u4e0b\u306e\u816b\u760d\u3067\uff0c\u958b\u982d\u624b\u8853\u3092\u63d0\u6848\u3055\u308c\u305f\u6642\u306b\u306f\uff0c\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u306e\u30ea\u30b9\u30af\u304c1%\u7a0b\u5ea6\u3067\u3042\u308b\u304b\u3069\u3046\u304b\u3092\u78ba\u8a8d\u3057\u3066\u4e0b\u3055\u3044<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticchou2-1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"296\" height=\"300\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticchou2-1-296x300.jpg\" alt=\"acousticchou2\" class=\"wp-image-9531\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticchou2-1-296x300.jpg 296w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticchou2-1-768x779.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticchou2-1-550x558.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticchou2-1.jpg 984w\" sizes=\"auto, (max-width: 296px) 100vw, 296px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><br>\u3053\u306e\u816b\u760d\u306f\u8133\u5e79\u90e8\u5909\u5f62\u304c\u3068\u3066\u3082\u5f37\u304f\uff0c\u5927\u304d\u3044\u306e\u3067\u624b\u8853\u6458\u51fa\u3059\u308b\u3057\u304b\u9078\u629e\u80a2\u306f\u3042\u308a\u307e\u305b\u3093<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomatinyat.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"297\" height=\"300\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomatinyat-297x300.jpg\" alt=\"\" class=\"wp-image-21693\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomatinyat-297x300.jpg 297w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomatinyat-550x555.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomatinyat.jpg 709w\" sizes=\"auto, (max-width: 297px) 100vw, 297px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><br>\u3053\u308c\u306f\u53f3\u5185\u8033\u9053\u306e\u5965\u6df1\u304f\u306b\u3067\u304d\u305f\u816b\u760d\u3067\u3059\u30024mm\u304f\u3089\u3044\u306e\u6975\u5c0f\u306e\u8074\u795e\u7d4c\u816b\u760d\u3068\u8a00\u3048\u307e\u3059\u3002\u3053\u306e\u5927\u304d\u3055\u3067\u3082\uff0c\u3081\u307e\u3044\u767a\u4f5c\u3068\u8074\u529b\u4f4e\u4e0b (50dB\u7a0b\u5ea6\uff0c\u4f4e\u97f3\u57df\u4f4e\u4e0b\uff09\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u3082\u3061\u308d\u3093\u306a\u306b\u3082\u3057\u306a\u3044\u3067\u307b\u3063\u3066\u304a\u304d\u307e\u3059<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u8133\u5e79\u90e8\u306e\u5909\u5f62\u304c\u9ad8\u5ea6\u306a\u5927\u304d\u306a\u816b\u760d\u306b\u306a\u308b\u3068\u624b\u8853\u3059\u308b\u3057\u304b\u3042\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>4cm\u3092\u8d85\u3048\u308b\u3068\u5371\u967a<\/strong><\/span>\u3060\u3068\u8003\u3048\u3066\u304f\u3060\u3055\u3044<\/li>\n\n\n\n<li>\u306e\u3046\u80de\u6027\uff08\u816b\u760d\u306e\u5185\u90e8\u304c\u307b\u3068\u3093\u3069\u6db2\u4f53\uff09\u306e\u3082\u306e\u306f4cm\u3092\u8d85\u3048\u3066\u3082\u624b\u8853\u306f\u5371\u306a\u304f\u306a\u3044\u3067\u3059<\/li>\n\n\n\n<li>\u5de8\u5927\u306a\u5145\u5b9f\u6027\u306e\u8074\u795e\u7d4c\u816b\u760d\u306e\u624b\u8853\u3067\u306f\u547d\u3092\u306a\u304f\u3059\u30ea\u30b9\u30af\u3082\u3042\u308b\u3082\u306e\u3067\u3059<\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u624b\u8853\u306f\u3068\u3066\u3082\u96e3\u3057\u3044\u306e\u3067\u624b\u8853\u7d4c\u9a13\u306e\u591a\u3044\u8133\u5916\u79d1\u533b\u3092\u635c\u3057\u307e\u3057\u3087\u3046<\/strong><\/span><\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u5927\u304d\u306a\u816b\u760d\u3067\u306f\u7121\u7406\u3057\u3066\u5168\u90e8\u6458\u51fa\u305b\u305a\uff0c\u90e8\u5206\u6458\u51fa\u8853\u3067\u5c0f\u3055\u304f\u3057\u3066\u304a\u3044\u3066\u304b\u3089\uff0c\u624b\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3059<\/strong><\/span><\/li>\n\n\n\n<li>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306a\u3069\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u526f\u4f5c\u7528\u3068\u3057\u3066\u816b\u760d\u306e\u60aa\u6027\u5316\u306a\u3069\u304c\u8a00\u308f\u308c\u307e\u3059\u304c\uff0c\u3059\u3054\u304f\u78ba\u7387\u304c\u4f4e\u3044\u3053\u3068\u3067\u3059\uff0c\u60d1\u308f\u3055\u308c\u3066\u306f\u306a\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li><span style=\"color: #000000;\"><span style=\"color: #333333;\">\u9006\u306b\uff0c\u5831\u544a\u3055\u308c\u306a\u3044\u624b\u8853\u6b7b\u4ea1\u3084<\/span><span style=\"color: #000080;\"><strong>\u91cd\u3044\u624b\u8853\u5408\u4f75\u75c7\u306f\u304b\u306a\u308a\u3042\u308a\u307e\u3059<\/strong><\/span><\/span><\/li>\n\n\n\n<li><span style=\"color: #333333;\">\u30cd\u30c3\u30c8\u4e0a\u3067\uff0c\u8074\u795e\u7d4c\u816b\u760d\u306e\u624b\u8853\u6570\u304c\u591a\u3044\u75c5\u9662\uff0c\u6cbb\u7642\u6210\u7e3e\u304c\u826f\u3044\u3068\u306e\u63b2\u793a\u304c\u5897\u3048\u3066\u3044\u307e\u3059\u304c\uff0c\u5ba3\u4f1d\u76ee\u7684\u306e\u53ef\u80fd\u6027\u3082\u3042\u308a\u307e\u3059\u304b\u3089\u6c17\u3092\u3064\u3051\u3066\u304f\u3060\u3055\u3044<\/span><\/li>\n<\/ul>\n\n\n\n<h1 class=\"wp-block-heading\"><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"schwann\/\">\u4e09\u53c9\u795e\u7d4c\u9798\u816b\u306a\u3069\u306e\u795e\u7d4c\u9798\u816b\u306f\u4ed6\u306e\u30da\u30fc\u30b8\u306b\u66f8\u3044\u3066\u307e\u3059<br>\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/a><\/strong><\/span><\/h1>\n\n\n\n<h5 class=\"wp-block-heading\"><span style=\"color: #000080;\">\u306a\u305c\u4f55\u3082\u6cbb\u7642\u3057\u306a\u3044\u3067\u7d4c\u904e\u89b3\u5bdf\u304c\u9078\u629e\u80a2\u306b\u306a\u308b\u306e\u304b\uff1f<\/span><\/h5>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u81ea\u7136\u306b\u5c0f\u3055\u304f\u306a\u3063\u3066\u3057\u307e\u3046\u3053\u3068\u304c\u3042\u308b\u816b\u760d\u3067\u3059<\/strong><\/h4>\n\n\n\n<p>\u81ea\u7136\u9000\u7e2e\uff08\u305f\u3044\u3057\u3085\u304f\uff09\u3068\u306f\u4f55\u3082\u3057\u306a\u304f\u3066\u3082\u816b\u760d\u304c\u5c0f\u3055\u304f\u306a\u3063\u3066\u3057\u307e\u3046\u3053\u3068\u3067\u3059\u3002\u8074\u795e\u7d4c\u816b\u760d\u3067\u306f10%\u4ee5\u4e0a\uff08\u6587\u732e\u306b\u3088\u3063\u3066\u306f30%\uff09\u306b\u3053\u308c\u304c\u8d77\u308a\u307e\u3059\u3002\u3067\u3059\u304b\u3089\uff0c\u306a\u3093\u306b\u3082\u6cbb\u7642\u3092\u3057\u306a\u304f\u3066\u307b\u3063\u3066\u304a\u3044\u3066\u3082\u4f55\u3067\u3082\u306a\u3044\u3053\u3068\u3082\u5c11\u306a\u304b\u3089\u305a\u3042\u308b\u306e\u3067\u3059\u3002<strong><span style=\"color: #ff0000;\">\u7121\u7406\u306b\u6cbb\u7642\u3092\u3057\u306a\u3044\u3067\u307e\u305a\u69d8\u5b50\u3092\u898b\u308b\u3053\u3068\u3082\u5927\u5207\u3067\u3059\u3002<\/span><\/strong>\u4fe1\u3058\u3089\u308c\u306a\u3044\u4eba\u306e\u305f\u3081\u306b\u4f8b\u3092\u898b\u305b\u307e\u3057\u3087\u3046\u3002<\/p>\n\n\n\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/spontaneous2.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/spontaneous2.png\" alt=\"\" width=\"482\" height=\"335\"><br><\/a><span style=\"color: #333333;\">\uff18\u5e74\u9593\u89b3\u5bdf\u3057\u3066\u4f55\u3082\u3057\u306a\u3044\u3067\u5c0f\u3055\u304f\u306a\u3063\u3066\u3057\u307e\u3063\u305f\u5927\u304d\u306a\u8074\u795e\u7d4c\u816b\u760d\u3067\u3059\u300260\u4ee3\u534a\u3070\u306e\u5973\u6027\u3067\u3057\u305f\u3002\u3053\u306e\u81ea\u7136\u9000\u7e2e\u306f\uff0c<\/span><span style=\"color: #000080;\"><strong>\u5e74\u9f62\u304c\u9ad8\u3044\u60a3\u8005\u3055\u3093\u307b\u3069\u751f\u3058\u3084\u3059\u3044<\/strong><\/span>\u3067\u3059<span style=\"color: #333333;\">\u3002\u307e\u305f\uff0c\u81ea\u7136\u9000\u7e2e\u3059\u308b\u524d\u306b\uff0c\u816b\u760d\u306e<\/span><span style=\"color: #000080;\"><strong>\u306e\u3046\u80de\u5316<\/strong><span style=\"color: #333333;\">\uff08\u816b\u760d\u306e\u4e2d\u306b\u6c34\u305f\u307e\u308a\u304c\u3067\u304d\u308b\uff09<\/span><\/span><span style=\"color: #333333;\">\u3068\u3044\u3046\u73fe\u8c61\u304c\u8d77\u304d\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002<\/span><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong><span style=\"color: #ff0000;\">\u307e\u305a\uff0cMRI\u3067\u7d4c\u904e\u89b3\u5bdf\u3059\u308b\u3068\u3044\u3046\u9078\u629e\u80a2<\/span><\/strong>\uff08wait and scan)<\/h4>\n\n\n\n<p>\u8133\u69fd\u5185\uff08\u5185\u8033\u9053\u5916\uff09\u306b30-40mm\u3092\u8d85\u3048\u308b\u3088\u3046\u306a\u8074\u795e\u7d4c\u816b\u760d\u306f\u6cbb\u7642\u3092\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002\u305d\u308c\u4ee5\u4e0b\u306e\u3082\u306e\u306f\u7d4c\u904e\u3092\u898b\u308b\u3068\u3044\u3046\u9078\u629e\u80a2\u304c\u51fa\u307e\u3059\u3002<\/p>\n\n\n\n<p>\u3067\u306f\uff0c\u3069\u306e\u304f\u3089\u3044\u306e\u78ba\u7387\u3067\u816b\u760d\u306f\u5927\u304d\u304f\u306a\u3063\u3066\u3057\u307e\u3046\u306e\u3067\u3057\u3087\u3046\u3002\u6587\u732e\u3092\u8abf\u3079\u3066\u3082\u306f\u3063\u304d\u308a\u3057\u307e\u305b\u3093\u300210%\u3068\u3044\u3046\u5831\u544a\u304b\u308980%\u3068\u3044\u3046\u5831\u544a\u307e\u3067\u3042\u308a\u307e\u3059\u3002\u3067\u3082\u6570\u5e74\u304f\u3089\u3044\u306e\u89b3\u5bdf\u3067\u3059\u3068\uff13\u5206\u306e\uff11\u7a0b\u5ea6\u306e\u78ba\u7387\u3060\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u5897\u5927\u3068\u3044\u3046\u306e\u30922mm\u4ee5\u4e0a\u5927\u304d\u304f\u306a\u308b\u3068\u3044\u3046\u5b9a\u7fa9\u304c\u3042\u308a\u307e\u3059\uff0c\u305d\u308c\u306b\u5f93\u3046\u3068<span style=\"color: #000080;\"><strong>5\u5e74\u306e\u7d4c\u904e\u89b3\u5bdf\u3067\uff13\u5272\u307b\u3069\u306e\u60a3\u8005\u3055\u3093\u3067\u5897\u5927\u3059\u308b<\/strong><\/span>\u3068\u3044\u3046\u5831\u544a\u3082\u3042\u308a\u307e\u3059\u3002\u9006\u306b\u8a00\u3048\u3070\uff0c\u534a\u6570\u4ee5\u4e0a\u306f\u6570\u5e74\u898b\u3066\u30822mm\u4ee5\u4e0a\u5927\u304d\u304f\u306a\u3089\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u60a3\u8005\u3055\u3093\u306e\u5e74\u9f62\u304c\u82e5\u3044\u307b\u3069\u816b\u760d\u306e\u5927\u304d\u304f\u306a\u308b\u78ba\u7387\u306f\u9ad8\u3044\u3067\u3057\u3087\u3046\u3002<\/p>\n\n\n\n<p><span style=\"color: #333333;\">\u3082\u3057\u816b\u760d\u304c\u5c0f\u3055\u304f\u3066\uff0c\u826f\u3044\u8074\u529b\u304c\u6b8b\u3063\u3066\u3044\u305f\u3089\u8074\u529b\u306f\u3069\u3046\u306a\u308b\u306e\u3067\u3057\u3087\u3046\u3002<span style=\"color: #000080;\"><strong>\u6b8b\u5ff5\u306a\u304c\u3089\u8074\u529b\u4f4e\u4e0b\u304c\u751f\u3058\u308b\u78ba\u7387\u306f\u9ad8\u304f<\/strong><\/span>\u3066\uff0c\uff13\u5e74\u304f\u3089\u3044\u89b3\u5bdf\u3059\u308b\u3068\uff12\u5206\u306e\uff11\u304b\uff13\u5206\u306e\uff11\u304f\u3089\u3044\u306e\u78ba\u7387\u3067\u305d\u306e\u8074\u529b\u306f\u4f7f\u3048\u306a\u304f\u306a\u308b\u307e\u3067\u4f4e\u4e0b\u3057\u307e\u3059\u3002\u3067\u3082\u624b\u8853\u3059\u308b\u3068\u534a\u5206\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093\u3067\u8074\u529b\u306f\u6d88\u5931\u3057\u307e\u3059\u3057\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u3066\u30827\u5272\u304f\u3089\u3044\u306e\u78ba\u7387\u3067\u6709\u7528\u8074\u529b\u306f\u4f4e\u4e0b\u3057\u307e\u3059\u3002<\/span><\/p>\n\n\n\n<p>\u6df7\u4e71\u3059\u308b\u3068\u3044\u3051\u306a\u3044\u306e\u3067\u307e\u3068\u3081\u307e\u3059\u3002\u304b\u306a\u308a\u591a\u304f\u306e\u60a3\u8005\u3055\u3093\u306b\u304a\u3044\u3066\u816b\u760d\u306f\u5927\u304d\u304f\u306a\u308a\u307e\u305b\u3093\u3002\u5927\u304d\u304f\u306a\u3063\u3066\u3053\u306a\u3044\u816b\u760d\u3092\u6cbb\u7642\u3057\u3066\u60a3\u8005\u3055\u3093\u306b\u3068\u3063\u3066\u3069\u306e\u3088\u3046\u306a\u5229\u76ca\u304c\u3042\u308b\u306e\u304b\u660e\u3089\u304b\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u624b\u8853\u3092\u3059\u308b\u3068\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u306a\u3069\u306e\u65b0\u305f\u306a\u5408\u4f75\u75c7\u304c\u52a0\u308f\u3063\u3066\u3057\u307e\u3046\u78ba\u7387\u306f\u4f4e\u304f\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u3067\u3059\u304b\u3089\uff0c\u305f\u3068\u3048\u8074\u529b\u4f4e\u4e0b\u304c\u9032\u884c\u3057\u3066\u3082\uff0c\u305d\u308c\u307b\u3069\u5927\u304d\u304f\u306a\u3044\u8074\u795e\u7d4c\u816b\u760d\u306f\uff0c\u307e\u305a\u306f\u7d4c\u904e\u89b3\u5bdf\u3057\u3066\u3044\u3044\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<p><span style=\"color: #333333;\">\u30ce\u30eb\u30a6\u30a7\u30fc\u306e\u75c5\u9662\u30672006\u5e74\u306b\u307e\u3068\u3081\u3089\u308c\u305f301\u4eba\u306e\u8074\u795e\u7d4c\u816b\u760d\u60a3\u8005\u3055\u3093\u306e\u5831\u544a\u304c\u3042\u308a\u307e\u3059\u3002\u60a3\u8005\u3055\u3093\u306b\u6cbb\u7642\u6cd5\u306a\u3069\u3044\u308d\u3044\u308d\u8aac\u660e\u3057\u3066\uff0c\u6700\u521d\u306e\u9078\u629e\u306f\uff0c\u7d4c\u904e\u89b3\u5bdf 165\u4eba\uff0c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5 81\u4eba\uff0c\u958b\u982d\u624b\u8853 55\u4eba (18%) \u3060\u3063\u305f\u305d\u3046\u3067\u3059&nbsp;(Myeseth, Acta Neurochir 2007)\u3002<\/span><span style=\"color: #000080;\"><span style=\"color: #333333;\">\u30d5\u30e9\u30f3\u30b9\u304b\u3089\u306e2008\u5e74\u306e\u5831\u544a\u3067\u306f\uff0c\u7d4c\u904e\u89b3\u5bdf\u3092\u3057\u3066\u6cbb\u7642\u304c\u5fc5\u8981\u306b\u306a\u3063\u305f\u60a3\u8005\u3055\u3093\u306f\uff0c325\u4eba\u4e2d\u306e77\u4eba (24%)\u3067\u3057\u305f<\/span><\/span><span style=\"color: #333333;\">(Bakkouri, J Neurosurg 2008)\u3002 \u30c7\u30f3\u30de\u30fc\u30af\u304b\u3089\u306e2,312\u4f8b\u306e\u7d4c\u904e\u89b3\u5bdf\u3067\u306f\uff0c<\/span><span style=\"color: #000080;\"><span style=\"color: #333333;\">434\u4f8b (19%<\/span><\/span><span style=\"color: #333333;\">)<\/span><span style=\"color: #000080;\"><span style=\"color: #333333;\">\u3067\u6cbb\u7642\u304c\u5fc5\u8981\u3068\u306a\u308a\uff0c<\/span><span style=\"color: #333333;\">2mm\u4ee5\u4e0a\u5927\u304d\u304f\u306a\u3063\u305f\u3082\u306e\u3092\u5897\u5927\u3068\u5b9a\u7fa9\u3059\u308b\u3068\uff0c5\u5e74\u3067\uff0c\u5185\u8033\u9053\u5185\u816b\u760d\u306f21%\uff0c\u5185\u8033\u9053\u5916\u816b\u760d\u306f37%\u3067\u5897\u5927\u3057\u307e\u3057\u305f(Reznitsky, Neuro Oncol 2021)\u3002<\/span><\/span><\/p>\n\n\n\n<p><strong><span style=\"color: #ff0000;\">\u6700\u521d\u306f6\u30f6\u6708\u304a\u304d\uff0c2\u5e74\u304f\u3089\u3044\u898b\u3066\u5909\u5316\u304c\u306a\u3051\u308c\u30701\u5e74\u304a\u304d\u304f\u3089\u3044\u306e\u89b3\u5bdf<\/span><\/strong>\u304c\u3044\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u6ce8\u610f\u3057\u305f\u3044\u306e\u306f\uff0c\u4e00\u6642\u7684\u306b\u816b\u760d\u306e\u3046\u80de\u304c\u5927\u304d\u304f\u306a\u3063\u3066\u3082\uff0c\u307e\u305f\u89b3\u5bdf\u3057\u3066\u3044\u308b\u3068\u5c0f\u3055\u304f\u306a\u3063\u3066\u304f\u308b\u3068\u3044\u3046\u3088\u3046\u306a\u3053\u3068\u304c\u3042\u308a\u5f97\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u3082\u3061\u308d\u3093\uff0c\u660e\u3089\u304b\u306b\u3069\u3093\u3069\u3093\u5927\u304d\u304f\u306a\u308b\u6642\u306b\u306f\u6cbb\u7642\u3092\u8003\u3048\u307e\u3057\u3087\u3046\u3002<\/p>\n\n\n\n<p><span style=\"color: #000080;\"><strong>\u4e00\u65b9\u3067\uff0c\u816b\u760d\u304c\u5c0f\u3055\u3044\u3046\u3061\u306b\u6cbb\u7642\u3057\u305f\u65b9\u304c\u624b\u8853\u306e\u5408\u4f75\u75c7\u304c\u5c11\u306a\u304f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u3088\u308b\u8074\u529b\u306e\u6e29\u5b58\u7387\u3082\u9ad8\u3044<\/strong><\/span>\u3068\u3044\u3046\u610f\u898b\u3082\u3042\u308a\uff0c\u5f8c\u306e\u65b9\u306b\u66f8\u3044\u3066\u3042\u308a\u307e\u3059\u3002<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"297\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2010-300x297.jpg\" alt=\"\" class=\"wp-image-15073\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2010-300x297.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2010-550x544.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2010-768x759.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2010.jpg 1390w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2020.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2020-300x300.jpg\" alt=\"\" class=\"wp-image-15074\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2020-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2020-550x550.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2020-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2020-768x769.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschot2020.jpg 1435w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>2020\u5e74\u306b\uff0c\u3042\u308b\u5973\u6027\u304b\u3089\u3044\u305f\u3060\u3044\u305f\u753b\u50cf\u3067\u3059\u30022010\u5e74 48\u6b73\u306e\u6642\u306b\u6771\u4eac\u306e\u5927\u304d\u306a\u75c5\u9662\u3067\u958b\u982d\u624b\u8853\u3092\u52e7\u3081\u3089\u308c\u307e\u3057\u305f\u3002\u4ed6\u306e\u75c5\u9662\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u3044\u3046\u610f\u898b\u3067\u3057\u305f\u3002\u5de6\u5074\u306eMRI\u3067\u306f\u8074\u795e\u7d4c\u816b\u760d\u304c\u8133\u5e79\u90e8\u306b\u5c11\u3057\u89e6\u308c\u3066\u3044\u307e\u3059\u3002\u3067\u3082\u3053\u306e\u5973\u6027\u306f\u7d4c\u904e\u89b3\u5bdf\u3059\u308b\u3053\u3068\u306b\u3057\u307e\u3057\u305f\u3002\u53f3\u306f2020\u5e74\u306eMRI\u3067\uff0c\u816b\u760d\u304c\u5c0f\u3055\u304f\u306a\u3063\u3066\u8133\u5e79\u90e8\u304b\u3089\u96e2\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<h5 class=\"wp-block-heading\">\u75c7\u72b6 <strong>Cushing chronology<\/strong><\/h5>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u524d\u5ead\u795e\u7d4c\u9798\u816b\u306e\u591a\u304f\u306f\u5185\u8033\u9053\u5185\u3088\u308a\u767a\u751f\u3057\u3066\uff0c\u5185\u8033\u9053\u3092\u62e1\u5927\u3057\u5c0f\u8133\u6a4b\u89d2\u90e8\u3078\u767a\u80b2\u3057\u3066\u304f\u308b\u305f\u3081\u305d\u306e\u75c7\u72b6\u767a\u73fe\u306b\u306f\u4e00\u5b9a\u306e\u7279\u5fb4\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u307e\u305a<span style=\"color: #000080;\"><strong>\u8033\u9cf4\u308a<\/strong><\/span>\u3084<strong><span style=\"color: #000080;\">\u96e3\u8074<\/span><\/strong>\u304c\u751f\u3058\uff0c\u6b21\u7b2c\u306b\u9032\u884c\u3057\u3066\uff0c\u5e73\u8861\u969c\u5bb3\u3068\u3057\u3066<span style=\"color: #000080;\"><strong>\u3081\u307e\u3044\u611f<\/strong><\/span>\uff0c<strong><span style=\"color: #000080;\">\u6b69\u884c\u4e0d\u5b89\u5b9a<\/span><\/strong>\uff0c<strong><span style=\"color: #000080;\">\u9854\u9762\u306e\u3057\u3073\u308c\u3084\u75db\u307f<\/span><\/strong>\uff0c\u773c\u632f\uff0c\u5c0f\u8133\u306e\u5727\u8feb\u75c7\u72b6\u3068\u3057\u3066\u5c0f\u8133\u6027\u904b\u52d5\u5931\u8abf\u304c\u51fa\u73fe\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u7d9a\u3044\u3066\u3042\u308b\u3044\u306f\u540c\u6642\u306b\uff0c\u8fd1\u63a5\u306e\u8133\u795e\u7d4c\u3067\u3042\u308b\u4e09\u53c9\u795e\u7d4c\uff0c\u5916\u8ee2\u795e\u7d4c\uff0c\u9854\u9762\u795e\u7d4c\u306e\u969c\u5bb3\u3082\u52a0\u308f\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u6700\u5f8c\u306b\u306f\u8133\u5e79\u3092\u5727\u8feb\u3057\u3066\u982d\u84cb\u5185\u5727\u4ea2\u9032\u3092\u304d\u305f\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u3053\u308c\u3089\u306e\u75c7\u72b6\u767a\u73fe\u7d4c\u904e\u306f \u53e4\u5178\u7684\u795e\u7d4c\u5b66\u306e<strong>Cushing chronology<\/strong> \u3068\u3057\u3066\u77e5\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u524d\u5ead\u795e\u7d4c\u9798\u816b\u304c\u3059\u3079\u3066\u3053\u308c\u306b\u5f93\u3046\u308f\u3051\u3067\u306f\u306a\u304f\uff0c\u6700\u8fd1\u3067\u306f\u308f\u305a\u304b\u306a\u8074\u529b\u4f4e\u4e0b\u3084\u8033\u9cf4\uff0c\u3081\u307e\u3044\u767a\u4f5c\u306e\u307f\u3067MRI\u691c\u67fb\u304c\u306a\u3055\u308c\u308b\u305f\u3081\u306b<strong><span style=\"color: #000080;\">\u8efd\u5ea6\u306e\u521d\u671f\u75c7\u72b6\u3067\u767a\u898b\u3055\u308c\u308b\u5c0f\u3055\u306a\u816b\u760d\u304c\u5727\u5012\u7684\u306b\u591a\u3044<\/span><\/strong>\u3067\u3059\u3002<\/li>\n\n\n\n<li>\u4e09\u53c9\u795e\u7d4c\u611f\u899a\u6839\u3088\u308a\u767a\u751f\u3059\u308b\u4e09\u53c9\u795e\u7d4c\u9798\u816b\u3067\u306f\uff0c\u9854\u9762\u306e\u75db\u307f\u3084\u3057\u3073\u308c\u306a\u3069\u306e\u611f\u899a\u969c\u5bb3\u304c\u751f\u3058\u307e\u3059<\/li>\n\n\n\n<li>\u75db\u307f\u306f\u4e09\u53c9\u795e\u7d4c\u75db\u3068\u3057\u3066\u8aa4\u8a3a\u3055\u308c\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u304c\uff0c\u795e\u7d4c\u9798\u816b\u3067\u306f\u89d2\u819c\u53cd\u5c04\u306e\u4f4e\u4e0b\u3084\u4e09\u53c9\u795e\u7d4c\u9818\u57df\u306e\u611f\u899a\u969c\u5bb3\u3092\u4f34\u3046\u3053\u3068\u304c\u3042\u308a\u4e09\u53c9\u795e\u7d4c\u75db\u3068\u306e\u795e\u7d4c\u5b66\u7684\u306a\u9451\u5225\u306f\u53ef\u80fd\u3067\u3059<\/li>\n\n\n\n<li>\u9854\u9762\u795e\u7d4c\u306e\u4e00\u90e8\u3067\u3042\u308b\u4e2d\u9593\u795e\u7d4c\u306e\u969c\u5bb3\u306b\u3088\u308a\u5473\u899a\u306e\u7570\u5e38\u3092\u8a34\u3048\u308b\u60a3\u8005\u3055\u3093\u3082\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u307e\u305f\uff0c\u5927\u304d\u306a\u816b\u760d\u3067\u306a\u304f\u3068\u3082\uff0c<strong><span style=\"color: #000080;\">\u9ac4\u6db2\u5438\u53ce\u969c\u5bb3\u306b\u3088\u308b\u4ea4\u901a\u6027\u6c34\u982d\u75c7<\/span><\/strong>\u3092\u5448\u3057\u3066\uff0c\u96c6\u4e2d\u529b\u3084\u8a18\u61b6\u529b\u306e\u4f4e\u4e0b\u306a\u3069\u306e\u832b\u6f20\u3068\u3057\u305f\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\u3092\u6765\u3059\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u9032\u884c\u3059\u308c\u3070\u4e0d\u5b89\u5b9a\u6b69\u884c\u3084\u5c3f\u5931\u7981\u3068\u306a\u308a\uff0c\u3044\u308f\u3086\u308b\u6b63\u5e38\u5727\u6c34\u982d\u75c7\u306b\u985e\u4f3c\u3057\u305f\u75c7\u5019\u304c\u51fa\u73fe\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u3053\u306e\u6c34\u982d\u75c7\u306f\uff0c\u8133\u840e\u7e2e\u3092\u4f34\u3046\u9ad8\u9f62\u8005\u3067\u306e\u75c7\u5019\u5b66\u7684\u306a\u9451\u5225\u8a3a\u65ad\u306f\u5bb9\u6613\u3067\u306a\u3044\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u306f\u6975\u3081\u3066\u307e\u308c\u3067\uff0c\u3082\u3057\u9854\u9762\u9ebb\u75fa\u304c\u3042\u308b\u3068\uff0c\u9854\u9762\u795e\u7d4c\u9798\u816b\u306a\u3069\u306e\u8074\u795e\u7d4c\u816b\u760d\u4ee5\u5916\u306e\u816b\u760d\u3092\u7591\u3044\u307e\u3059<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">\u7a81\u767a\u6027\u96e3\u8074<\/h4>\n\n\n\n<p><span style=\"color: #000080;\"><strong>\u6025\u6fc0\u306a\u8074\u529b\u4f4e\u4e0b\uff08\u7a81\u767a\u6027\u96e3\u8074\uff09<\/strong><\/span>\u3067\u767a\u75c7\u3059\u308b\u4f8b\u3082\u591a\u3044\u3068\u3044\u3048\u307e\u3059\u3002<strong><span style=\"color: #000080;\">\u524d\u5ead\u795e\u7d4c\u9798\u816b\u3067\u306f10-20%\u306e\u60a3\u8005\u304c\u7a81\u767a\u6027\u96e3\u8074<\/span><\/strong>\u3067\u8074\u529b\u4f4e\u4e0b\u3092\u81ea\u899a\u3057\u307e\u3059<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/tinyacoustictumor.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/tinyacoustictumor-200x200.jpg\" alt=\"\" class=\"wp-image-9700\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/tinyacoustictumor-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/tinyacoustictumor-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p>8mm\u7a0b\u5ea6\u306e\u3068\u3066\u3082\u5c0f\u3055\u306a\u8074\u795e\u7d4c\u816b\u760d\u3067\u3059\u30022000\u5e74\u306b30\u6b73\u3067\u7a81\u767a\u6027\u96e3\u8074\u3068\u3081\u307e\u3044\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u8033\u9f3b\u54bd\u5589\u79d1\u3067\u30b9\u30c6\u30ed\u30a4\u30c9\u6cbb\u7642\u3092\u3057\u3066\u96e3\u8074\u306f\u6539\u5584\u3057\u307e\u3057\u305f\u30022003\u5e74\uff0c2007\u5e74\uff0c2008\u5e74\uff0c2011\u5e74\uff0c2012\u5e74\uff0c2014\u5e74\uff0c2015\u5e74\uff0c2016\u5e743\u56de\u3068\u7a81\u767a\u6027\u96e3\u8074\u306b\u306a\u308a\uff0c\u305d\u308c\u305e\u308c\u30b9\u30c6\u30ed\u30a4\u30c9\u6cbb\u7642\u3067\u6709\u7528\u8074\u529b\u307e\u3067\u6539\u5584\u3057\u3066\u3044\u307e\u3059\u3002<br>\u3053\u306e\u5c0f\u3055\u306a\u816b\u760d\u306f\u5185\u8033\u9053\u5e95\uff08\u4e00\u756a\u6df1\u304f\u3066\u8778\u725b\u306b\u8fd1\u3044\u3068\u3053\u308d\uff09\u306b\u3042\u308a\u624b\u8853\u3057\u3066\u3082\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3057\u3066\u3082\u8074\u529b\u6e29\u5b58\u306f\u96e3\u3057\u3044\u3068\u5224\u65ad\u3057\u307e\u3057\u305f\u3002<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/tinyacoustictumor2.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/tinyacoustictumor2-200x200.jpg\" alt=\"\" class=\"wp-image-9701\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/tinyacoustictumor2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/tinyacoustictumor2-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><br>11\u56de\u306e\u7a81\u767a\u6027\u96e3\u8074\u306e\u5f8c\uff0c\u767a\u75c7\u3057\u3066\u304b\u308917\u5e74\u5f8c\u306e\u8074\u529b\u3067\u3059\u3002\u307e\u3060\u8074\u529b\u304c\u6b8b\u3063\u3066\u3044\u3066\u30b9\u30c6\u30ed\u30a4\u30c9\u6cbb\u7642\u3067\u5c11\u3057\u826f\u304f\u306a\u3063\u3066\u304d\u3066\u3044\u307e\u3059\u3002\u816b\u760d\u306e\u30b5\u30a4\u30ba\u306f16\u5e74\u9593\u3067 1mm\u304f\u3089\u3044\u5927\u304d\u304f\u306a\u3063\u3066\u3044\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u300230\u6b73\u304b\u308947\u6b73\u307e\u3067\u816b\u760d\u306f\u307b\u3068\u3093\u3069\u5909\u308f\u3089\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n<p>\u8074\u795e\u7d4c\u816b\u760d\u304c\u7a81\u767a\u6027\u96e3\u8074\u3067\u767a\u75c7\u3059\u308b\u3053\u3068\u306f\u591a\u3044\u3067\u3059\u30023\u56de\u304f\u3089\u3044\u7e70\u308a\u8fd4\u3059\u3068\u6709\u7528\u8074\u529b\u304c\u306a\u304f\u306a\u3063\u3066\u3057\u307e\u3046\u3053\u3068\u3082\u3042\u308b\u306e\u3067\u3059\u304c\uff0c\u3053\u306e\u60a3\u8005\u3055\u3093\u306e\u3088\u3046\u306b\u4f55\u56de\u7e70\u308a\u8fd4\u3057\u3066\u3082\u623b\u308b\u30bf\u30a4\u30d7\u3082\u3042\u308a\u307e\u3059\u3002\u7a81\u767a\u6027\u96e3\u8074\u306e\u53cd\u5fa9\u304c\u624b\u8853\u3084\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u6839\u62e0\u306b\u306a\u308b\u3068\u3082\u65ad\u5b9a\u3067\u304d\u306a\u3044\u3068\u3044\u3048\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u982d\u4f4d\u5909\u63db\u6027\u3081\u307e\u3044\uff0c\u826f\u6027\u767a\u4f5c\u6027\u3081\u307e\u3044<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u524d\u5ead\u795e\u7d4c\u9798\u816b\u306e\u3081\u307e\u3044\u306f\uff0c\u3075\u3089\u3075\u3089\u3059\u308b\uff0c\u3075\u308f\u3075\u308f\u3059\u308b\uff0c\u304f\u3089\u3063\u3068\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u306a\u3069\u306e\u8efd\u3044\u3081\u307e\u3044\u611f\u304c\u591a\u3044\u3067\u3059<\/li>\n\n\n\n<li>\u3067\u3082\u7a81\u7136\uff0c\u7acb\u3063\u3066\u3044\u308b\u3053\u3068\u3082\u3067\u304d\u306a\u3044\u3088\u3046\u306a\u6fc0\u3057\u3044\u3081\u307e\u3044\u767a\u4f5c\u304c\u751f\u3058\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u3081\u307e\u3044\u3067\u5410\u304d\u6c17\u304c\u304a\u304d\u3066\u5614\u5410\u3059\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u3073\u3063\u304f\u308a\u3057\u3066\uff0c\u6b7b\u306c\u304b\u3082\u3057\u308c\u306a\u3044\u3068\u601d\u3063\u3066\uff0c\u6551\u6025\u8eca\u3067\u75c5\u9662\u306b\u884c\u304f\u60a3\u8005\u3055\u3093\u3082\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u3067\u3082\uff0c\u3053\u306e\u56de\u8ee2\u6027\u306e\u3081\u307e\u3044\u306f\uff0c\u6cbb\u7642\u3057\u306a\u304f\u3066\u3082\u6570\u65e5\u9593\u3067\u826f\u304f\u306a\u308b\u3053\u3068\u304c\u307b\u3068\u3093\u3069\u3067\u3059<\/li>\n\n\n\n<li>\u3053\u306e\u3081\u307e\u3044\u767a\u4f5c\u3092\u7e70\u308a\u8fd4\u3057\u3066\u751f\u3058\u308b\u60a3\u8005\u3055\u3093\u3082\u3044\u307e\u3059<\/li>\n\n\n\n<li>\u3060\u304b\u3089\uff0c\u3081\u307e\u3044\u767a\u4f5c\u3092\u304a\u3053\u3057\u3066\u3082\u3073\u3063\u304f\u308a\u3057\u306a\u3044\u3067\u5b89\u9759\u306b\u3057\u3066\u69d8\u5b50\u3092\u307f\u3066\u304f\u3060\u3055\u3044<\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>\u691c\u67fb<\/strong><\/h5>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u8074\u795e\u7d4c\u816b\u760d\u3092\u7591\u3048\u3070MRI\u691c\u67fb\u3092\u3057\u307e\u3059<\/li>\n\n\n\n<li>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37MRI\u3067\u306f\uff0c\u5185\u8033\u9053\u5185\u306b\u9650\u5c40\u3059\u308b\u6570 mm\u7a0b\u5ea6\u306e\u5c0f\u816b\u760d\u304b\u3089\uff0c\u5c0f\u8133\u6a4b\u89d2\u90e8\u306b\u767a\u80b2\u3057\u305f\u5927\u304d\u306a\u3082\u306e\u307e\u3067\u660e\u77ad\u306b\u63cf\u51fa\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059<\/li>\n\n\n\n<li>\u8a3a\u65ad\u304c\u3064\u3044\u305f\u5f8c\u306e\u7d4c\u904e\u89b3\u5bdf\u3067\u306f\uff0c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u9020\u5f71\u5264\u306e\u4f7f\u7528\u306f\u4e0d\u8981\u3067\u3059<\/li>\n\n\n\n<li><strong><span style=\"color: #000080;\">CISS\uff08\u30b7\u30b9\uff09<\/span><\/strong> image\u3042\u308b\u3044\u306f <span style=\"color: #000080;\"><strong>FIESTA<\/strong><\/span> \u3067\u306e\u7d4c\u904e\u89b3\u5bdf\u3067\u5341\u5206\u3067\u3059\uff0c\u816b\u760d\u30b5\u30a4\u30ba\u30821 mm\u5358\u4f4d\u3067\u7cbe\u5bc6\u306b\u6e2c\u5b9a\u3067\u304d\u308b\u306e\u3067\u512a\u308c\u3066\u3044\u307e\u3059\uff0c\u6240\u8981\u6642\u9593\u306f15\u5206\u304f\u3089\u3044<\/li>\n\n\n\n<li>\u8074\u529b\u691c\u67fb\u304c\u5fc5\u8981\u3067\u3059\uff0c\u4e00\u5074\u6027\u306e\u611f\u97f3\u6027\u96e3\u8074\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u5fc5\u9808\u3067\u306f\u306a\u3044\u306e\u3067\u3059\u304c\uff0c\u8074\u6027\u8133\u5e79\u53cd\u5fdc\u3067I-II\u6ce2\u9593\u9694\u306e\u5ef6\u9577\uff0c\u305d\u3057\u3066\u524d\u5ead\u6a5f\u80fd\u4f4e\u4e0b\u306e\u6307\u6a19\u3068\u3057\u3066\u6e29\u5ea6\u773c\u632f\u8a66\u9a13\u306e\u53cd\u5fdc\u4f4e\u4e0b\u3042\u308b\u3044\u306f\u6d88\u5931\u304c\u308f\u304b\u308a\u307e\u3059<\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\"><span style=\"color: #000080;\">\u6cbb\u7642\u304c\u5fc5\u8981\u3060\u3068\u306a\u3063\u305f\u3089\uff1f<\/span><\/h5>\n\n\n\n<h4 class=\"wp-block-heading\"><strong><span style=\"color: #ff0000;\">\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u65b9\u304c\u624b\u8853\u3088\u308a\u6210\u7e3e\u304c\u3044\u3044<\/span><\/strong><\/h4>\n\n\n\n<p>\u8a3c\u62e0\u3068\u8a00\u3063\u3066\u306f\u306a\u3093\u3067\u3059\u304c\u3001<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=14567604\" target=\"_blank\" rel=\"noopener noreferrer\">\u79c1\u306e\u66f8\u3044\u305f\u8ad6\u6587<\/a><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=14567604\" target=\"_blank\" rel=\"noopener noreferrer\">\uff08\u30af\u30ea\u30c3\u30af\uff09<\/a>\u304c\u30a2\u30e1\u30ea\u30ab\u8133\u795e\u7d4c\u5916\u79d1\u5b66\u4f1a\u306e\u6a5f\u95a2\u7d19\u306b\u8f09\u3063\u3066\u3044\u308b\u306e\u3067\u307f\u3066\u4e0b\u3055\u3044\uff08\u56fd\u969b\u5b66\u8853\u8a8c\u306a\u306e\u3067\u82f1\u8a9e\uff09<\/p>\n\n\n\n<p>\u79c1\u3068\u4e00\u7dd2\u306b\u8ad6\u6587\u3092\u66f8\u3044\u305f\u5317\u5927\u8033\u9f3b\u79d1\u306e\u5742\u672c\u5fb9\u5148\u751f\u306e\u30c7\u30fc\u30bf\u3067\u306f\uff0c2004\u5e74\u307e\u3067\u306b165\u4f8b\u306e\u8074\u795e\u7d4c\u816b\u760d\u3092\u5b9a\u4f4d\u5206\u5272\u653e\u5c04\u7dda\u6cbb\u7642\u3057\u3066\uff0c\u3046\u307e\u304f\u884c\u304b\u306a\u3044\u3067\u7d50\u5c40\u624b\u8853\u306b\u306a\u3063\u305f\u4eba\u306f\uff13\u4eba (2%) \u306e\u307f\u3067\u3059\u3002\u6b8b\u308a\u306e162\u4eba\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3060\u3051\u3067\u3059\u3093\u3067\u3044\u307e\u3059\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u524d\u306b\u816b\u760d\u304c\u3042\u308b\u5074\u306e<span style=\"color: #000080;\"><strong>\u8074\u529b\u304c\u3042\u3063\u305f122\u4eba\u306e\u60a3\u8005\u3055\u3093\u306771.5%\uff08\u7167\u5c04\u5f8c\uff17\u5e74\uff09\u306e\u4eba\u306b\u3042\u308b\u7a0b\u5ea6\u306e\u8074\u529b\u304c\u4fdd\u5b58\u3067\u304d\u3066\u3044\u307e\u3059\u3002<\/strong><\/span>\u3072\u3069\u3044<strong><span style=\"color: #ff0000;\">\u9854\u9762\u795e\u7d4c\u307e\u3072\u3092\u751f\u3058\u305f\u4eba\u306f\u4e00\u4eba\u3082\u3044\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/span><\/strong>\u8074\u529b\u306e\u76f8\u5f53\u60aa\u304b\u3063\u305f\u4eba\u3082\u542b\u3081\u3066\u3082\uff0c\u816b\u760d\u306e\u3042\u308b\u5074\u306e\u8033\u304c\u5168\u304f\u805e\u3053\u3048\u306a\u304f\u306a\u3063\u305f\u60a3\u8005\u3055\u3093\u306f\uff16\u4eba\u3060\u3051\u3067\u3059\u3002\u305f\u3060\u3057\uff0c\u3053\u306e\u8ad6\u6587\u306e\u5f8c\u3067\u3082\u3063\u3068\u8d85\u9577\u671f\u9593\u89b3\u5bdf\u3057\u305f\u3089\uff0c\u624b\u8853\u304c\u5fc5\u8981\u306b\u306a\u308b\u306e\u306f5%\u5f31\uff0c\u8074\u529b\u306f\u805e\u3053\u3048\u3066\u3044\u3066\u3082\uff0c\u3084\u304c\u3066\u6709\u7528\u306a\u30ec\u30d9\u30eb\u3067\u306f\u306a\u3044\u304f\u3089\u3044\u306b\u4f4e\u4e0b\u3059\u308b\u4eba\u304c\u591a\u304b\u3063\u305f\u3067\u3059\u3002<\/p>\n\n\n\n<p>\u8133\u5916\u79d1\u533b\u306e\u79c1\u304c\u8a00\u3046\u306e\u306f\u5909\u3067\u3059\u304c\u3001\u3059\u3054\u304f\u624b\u8853\u306e\u4e0a\u624b\u306a\u8133\u5916\u79d1\u533b\u306e\u6210\u7e3e\u3067\u3082\u3053\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u6210\u7e3e\u306b\u306f\u304b\u306a\u3044\u307e\u305b\u3093\u3002\u3067\u3082\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3067\u304d\u308b\u306e\u306f3cm\u304f\u3089\u3044\u307e\u3067\u306e\u8074\u795e\u7d4c\u816b\u760d\u3067\u3059\u3002\u305d\u308c\u4ee5\u4e0a\u306f\u624b\u8853\u304c\u5fc5\u8981\u3068\u306a\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3057\u3087\u3046\u3002<\/p>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/acousticsrt.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/acousticsrt.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>\u5b9a\u4f4d\u5206\u5272\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u305f\u8074\u795e\u7d4c\u816b\u760d\u306e\u4f8b\uff08\u5de6\uff09\u300220%\u304f\u3089\u3044\u306e\u78ba\u7387\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306b\u4e00\u6642\u7684\u306b\u5927\u304d\u304f\u306a\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\uff08\u4e2d\u592e\uff09\u3002\u3084\u304c\u3066\u5c0f\u3055\u304f\u306a\u3063\u3066\u3044\u304d\u307e\u3059\uff08\u53f3\uff09\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306b\u816b\u760d\u304c\u5927\u304d\u304f\u306a\u3063\u3066\u3082\uff0c\u3042\u308f\u3066\u3066\u624b\u8853\u3092\u53d7\u3051\u5165\u308c\u3066\u306f\u3044\u3051\u307e\u305b\u3093\u3002<br>\u3053\u306e\u753b\u50cf\u306fMRI\u306eCISS\/FIESTA\u753b\u50cf\u3068\u3044\u3046\u306e\u3092\u7528\u3044\u3066\u3044\u307e\u3059\u3002\u9020\u5f71\u5264\u3092\u4f7f\u308f\u306a\u3044\u3067\u3082\u816b\u760d\u306e\u5f62\u3068\u5927\u304d\u3055\u304c\u7cbe\u5bc6\u306b\u89e3\u308b\u306e\u3067\uff0c\u7d4c\u904e\u89b3\u5bdf\u306b\u306f\u9069\u3057\u3066\u3044\u308b\u691c\u67fb\u6cd5\u3067\u3059\u3002<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u306f\uff12\u3064\u306e\u65b9\u6cd5\u304c\u3042\u308a\u307e\u3059<\/strong><\/h5>\n\n\n\n<h4 class=\"wp-block-heading\"><strong><span style=\"color: #ff0000;\"><span style=\"color: #000080;\">\u653e\u5c04\u7dda\u5916\u79d1<\/span><\/span><\/strong><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">\uff08\uff11\u56de\u7167\u5c04\uff09 <strong><span style=\"color: #ff0000;\">SRS<\/span><\/strong><\/span><\/span><span style=\"color: #ff0000;\"><span style=\"color: #000000;\"> stereotactic radiosurgery\uff08\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\uff09<\/span><\/span><\/h4>\n\n\n\n<h4 class=\"wp-block-heading\"><strong><span style=\"color: #ff0000;\"><span style=\"color: #000080;\">\u5b9a\u4f4d\u5206\u5272\u7167\u5c04<\/span><span style=\"color: #000000;\"><span style=\"color: #ff0000;\">&nbsp;fSRT<\/span><\/span><\/span><\/strong><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">fractionated&nbsp;<\/span><\/span><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">stereotactic radiotherapy\uff08\u30ce\u30d0\u30ea\u30b9\uff0c\u30ea\u30cb\u30a2\u30c3\u30af\uff0c\u30b5\u30a4\u30d0\u30fc\u30ca\u30a4\u30d5\uff09<\/span><\/span><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>1\u56de\u3067\u7167\u5c04\u3059\u308b\u306e\u3092\u653e\u5c04\u7dda\u5916\u79d1\u3068\u3044\u3044\u307e\u3059\uff0c\u4f55\u56de\u304b\u306b\u5206\u3051\u308b\u306e\u306f\u5206\u5272\u7167\u5c04\u3068\u3044\u3044\u307e\u3059<\/li>\n\n\n\n<li><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">\u7167\u5c04\u88c5\u7f6e\u306e\u5546\u54c1\u540d\u3068\u3057\u3066\uff0c<\/span><\/span><span style=\"color: #000080;\"><strong>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\uff0c\u30ea\u30cb\u30a2\u30c3\u30af\u30e1\u30b9\uff0c\u30b5\u30a4\u30d0\u30fc\u30ca\u30a4\u30d5\uff0c\u30c8\u30e2\u30c6\u30e9\u30d4\u30fc\uff0c\u30ce\u30d0\u30ea\u30b9\uff0c\u30a8\u30c3\u30af\u30b9\u30ca\u30a4\u30d5\uff0c\u30cf\u30a4\u30d1\u30fc\u30ca\u30a4\u30d5<\/strong><\/span>\u306a\u3069\u304c\uff0c\u3044\u308d\u3044\u308d\u306a\u7279\u5fb4\u3092\u6301\u3063\u3066\u5ba3\u4f1d\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n\n\n\n<li><strong><span style=\"color: #ff0000;\">\u3069\u306e\u88c5\u7f6e\u304c\u683c\u6bb5\u306b\u512a\u308c\u3066\u3044\u308b\u3068\u3044\u3046\u8a3c\u62e0\u306f\u306a\u3044<\/span><\/strong><span style=\"color: #000000;\">\u306e\u3067\uff0c\u7279\u5b9a\u306e\u75c5\u9662\u306e\u6700\u65b0\u3068\u3044\u3046<strong><span style=\"color: #ff0000;\">\u5ba3\u4f1d\u6587\u53e5\u306b\u60d1\u308f\u3055\u308c\u306a\u3044<\/span><\/strong>\u3088\u3046\u306b\u3057\u307e\u3057\u3087\u3046<\/span><\/li>\n\n\n\n<li>\u65e5\u672c\u5168\u4f53\u3067\u306f<strong><span style=\"color: #000080;\">\u30ac\u30f3\u30de\u30ca\u30a4\u30d5<\/span><\/strong>\u6cbb\u7642\u306e\u65b9\u304c\u591a\u3044\u306e\u3067\u3059\u304c\u3001<strong><span style=\"color: #000080;\">\u5b9a\u4f4d\u5206\u5272\u7167\u5c04<\/span><\/strong>\u306e\u65b9\u304c\u526f\u4f5c\u7528\u304c\u5c11\u306a\u3044\u3067\u3059<\/li>\n\n\n\n<li>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u3067\u306f\u5165\u96622-3\u65e5\u3067\u3057\u3087\u3046\uff0c\u624b\u8853\u6cbb\u7642\u3088\u308a\u306f\u305a\u3063\u3068\u30ea\u30b9\u30af\u3082\u4f4e\u304f\u3066\u60a3\u8005\u3055\u3093\u306f\u697d\u3067\u3059<\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u30ea\u30cb\u30a2\u30c3\u30af<\/strong><\/span>\u3067\u306e\u5206\u5272\u7167\u5c04\u306e\u65b9\u304c\u8074\u529b\u306e\u4f4e\u4e0b\u3084\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u306f\u5c11\u306a\u3044\u3068\u8003\u3048\u3089\u308c\u307e\u3059\u304c\u3001\u6700\u5927\u306750\u30b0\u30ec\u30a4\u3068\u3044\u3046\u7dda\u91cf\u309225\u56de\u306b\u5206\u3051\u3066\u304b\u3051\u307e\u3059\u306e\u3067\uff0c\uff16\u9031\u9593\u304f\u3089\u3044\u306e\u5916\u6765\u901a\u9662\u304c\u5fc5\u8981\u306b\u306a\u308a\u307e\u3059\u3002<\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u30b5\u30a4\u30d0\u30fc\u30ca\u30a4\u30d5<\/strong><span style=\"color: #000000;\">\u3084<\/span><strong> \u30ce\u30d0\u30ea\u30b9<\/strong><\/span>\u3067\u306f\uff0c3\u56de\u3068\u304b5\u56de\u3068\u304b7\u56de\u3068\u304b13\u56de\u3068\u304b\u306e\u5206\u5272\u7167\u5c04\u306b\u3067\u304d\u307e\u3059\u304b\u3089\uff0c\u6cbb\u7642\u671f\u9593\u304c\uff11\u9031\u9593\u3068\u304b2\u9031\u9593\u3067\u3082\u3067\u304d\u307e\u3059<\/li>\n\n\n\n<li>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u3088\u308a\u5206\u5272\u7167\u5c04\u304c\u512a\u308c\u3066\u3044\u308b\u70b9\u306f\uff0c\u3088\u308a\u5927\u304d\u306a\u8074\u795e\u7d4c\u816b\u760d\u3092\u6cbb\u7642\u3067\u304d\u308b\u3053\u3068\u306b\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306e\u6cbb\u7642\u3067\u304d\u308b\u6700\u5927\u306e\u816b\u760d\u306e\u76f4\u5f84\u306f2.5cm\u3068\u8003\u3048\u3066\u304f\u3060\u3055\u3044<\/li>\n\n\n\n<li>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306e\u6b20\u70b9\u306f\u91d1\u5c5e\u306e\u30ea\u30f3\u30b0\u3092\u91dd\uff08\u30d4\u30f3\uff09\u3067\u982d\u306b\u56fa\u5b9a\u3059\u308b\u306e\u3067\u75db\u3044\u304b\u3089\u5168\u8eab\u9ebb\u9154\u304c\u5fc5\u8981\u306a\u3053\u3068\u3067\u3059\uff0c\u4ed6\u306e\u5b9a\u4f4d\u7167\u5c04\u88c5\u7f6e\u3067\u306f\u30d7\u30e9\u30b9\u30c1\u30c3\u30af\u306e\u30de\u30b9\u30af\uff08\u30d7\u30e9\u30b9\u30c1\u30c3\u30af\u30b7\u30a7\u30eb\uff09\u3067\u3067\u304d\u307e\u3059<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong><span style=\"color: #ff0000;\">\u967d\u5b50\u7dda\u306f\u4f7f\u3044\u307e\u305b\u3093<\/span><\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u304a\u91d1\u3082\u304b\u304b\u308b\u3057\u9577\u671f\u306e\u6cbb\u7642\u5b9f\u7e3e\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u3092\u4f7f\u3063\u3066\u306f\u3044\u3051\u306a\u3044\u6642<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>25mm\u3092\u8d8a\u3048\u308b\u5927\u304d\u3055\u306e\u816b\u760d\u306e\u6642\u306f\uff0c\uff11\u56de\u7167\u5c04\u3067\u3042\u308b\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306f\u7406\u8ad6\u7684\u306b\u3082\u9069\u3055\u306a\u3044\u3082\u306e\u3067\u3059<\/li>\n\n\n\n<li>\u9854\u9762\u306e\u611f\u899a\u969c\u5bb3\uff08\u3057\u3073\u308c\u3084\u75db\u307f\uff09\u304c\u5f37\u3044\u60a3\u8005\u3055\u3093\u304c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u3092\u53d7\u3051\u308b\u3068\uff0c\u4f55\u5e74\u304b\u5f8c\u3067\u8010\u3048\u304d\u308c\u306a\u3044\u9854\u9762\u75db\uff08\u4e09\u53c9\u795e\u7d4c\u969c\u5bb3\uff09\u3068\u306a\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li><span style=\"color: #ff0000;\"><strong>\u9854\u9762\u75db\uff08\u4e09\u53c9\u795e\u7d4c\u75db\uff09\u304c\u3042\u308b\u5834\u5408\u306b\u306f\uff0c\u624b\u8853\u6458\u51fa\u3057\u305f\u65b9\u304c\u3088\u3044<\/strong><\/span>\u3067\u3057\u3087\u3046<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">\u3069\u306e\u7a0b\u5ea6\u306e\u5927\u304d\u3055\u307e\u3067\u5b9a\u4f4d\u5206\u5272\u7167\u5c04\u3067\u6cbb\u7642\u3067\u304d\u308b\u306e\u304b\uff1f<\/h4>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt025.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt025-200x200.jpg\" alt=\"\" class=\"wp-image-10822\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt025-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt025-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt037.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt037-200x200.jpg\" alt=\"\" class=\"wp-image-10823\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt037-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt037-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt052.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt052-200x200.jpg\" alt=\"\" class=\"wp-image-10824\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt052-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomafsrt052-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>2001\u5e74\u306b\u6cbb\u7642\u3092\u3057\u305f\uff0c40\u4ee3\u5973\u6027\u306e\u5927\u304d\u306a\u8074\u795e\u7d4c\u816b\u760d\u3067\u3059\u300250\u30b0\u30ec\u30a425\u5206\u5272\u306e\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u3044\u307e\u3057\u305f\u3002\u4e2d\u592e\u304c1\u5e74\u5f8c\uff0c\u53f3\u304c3\u5e74\u5f8c\u3067\u3059\u3002\u5f90\u3005\u306b\u7e2e\u5c0f\u3057\u3066\u624b\u8853\u3092\u5fc5\u8981\u3068\u3057\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u3053\u306e\u30b5\u30a4\u30ba\u306e\u8074\u795e\u7d4c\u816b\u760d\u3067\u3082\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u9078\u629e\u3067\u304d\u308b\u306e\u3067\u3059\u304c\uff0c\u591a\u304f\u306e\u5834\u5408\u306f\u958b\u982d\u624b\u8853\u3092\u304a\u52e7\u3081\u3059\u308b\u30b5\u30a4\u30ba\u3068\u3082\u8a00\u3048\u307e\u3059\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span style=\"color: #000080;\"><strong>\u6ce8\u610f\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u6c34\u982d\u75c7<\/strong><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u8074\u795e\u7d4c\u816b\u760d\u306f<strong><span style=\"color: #ff0000;\">\u4ea4\u901a\u6027\u6c34\u982d\u75c7\uff08\u9ac4\u6db2\u5438\u53ce\u969c\u5bb3\uff09<\/span><\/strong>\u3068\u3044\u3046\u982d\u306e\u4e2d\u306b\u6c34\uff08\u9ac4\u6db2\uff09\u304c\u305f\u307e\u308b\u5408\u4f75\u75c7\u3092\u3057\u3070\u3057\u3070\u751f\u3058\u307e\u3059<\/li>\n\n\n\n<li>MRI\u3067\u8133\u5ba4\u304c\u5927\u304d\u304f\u306a\u3063\u3066\uff0c<span style=\"color: #000080;\"><strong>\u304f\u3082\u819c\u4e0b\u8154\u304c\u62e1\u5927\u3059\u308b<\/strong><\/span>\u306e\u304c\u7279\u5fb4\u3067\u3059<\/li>\n\n\n\n<li>\u6c34\u982d\u75c7\u304c\u9032\u884c\u3059\u308b\u3068\uff0c<span style=\"color: #000080;\"><strong>\u610f\u6b32\u304c\u306a\u304f\u306a\u3063\u3066\u7cbe\u795e\u6a5f\u80fd\u304c\u4f4e\u4e0b\u3057\u3066\u8a8d\u77e5\u75c7\u306b\u306a\u3063\u305f\u308a\uff0c\u6b69\u884c\u304c\u4e0d\u5b89\u5b9a\u306b\u306a\u3063\u3066\u6b69\u3051\u306a\u304f\u306a\u3063\u305f\u308a\uff0c\u304a\u3057\u3063\u3053\u3092\u5931\u7981\u3057\u305f\u308a\u3059\u308b\u75c7\u72b6<\/strong><\/span>\u304c\u51fa\u307e\u3059<\/li>\n\n\n\n<li><span style=\"color: #ff0000;\"><strong>25mm\u4ee5\u4e0a\u306e\u5927\u304d\u3081\u306e\u8074\u795e\u7d4c\u816b\u760d\u306b\u591a\u3044<\/strong><\/span>\u3067\u3059<\/li>\n\n\n\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u3066\u3082\u3057\u306a\u304f\u3066\u3082\u3053\u306e\u5408\u4f75\u75c7\u306f\u751f\u3058\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3057\uff0c\u816b\u760d\u306e\u6458\u51fa\u5f8c\u306b\u3055\u3048\u751f\u3058\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u305d\u306e\u6642\u306f\u3001<strong><span style=\"color: #000080;\">\u30b7\u30e3\u30f3\u30c8\u624b\u8853\u3068\u3044\u3063\u3066\uff0c\u982d\u306e\u6c34\uff08\u9ac4\u6db2\uff09\u3092\u304a\u8179\u306e\u4e2d\u306b\u30c1\u30e5\u30fc\u30d6\u3092\u5165\u308c\u3066\u6d41\u3059<\/span><\/strong>\u7c21\u5358\u306a\u624b\u8853\u3092\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u6c34\u982d\u75c7\u3092\u5408\u4f75\u3057\u3066\u3044\u308b\u8074\u795e\u7d4c\u816b\u760d\u3092\u624b\u8853\u3067\u6458\u51fa\u3059\u308b\u3068\u6c34\u982d\u75c7\u304c\u6539\u5584\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u3067\u3059\u304b\u3089\uff0c\u6bd4\u8f03\u7684\u82e5\u3044\u60a3\u8005\u3055\u3093\u3067\u6c34\u982d\u75c7\u3092\u5408\u4f75\u3057\u3066\u3044\u308b\u6642\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3088\u308a\u3082\u958b\u982d\u6458\u51fa\u8853<\/strong><\/span>\u304c\u52e7\u3081\u3089\u308c\u307e\u3059<\/li>\n\n\n\n<li>\u9ad8\u9f62\u8005\u3067\u306f\u5224\u65ad\u306f\u96e3\u3057\u304f\u306a\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u6ce8\u610f\u3059\u308b\u3079\u304d\u3053\u3068\u306f\uff0c\u8efd\u5ea6\u306e\u8133\u5ba4\u62e1\u5927\u3067\u75c7\u72b6\u3082\u306a\u3044\u60a3\u8005\u3055\u3093\u3092\uff0c\u6cbb\u7642\u304c\u5fc5\u8981\u306a\u6c34\u982d\u75c7\u3068\u52d8\u9055\u3044\u3057\u3066\u306f\u3044\u3051\u306a\u3044\u3053\u3068\u3067\u3059<\/li>\n\n\n\n<li><strong><span style=\"color: #000080;\">\u5c0f\u3055\u306a\u816b\u760d\u3067\u6c34\u982d\u75c7\u3082\u7121\u75c7\u72b6\u306e\u521d\u671f\u306a\u3089\u3070\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3067\u304d\u307e\u3059<\/span><\/strong><\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/acohydro1-2.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/acohydro1-2.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/acohydro1-1.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/acohydro1-1.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>\u4e0a\u306e\u5199\u771f\u304c\u5c0f\u3055\u306a\u8074\u795e\u7d4c\u816b\u760d\u3068\u304b\u306a\u308a\u9032\u884c\u3057\u305f\u6c34\u982d\u75c7\u3067\u3059\u300280\u6b73\u8fd1\u3044\u7537\u6027\u306e\u60a3\u8005\u3055\u3093\u304c\u8a8d\u77e5\u75c7\uff08\u75f4\u5446\uff09\u3068\u307e\u3061\u304c\u3048\u3089\u308c\u3066\u3044\u307e\u3057\u305f\u3002\u304a\u3057\u3063\u3053\u3092\u3082\u3089\u3057\u305f\u308a\uff0c\u6b69\u884c\u304c\u4e0d\u5b89\u5b9a\u3067\u3088\u305f\u3088\u305f\u3057\u3066\u3044\u307e\u3057\u305f\u3002\u3053\u308c\u306f\u5c0f\u3055\u306a15mm\u304f\u3089\u3044\u306e\u8074\u795e\u7d4c\u816b\u760d\u304c\u3042\u308b\u305f\u3081\u306b\u6c34\u982d\u75c7\u306b\u306a\u3063\u3066\u3057\u307e\u3063\u305f\u304b\u3089\u8d77\u3053\u3063\u305f\u75c7\u72b6\u3067\u3059\u3002\u3067\u3059\u304b\u3089\uff0c\u8133\u306e\u4e2d\u306b\u6e9c\u3063\u305f\u6c34\u3092\u304a\u8179\u307e\u3067\u30c1\u30e5\u30fc\u30d6\u3067\u6d41\u3059<strong><span class=\"style1\" style=\"color: #ff0000;\">\u30b7\u30e3\u30f3\u30c8\u624b\u8853<\/span><\/strong>\u3068\u3044\u3046\u7c21\u5358\u306a\u624b\u8853\u3067\u8a8d\u77e5\u75c7\u3082\u6b69\u884c\u969c\u5bb3\u3082\u6cbb\u308a\u307e\u3057\u305f\u3002\u3082\u3061\u308d\u3093\u3053\u306e\u5c0f\u3055\u306a\u816b\u760d\u306f\u6cbb\u7642\u3059\u308b\u5fc5\u8981\u304c\u306a\u3044\u306e\u3067\u4f55\u3082\u3057\u306a\u3044\u3067\u307b\u3063\u3066\u304a\u304d\u307e\u3057\u305f\u3002\u304a\u305d\u3089\u304f\u304b\u3064\u3066\u306f\u3082\u3063\u3068\u5927\u304d\u306a\u816b\u760d\u3060\u3063\u305f\u306e\u3067\u3057\u3087\u3046\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span style=\"color: #000080;\">\u3069\u3093\u306a\u6642\u306b\u624b\u8853\u3092\u3059\u308b\u306e\u304b<\/span><\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">\u3069\u3053\u307e\u3067\u5927\u304d\u304f\u306a\u3063\u305f\u3089\u75c7\u72b6\u304c\u51fa\u308b\u306e\u304b<\/h4>\n\n\n\n<p>\u7d4c\u904e\u89b3\u5bdf\u3092\u3057\u3066\u300c\u3069\u306e\u7a0b\u5ea6\u306e\u5927\u304d\u3055\u307e\u3067\u69d8\u5b50\u3092\u898b\u3066\u3044\u3044\u306e\u304b\u300d\u3068\u3044\u3046\u3053\u3068\u3092\u3088\u304f\u60a3\u8005\u3055\u3093\u304b\u3089\u805e\u304b\u308c\u307e\u3059\u3002<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"297\" height=\"300\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy1-297x300.jpg\" alt=\"vestschwauy1\" class=\"wp-image-9196\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy1-297x300.jpg 297w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy1-768x777.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy1-550x556.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy1-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy1.jpg 850w\" sizes=\"auto, (max-width: 297px) 100vw, 297px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy2.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"288\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy2-300x288.jpg\" alt=\"vestschwauy2\" class=\"wp-image-9197\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy2-300x288.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy2-768x737.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy2-550x528.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschwauy2.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>\u3053\u308c\u306f\u82e5\u3044\u5973\u6027\u306e\u3082\u306e\u3067\uff0c\u51fa\u7523\u3057\u305f\u3059\u3050\u5f8c\u3067\u767a\u898b\u3055\u308c\u307e\u3057\u305f\u3002\u4ed5\u4e8b\u3082\u3057\u3066\u3044\u3066\u77e5\u80fd\u3082\u9ad8\u3044\u5973\u6027\u3067\uff0c\u3072\u3069\u3044\u75c7\u72b6\u304c\u3042\u3063\u3066\u898b\u9003\u3055\u308c\u305f\u3082\u306e\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u3053\u306e\u6642\u70b9\u3067\u3082\u666e\u901a\u306b\u6b69\u3051\u307e\u3059\u3057\uff0c\u304b\u308b\u3044\u982d\u75db\u3068\u3075\u3089\u3064\u304d\u3068\u53f3\u96e3\u8074\u304f\u3089\u3044\u306e\u3082\u306e\u3067\u3059\u3002\u6c34\u982d\u75c7\u3082\u3042\u308a\uff0c\u306a\u3093\u3068\u304b\u9854\u9762\u795e\u7d4c\u3092\u6b8b\u3057\u3066\u6458\u51fa\u3067\u304d\u307e\u3057\u305f\u3002\u3053\u3053\u307e\u3067\u307b\u3063\u3066\u304a\u304f\u3068\u547d\u304c\u5371\u306a\u304f\u306a\u308b\u306e\u3067\uff0c\u3053\u308c\u3067\u826f\u3044\u3068\u3044\u3046\u610f\u5473\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u304c\uff0c\u3053\u306e\u5927\u304d\u3055\u306b\u8fd1\u3044\u8074\u795e\u7d4c\u816b\u760d\u304c\u3042\u3063\u3066\u3082\u598a\u5a20\u51fa\u7523\u3082\u3067\u304d\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u3082\u3063\u3068\u5c0f\u3055\u306a\u8074\u795e\u7d4c\u816b\u760d\u306f\u614c\u3066\u306a\u3044\u3067\u3086\u3063\u304f\u308a\u8003\u3048\u308b\u3002<br>MIB-1 5%\u3068\u5897\u5927\u901f\u5ea6\u304c\u901f\u3044\u30bf\u30a4\u30d7\u3067\u3057\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u624b\u8853\u3067\u816b\u760d\u3092\u5168\u3066\u53d6\u308b\u5fc5\u8981\u304c\u3042\u308b\u306e\u304b\uff1f<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u5fc5\u8981\u3042\u308a\u307e\u305b\u3093<\/li>\n\n\n\n<li>\u3054\u304f\u5c0f\u3055\u306a\u816b\u760d\u3092\u9664\u3051\u3070\uff0c2018\u5e74\u6642\u70b9\u3067\uff0c\u4e16\u754c\u7684\u6a19\u6e96\u7684\u306b\u306f\u4e9c\u5168\u6458\u51fa\u3042\u308b\u3044\u306f\u90e8\u5206\u6458\u51fa\u3067\u3059<\/li>\n\n\n\n<li>\u3069\u306e\u7a0b\u5ea6\u6458\u51fa\u3059\u308b\u304b\u306f\uff0c\uff12\u3064\u306e\u8003\u3048\u65b9\u304c\u3042\u308a\u307e\u3059<\/li>\n\n\n\n<li>\u4e9c\u5168\u6458\u51fa\u3068\u3044\u3063\u3066\uff0c\u9854\u9762\u795e\u7d4c\u3068\u5185\u8033\u9053\u5e95\u306b\u3054\u304f\u308f\u305a\u304b\u306b\u816b\u760d\u3092\u6b8b\u3057\u307e\u3059\uff0c\u3053\u306e\u65b9\u6cd5\u3060\u3068\u624b\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3067\u3082\u6e08\u3080\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n\n\n\n<li>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306a\u3069\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u624b\u8853\u5f8c\u306b\u884c\u3046\u524d\u63d0\u3067\uff0c\u610f\u56f3\u7684\u90e8\u5206\u6458\u51fa\u8853\u3092\u3057\u307e\u3059\uff0c\u3053\u306e\u65b9\u6cd5\u3060\u3068\u7121\u7406\u305b\u305a\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u53ef\u80fd\u306a\u3068\u3053\u308d\u307e\u3067\u816b\u760d\u3092\u53d6\u308c\u3070\u3044\u3044\u306e\u3067\uff0c\u624b\u8853\u30ea\u30b9\u30af\u304c\u4f4e\u304f\u306a\u308a\u307e\u3059<\/li>\n\n\n\n<li>3cm\u307b\u3069\u306e\u5927\u304d\u76ee\u306e\u816b\u760d\u3067\u6709\u7528\u8074\u529b\u3092\u5b88\u308a\u305f\u3044\u6642\u306b\u306f\uff0c\u90e8\u5206\u6458\u51fa\u3092\u3057\u3066\uff0c\u8778\u725b\u795e\u7d4c\u3092\u6e29\u5b58\u3057\u307e\u3059\uff0c\u304b\u306a\u308a\u306e\u816b\u760d\u4f53\u7a4d\u3092\u6b8b\u3059\u3053\u3068\u306b\u306a\u308a\uff0c\u534a\u5e74\u304f\u3089\u3044\u5f8c\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u308b\u4e88\u5b9a\u3068\u3057\u307e\u3059<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">\u4f55\u3082\u8003\u3048\u306a\u3044\u3067\u624b\u8853\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u6642<\/h4>\n\n\n\n<p>\u8074\u795e\u7d4c\u816b\u760d\u3067\u307e\u305a\u624b\u8853\u304c\u5fc5\u8981\u306a\u306e\u306f\u5de8\u5927\u306a\u3082\u306e\u3067\u3059\u3002\u3053\u306e\uff14\u679a\u306e\u5199\u771f\u306f\u79c1\u304c\u5b9f\u969b\u306b\u624b\u8853\u3092\u3057\u305f\u60a3\u8005\u3055\u3093\u306e\u3082\u306e\u3067\u3059\u3002\u8133\u5e79\u90e8\u3068\u3044\u3046\u8133\u306e\u6700\u3082\u5927\u5207\u306a\u3068\u3053\u308d\u304c\u816b\u760d\u306b\u3088\u3063\u3066\u5727\u8feb\u3055\u308c\u3066\u5909\u5f62\u3057\u3066\u3044\u308b\u306e\u304c\u7279\u5fb4\u3067\u3059\u3002\u53f3\u4e0a\u306e\u3082\u306e\u306f\u306e\u3046\u80de\u6027\u816b\u760d\u306a\u306e\u3067\u5927\u304d\u3055\u306e\u5272\u306b\u624b\u8853\u306e\u30ea\u30b9\u30af\u306f\u9ad8\u304f\u3042\u308a\u307e\u305b\u3093\u304c\uff0c\u5de6\u4e0a\u306e\u3082\u306e\u306f\u5b9f\u8cea\u6027\u3067\u51fa\u8840\u6027\u306e\u3082\u306e\u3067\u3059\u3054\u304f\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u624b\u8853\u3067\u3057\u305f\u3002\u5de6\u4e0b\u306e\u3082\u306e\u306f\u666e\u901a\u306e\u30ea\u30b9\u30af\u3002\u53f3\u4e0b\u306e\u3082\u306e\u306f\u8d85\u9ad8\u96e3\u6613\u5ea6\u306e\u3082\u306e\u3067\u3059\u3002<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticopecase.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"403\" height=\"411\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticopecase.jpg\" alt=\"\" class=\"wp-image-3284\" title=\"acousticopecase\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticopecase.jpg 403w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/acousticopecase-294x300.jpg 294w\" sizes=\"auto, (max-width: 403px) 100vw, 403px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p class=\"has-text-align-center\"><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u624b\u8853\u3059\u308b\u3079\u304d\u304b\u3069\u3046\u304b\u306e\u5224\u65ad\u306f\u5b9f\u969b\u306b\u306f\u3068\u3066\u3082\u96e3\u3057\u3044\u3067\u3059<\/li>\n\n\n\n<li>3cm\u304f\u3089\u3044\u307e\u3067\u306f\u5b9a\u4f4d\u5206\u5272\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u6cbb\u7642\u3067\u304d\u307e\u3059\u304b\u3089\uff0c\u305d\u306e\u9006\u306e4cm\u3092\u8d85\u3048\u308b\u3082\u306e\u306f\u624b\u8853\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059<\/li>\n\n\n\n<li>3cm &#8211; 4cm\u3067\u3082\u8133\u5e79\u90e8\u306e\u5909\u5f62\u304c\u3068\u3066\u3082\u5f37\u3044\u3068\u304d\u306f\u624b\u8853\u3067\u3059<\/li>\n\n\n\n<li>\u306e\u3046\u80de\u6027\u3067\u624b\u8853\u30ea\u30b9\u30af\u304c\u3068\u3066\u3082\u4f4e\u3044\u3068\u8003\u3048\u3089\u308c\u308b3cm\u304f\u3089\u3044\u306e\u816b\u760d<\/li>\n\n\n\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u5f8c\u3067\u816b\u760d\u304c\u5927\u304d\u304f\u306a\u3063\u3066\u6765\u3066\u6b62\u307e\u3089\u306a\u3044\u5834\u5408<\/li>\n\n\n\n<li>\u6bd4\u8f03\u7684\u5c0f\u3055\u306a\u816b\u760d\u3067\u3082\u660e\u3089\u304b\u306b\u6c34\u982d\u75c7\u3092\u4f75\u767a\u3057\u3066\u3044\u308b\u3068\u304d\uff08\u3067\u3082\u30b7\u30e3\u30f3\u30c8\u3060\u3051\u3068\u3044\u3046\u9078\u629e\u80a2\u3082\u3042\u308a\u307e\u3059\uff09<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">\u3069\u3053\u3067\u624b\u8853\u3092\u53d7\u3051\u308b\u306e\u304b<\/h4>\n\n\n\n<p>\u5916\u79d1\u533b\u304c\u3061\u3083\u3093\u3068\u3057\u305f\u624b\u8853\u6210\u7e3e\u3092\u5f97\u308b\u306b\u306f\uff0c\u3042\u308b\u7a0b\u5ea6\u306e\u624b\u8853\u7d4c\u9a13\u304c\u5fc5\u8981\u3067\u3059\uff08\u82f1\u8a9e\u3067\u306foperative learning curve\u3068\u3044\u3044\u307e\u3059\uff09\u3002Elsmore\u3068\u3044\u3046\u82f1\u56fd\u306e\u8133\u795e\u7d4c\u5916\u79d1\u533b\u306b\u3088\u308c\u3070\uff0c\u8074\u795e\u7d4c\u816b\u760d\uff08\u524d\u5ead\u795e\u7d4c\u9798\u816b\uff09\u306e \u624b\u8853\u6210\u7e3e\u304c\u5b89\u5b9a\u3059\u308b\u306e\u306f\uff0c\u8853\u8005\u3068\u3057\u306650\u4eba\u304f\u3089\u3044\u306e\u60a3\u8005\u3055\u3093\u3092\u624b\u8853\u3057\u305f\u5f8c\u3060\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u3067\u3059\u304b\u3089\uff0c<strong><span style=\"color: #ff0000;\">\u3053\u3068\u306f\u7c21\u5358\u3067\uff0c<\/span><span style=\"color: #ff0000;\">50\u4f8b\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093\u3092\u624b\u8853\u3057\u305f\u7d4c\u9a13\u306e\u3042\u308b\u8133\u5916\u79d1\u306e\u5148\u751f<\/span><\/strong>\u306b\u624b\u8853\u3092\u3057\u3066\u3044\u305f\u3060\u304d\u307e\u3057\u3087\u3046\u3002\u3060\u304b\u3089\u3068\u3044\u3063\u3066\u5b89\u5fc3\u304c\u3067\u304d\u308b\u304b\u3069\u3046\u304b\u306f\u307e\u305f\u5225\u7269\u3067\u3059\u304c\uff0c\u624b\u8853\u304c\u5fc5\u8981\u306a\u5834\u5408\u306b\u306f\u305d\u3046\u3057\u307e\u3057\u3087\u3046\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u305f\u5f8c\u306b\u518d\u767a\u3057\u305f\u3068\u304d\u3067\u3082\u624b\u8853\u306f\u3067\u304d\u307e\u3059<\/strong><\/h4>\n\n\n\n<p>Gerganov VM, et al.: Surgical treatment of patients with vestibular schwannomas after failed previous radiosurgery. J Neurosurg 116: 713-720, 2012<br><span style=\"color: #000080;\"><strong>\u30c9\u30a4\u30c4\u306eHannover\u3068\u3044\u3046\u8074\u795e\u7d4c\u816b\u760d\u306e\u624b\u8853\u3067\u306f\u4e16\u754c\u3067\u3082\u6700\u3082\u6709\u540d\u306a\u65bd\u8a2d<\/strong><\/span>\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u307e\u305a\uff0c\u653e\u5c04\u7dda\u3067\u6cbb\u7642\u3092\u53d7\u3051\u308b\u8074\u795e\u7d4c\u816b\u760d\u306e\u60a3\u8005\u3055\u3093\u306e\u5272\u5408\u304c\u9ad8\u304f\u306a\u3063\u3066\u3044\u308b\u3053\u3068\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u5f8c\u3067\u816b\u760d\u304c\u5897\u5927\u3059\u308b\u53ef\u80fd\u6027\u304c2%\u304b\u30899%\u304f\u3089\u3044\u3067\u3042\u308b\u3053\u3068\uff0c\u518d\u767a\uff08\u518d\u71c3\uff09\u3067\u3042\u3063\u3066\u3082\u8133\u5e79\u90e8\u304c\u5f37\u304f\u5727\u8feb\u3055\u308c\u3066\u3044\u308b\u5834\u5408\u3084\u60a3\u8005\u3055\u3093\u306e\u75c7\u72b6\u304c\u6025\u901f\u306b\u60aa\u304f\u306a\u3063\u3066\u3044\u308b\u6642\u3060\u3051\u306b\uff0c\u958b\u982d\u624b\u8853\u3092\u884c\u306a\u3046\u3079\u304d\u3067\u3042\u308b\u3053\u3068\u3092\u524d\u63d0\u3068\u3057\u3066\u307e\u3059\u3002<br>15\u4f8b\u306e\u60a3\u8005\u3055\u3093\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306b\u816b\u760d\u5897\u5927\u3057\u3066\u958b\u982d\u624b\u8853\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u5168\u54e1\u3067\u816b\u760d\u306e\u5168\u6458\u51fa\u304c\u53ef\u80fd\u3067\u3057\u305f\u3002\u795e\u7d4c\u640d\u50b7\u3082\u305d\u306e\u4ed6\u306e\u624b\u8853\u5408\u4f75\u75c7\u3082\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u306a\u3044\u3067\u6458\u51fa\u8853\u3092\u53d7\u3051\u305f\u4f8b\u3068\u5909\u308f\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002 \u305f\u3060\u3057\uff0c\u8853\u5f8c\u51fa\u8840\u306e\u983b\u5ea6\u304c\u5c11\u3057\u9ad8\u304f\uff0c\u9854\u9762\u795e\u7d4c\u6a5f\u80fd\u6e29\u5b58\u7387 (78%\uff1b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u3066\u306a\u3044\u7fa4\u3067\u306f87%)\u304c\u4f4e\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n<p>\u300c\u89e3\u8aac\u300d\u307e\u305a\u3053\u306e\u5831\u544a\u3067\u308295\uff05\u304f\u3089\u3044\u306e\u60a3\u8005\u3055\u3093\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u307f\u3067\u4f55\u3068\u304b\u306a\u3063\u3066\u3044\u308b\u3053\u3068\u3092\u8a8d\u3081\u3066\u3044\u308b\u3053\u3068\u3067\u3059\u3002\u5916\u6765\u3067\uff0c\u60a3\u8005\u3055\u3093\u304b\u3089\u3057\u3070\u3057\u3070\u304a\u805e\u304d\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\uff0c\u300c<span style=\"color: #000080;\"><strong>\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u3068\u8133\u5e79\u90e8\u3078\u7652\u7740\u304c\u3072\u3069\u304f\u306a\u3063\u3066\u518d\u767a\u3057\u305f\u6642\u306b\u624b\u8853\u3067\u304d\u306a\u304f\u306a\u308b<\/strong><\/span>\u300d\u3068\u3044\u3046\u8aac\u660e\u3092\u53d7\u3051\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>\u305d\u3093\u306a\u3053\u3068\u306f\u3042\u308a\u307e\u305b\u3093<\/strong><\/span>\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306e\u8074\u795e\u7d4c\u816b\u760d\u3082\u305f\u304f\u3055\u3093\u6458\u51fa\u3057\u3066\u304d\u307e\u3057\u305f\u304c\uff0c\u7652\u7740\u3067\u5265\u304c\u305b\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u3057\u304b\u3057\uff0c\u816b\u760d\u304c\u7dda\u7dad\u5316\u3057\u3066\u591a\u5c11\u786c\u304f\u306a\u3063\u3066\u6458\u51fa\u306e\u96e3\u6613\u5ea6\u304c\u3042\u304c\u308b\u3053\u3068\u306f\u4e8b\u5b9f\u3067\u3059\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u8074\u529b\u6e29\u5b58\u624b\u8853<\/h3>\n\n\n\n<p>\u3053\u306e\u8868\u306f\uff0c\u524d\u5ead\u795e\u7d4c\u9798\u816b\uff08\u8074\u795e\u7d4c\u816b\u760d\uff09\u304c\u3042\u3063\u305f29\u6b73\u5973\u6027\u306e\u53f3\u8033\u306e\u8074\u529b\u691c\u67fb (PTA) \u3067\u3059\u3002\u5de6\u304c\u624b\u8853\u524d\u3067\uff0c1000Hz\u304b\u30892000Hz\u304f\u3089\u3044\u306e\u4f1a\u8a71\u306b\u4f7f\u3046\u97f3\u57df\u306e\u8c37\u578b\u306e\u8074\u529b\u4f4e\u4e0b\u3067\uff0c\u8074\u795e\u7d4c\u816b\u760d\u3067\u306f\u5178\u578b\u7684\u306a\u3082\u306e\u3067\u3059\u3002<br>\u3053\u306e\u60a3\u8005\u3055\u3093\u306b\u306f\u8074\u529b\u3092\u6e29\u5b58\u3059\u308b\u305f\u3081\u306e\u624b\u8853\u6458\u51fa\u3092\u3057\u307e\u3057\u305f\u3002\u53f3\u5074\u304c\u816b\u760d\u3092\u6458\u51fa\u3057\u305f\u624b\u8853\u5f8c\u306e\u8074\u529b\u3067\u3059\u3002\u5c0f\u3055\u306a\u816b\u760d (20mm\u4ee5\u4e0b\uff09\u306b\u9650\u3063\u3066\u3044\u3048\u3070\uff0c\u534a\u5206\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093\u3067\u624b\u8853\u3067\u3082\u3053\u306e\u3088\u3046\u306b\u8074\u529b\u306f\u6e29\u5b58\u3067\u304d\u308b\u3067\u3057\u3087\u3046\u3002\u3057\u304b\u3057\uff0c<strong><span style=\"color: #000080;\">\u300c\u97f3\u306e\u8cea\u300d<\/span><\/strong>\u3068\u3044\u3046\u3082\u306e\u304c\u554f\u984c\u306b\u306a\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u8074\u529b\u691c\u67fb\u3067\u306f\u8074\u529b\u304c\u6b8b\u3063\u3066\u3044\u3066\u3082\uff0c\u3072\u3069\u3044\u8033\u9cf4\u308a\u304c\u6b8b\u3063\u305f\u308a\uff0c\u3042\u308b\u4e00\u5b9a\u306e\u97f3\u3060\u3051\u304c\u3059\u3054\u304f\u97ff\u3044\u3066\u3057\u307e\u3063\u3066\u826f\u304f\u805e\u3053\u3048\u306a\u3044\u306a\u3069\u306e\u554f\u984c\u304c\u751f\u3058\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/hearingpreserve.png\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/hearingpreserve.png\" alt=\"\"\/><\/a><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<h5 class=\"wp-block-heading\">\u6025\u3044\u3067\u624b\u8853\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u6642\uff08\u7dca\u6025\u624b\u8853\uff09<\/h5>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #000080;\">\u306e\u3046\u80de\u6027\u62e1\u5927\uff0c\u9589\u585e\u6027\u6c34\u982d\u75c7\uff0c\u816b\u760d\u5185\u51fa\u8840\u304c\u3042\u308a\u307e\u3059<\/span><\/h4>\n\n\n\n<p>\u816b\u760d\u304c\u56a2\u80de\u6027\u62e1\u5927\u3067\u5927\u304d\u304f\u306a\u3063\u3066\uff0c\u816b\u760d\u5185\u51fa\u8840\u3057\u3066\uff0c\u9589\u585e\u6027\u6c34\u982d\u75c7\u306b\u306a\u3063\u3066\u610f\u8b58\u969c\u5bb3\u3092\u751f\u3058\u305f\u60a3\u8005\u3055\u3093\u3067\u3059\u3002\u3053\u306e\u3088\u3046\u306a\u4e8b\u614b\u306b\u306a\u308b\u3068\u81e8\u6642\u624b\u8853\u3067\u816b\u760d\u3092\u6458\u51fa\u3057\u307e\u3059\u3002<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"292\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst1-300x292.jpg\" alt=\"\" class=\"wp-image-6786\" title=\"vestschcyst1\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst1-300x292.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst1-550x536.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst1.jpg 567w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst2.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"298\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst2-300x298.jpg\" alt=\"\" class=\"wp-image-6787\" title=\"vestschcyst2\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst2-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst2-550x548.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst2.jpg 567w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>\u5927\u304d\u306a\u306e\u3046\u80de\u6027\u8074\u795e\u7d4c\u816b\u760d\u3067\u3059\u3002\u3044\u304f\u3064\u304b\u306e\u888b\u304c\u91cd\u306a\u3063\u3066\u816b\u760d\u3092\u5f62\u6210\u3057\u3066\u3044\u307e\u3059\u3002\u6a4b\u3084\u5ef6\u9ac4\uff08\u8133\u5e79\u90e8\uff09\u304c\u5909\u5f62\u3057\u3066\uff0c\u7b2c\uff14\u8133\u5ba4\u304c\u3064\u3076\u308c\u3066\u9589\u585e\u3057\u3066\u3044\u307e\u3059\u3002\u888b\u306e\u5468\u308a\u304c\u767d\u304f\u7dda\u72b6\u306b\u9020\u5f71\u3055\u308c\u3066\u3044\u308b\u306e\u3067\u3059\u304c\uff0c\u3053\u306e\u888b\u306e\u58c1\u3060\u3051\u306b\u816b\u760d\u7d30\u80de\u304c\u3042\u308a\u307e\u3059\u304b\u3089\uff0c\u3053\u308c\u3092\u5265\u304c\u3059\u3088\u3046\u306b\u6458\u51fa\u3057\u307e\u3059\u3002\u9854\u9762\u795e\u7d4c\u304c\u8584\u304f\u306a\u3063\u3066\u888b\u306e\u58c1\u306b\u304f\u3063\u3064\u3044\u3066\u3044\u308b\u306e\u3067\u3059\u304c\uff0c\u888b\u3092\u7834\u3063\u3066\u304f\u3057\u3083\u304f\u3057\u3083\u306b\u3059\u308b\u3068\u9854\u9762\u795e\u7d4c\u306e\u4f4d\u7f6e\u304c\u5909\u308f\u3063\u3066\u3057\u307e\u3063\u3066\uff0c\u9854\u9762\u795e\u7d4c\u3092\u640d\u50b7\u3059\u308b\u3053\u3068\u304c\u3042\u308b\u306e\u3067\u8981\u6ce8\u610f\u3067\u3059\u3002\u306e\u3046\u80de\u6027\u8074\u795e\u7d4c\u816b\u760d\u306e\u65b9\u304c\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u306e\u5f8c\u907a\u75c7\u306e\u983b\u5ea6\u304c\u9ad8\u3044\u3068\u3044\u3046\u5831\u544a\u3082\u3042\u308b\u304f\u3089\u3044\u3067\u3059\u3002\u3053\u306e\u60a3\u8005\u3055\u3093\u306f\u8ff7\u8d70\u795e\u7d4c\u3068\u820c\u54bd\u795e\u7d4c\u306e\u5727\u8feb\u3082\u5f37\u304f\u3066\uff0c\u3054\u98ef\u3092\u98f2\u307f\u8fbc\u3080\u3053\u3068\u304c\u96e3\u3057\u304f\u306a\u3063\u3066\u3044\u307e\u3057\u305f\uff08\u56a5\u4e0b\u969c\u5bb3\uff09\u3002<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst3.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"297\" height=\"300\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst3-297x300.jpg\" alt=\"\" class=\"wp-image-6788\" title=\"vestschcyst3\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst3-297x300.jpg 297w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst3-550x553.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst3.jpg 567w\" sizes=\"auto, (max-width: 297px) 100vw, 297px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst4.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst4-300x300.jpg\" alt=\"\" class=\"wp-image-6789\" title=\"vestschcyst4\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst4-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst4-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst4-550x549.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschcyst4.jpg 567w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>\u307e\u305f\uff0c\u3053\u306e\u60a3\u8005\u3055\u3093\u306f\u6025\u306b\u5bb9\u614b\u304c\u60aa\u304f\u306a\u3063\u3066\u610f\u8b58\u969c\u5bb3\u3068\u306a\u308a\u307e\u3057\u305f\u3002\u4f55\u6545\u306a\u3089\u816b\u760d\u306e\u5185\u90e8\u3067\u51fa\u8840\u3057\u305f\u304b\u3089\u3067\u3059\uff08\u9ec4\u8272\u306e\u77e2\u5370\u306e\u90e8\u5206\uff09\u3002\u7b2c\uff14\u8133\u5ba4\u304c\u8a70\u307e\u3063\u3066\u9589\u585e\u6027\u6c34\u982d\u75c7\u306b\u306a\u3063\u3066\u5074\u8133\u5ba4\u304c\u62e1\u5927\u3057\u3066\u3044\u307e\u3059\uff08\u53f3\u306e\u753b\u50cf\uff09\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span style=\"color: #000080;\">\u7d4c\u904e\u89b3\u5bdf\u3092\u3059\u308b\u3079\u304d\u304b\uff1f<\/span><\/h3>\n\n\n\n<p>2021\u5e74\u3067\u3082\u56fd\u969b\u7684\u306a\u5408\u610f international consensus \u306f\u306a\u3044\u3067\u3059<\/p>\n\n\n\n<h4 class=\"wp-block-heading style1\"><strong style=\"color: #000080;\">\u7d4c\u904e\u89b3\u5bdf\u3057\u305f\u3089\u3069\u3046\u306a\u308b\u306e\u304b\uff1f<\/strong><\/h4>\n\n\n\n<p class=\"heading-title\"><span class=\"authors-list-item \">Reznitsky M:&nbsp;<\/span>The natural history of vestibular schwannoma growth-prospective 40-year data from an unselected national cohort. Neuro Oncol 2021<br>\u30c7\u30f3\u30de\u30fc\u30af\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30021976\u5e74\u304b\u3089<span style=\"color: #000080;\"><strong>\u7d4c\u904e\u89b3\u5bdf\u3068\u3055\u308c\u305f\u524d\u5ead\u795e\u7d4c\u9798\u816b 2,312\u4f8b\uff0c\u4e2d\u592e\u50247.3\u5e74\u7d4c\u904e\u89b3\u5bdf\u3057\u305f\u89e3\u6790\u3067\u3059\u3002<\/strong><strong>434\u4f8b (19%<\/strong><\/span>)<span style=\"color: #000080;\"><strong>\u3067\u6cbb\u7642\u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3057\u305f\u3002<\/strong><span style=\"color: #333333;\">\u5185\u8033\u9053\u5185102\u4f8b\u3067\u3042\u3063\u305f\u3082\u306e\uff0c\u5185\u8033\u9053\u5916332\u4f8b\u3067\u3057\u305f\u30022mm\u4ee5\u4e0a\u5927\u304d\u304f\u306a\u3063\u305f\u3082\u306e\u3092\u5897\u5927\u3068\u5b9a\u7fa9\u3059\u308b\u3068\uff0c5\u5e74\u3067\uff0c\u5185\u8033\u9053\u5185\u816b\u760d\u306f21%\uff0c\u5185\u8033\u9053\u5916\u816b\u760d\u306f37%\u3067\u5897\u5927\u3057\u307e\u3057\u305f\u300210\u5e74\u3067\u306f\u305d\u308c\u305e\u308c\uff0c25%\u306842\uff05\u3067\u3057\u305f\u3002\u5897\u5927\u3059\u308b\u3082\u306e\u306f5\u5e74\u4ee5\u5185\u306b\u5897\u5927\u3057\uff0c5\u5e74\u3067\u9855\u8457\u306a\u5897\u5927\u3092\u3057\u306a\u3044\u816b\u760d\u306f\u305d\u306e\u307e\u307e\u7d4c\u904e\u3059\u308b\u3068\u3044\u3046\u50be\u5411\u304c\u3042\u308a\u307e\u3057\u305f\u3002<br>\u300c\u89e3\u8aac\u300d10\u5e74\u898b\u3066\u3082\u534a\u6570\u4ee5\u4e0a\u306e\u8074\u795e\u7d4c\u816b\u760d\u306f\u5897\u5927\u3057\u306a\u3044\uff0c<span style=\"color: #ff0000;\"><strong>\u6cbb\u7642\u304c\u5fc5\u8981\u3068\u306a\u308b\u3082\u306e\u306f\uff12\u5272\u7a0b\u5ea6<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/span><\/span><\/p>\n\n\n\n<h4 class=\"wp-block-heading style1\"><strong style=\"color: #000080;\">\u7d4c\u904e\u89b3\u5bdf\u3057\u305f\u3089\u3069\u3046\u306a\u308b\u306e\u304b\uff1f<\/strong><\/h4>\n\n\n\n<p>Bakkouri WE: Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequence for treatment. J Neurosurg 2008<br>1990-2005\u5e74\u306e\u9593\u306b\u7d4c\u904e\u89b3\u5bdf\u3092\u3057\u305f (wait-and-scan\uff09\u5831\u544a\u3067\u3059\u3002\u7406\u7531\u306f\uff0c60\u6b73\u4ee5\u4e0a\uff0c\u4e00\u822c\u72b6\u614b\u304c\u60aa\u3044\uff0c\u826f\u597d\u306a\u8074\u529b\u304c\u3042\u308b\uff0c\u816b\u760d\u304c\u5c0f\u3055\u3044\uff0c\u75c7\u72b6\u304c\u8efd\u3044\uff0c\u60a3\u8005\u306e\u5e0c\u671b\u306a\u3069\u3067\u3057\u305f\u3002\u7d4c\u904e\u89b3\u5bdf\u306eMRI\u306f\uff11\u5e74\u306b\uff11\u56de\u3060\u3051\u3067\u3059\u3002\uff11\u5e74\u4ee5\u4e0a\u7d4c\u904e\u3092\u898b\u305f325\u4eba\u306e\u60a3\u8005\u3055\u3093\u3067\uff0c39\u4f8b\u30673mm\u4ee5\u4e0a\u306e\u816b\u760d\u5897\u5927\u304c\u3042\u3063\u305f\u305f\u3081\u306b\u6cbb\u7642\u304c\u306a\u3055\u308c\u307e\u3057\u305f\u3002\u4ed6\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\u3055\u3089\u306b\u8ffd\u8a18\u3092\u3057\u305f\u3068\u3053\u308d\uff0c\u816b\u760d\u306e\u5927\u304d\u3055\u306f\uff11\u5e74\u3042\u305f\u308a1.15mm (SD 2.4) \u5897\u5927\u3057\u3066\u3044\u307e\u3057\u305f\u300259%\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\u816b\u760d\u306e\u5927\u304d\u304f\u306a\u308a\u304b\u305f\u306f\uff11\u5e74\u306b1mm\u672a\u6e80\u3067\u3057\u305f\u304c\uff0c12%\u306e\u60a3\u8005\u3055\u3093\u30673mm\u4ee5\u4e0a\u5897\u5927\u3057\u307e\u3057\u305f\u3002\u5185\u8033\u9053\u5185\u306b\u3068\u3069\u307e\u308b\u5c0f\u3055\u306a\u3082\u306e\u3068\u5185\u8033\u9053\u3092\u3067\u3066\u5927\u304d\u304f\u306a\u3063\u305f\u3082\u306e\u3067\u306f\u306f\u3063\u304d\u308a\u3057\u305f\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u898b\u3064\u304b\u3063\u305f\u3068\u304d\u306e\u816b\u760d\u306e\u5927\u304d\u3055\u3084\u5e74\u9f62\u3068\u816b\u760d\u306e\u5897\u5927\u901f\u5ea6\u306b\u95a2\u4fc2\u306f\u306a\u304b\u3063\u305f\u3068\u3057\u3066\u3044\u307e\u3059\u3002\u7d50\u679c\u7684\u306b325\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u4e2d\u3067\uff0c\u5916\u79d1\u624b\u8853\u3092\u53d7\u3051\u305f\u4eba\u304c60\u4eba (18%) \u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u305f\u4eba\u304c17\u4eba\u3067\u3057\u305f\u3002\u3068\u3044\u3046\u3053\u3068\u306f\uff0c248\u4eba\u306f\u7d4c\u904e\u89b3\u5bdf\u306e\u307e\u307e\u3067\u3057\u305f\u3002\u300c\u89e3\u8aac\u300d\u7d50\u679c\u7684\u306b76% (248\/325) \u306e\u60a3\u8005\u3055\u3093\u304c\u7d4c\u904e\u89b3\u5bdf\u306e\u307e\u307e\u3067\u6cbb\u7642\u306a\u3057\u3067\u3059\u3002<strong><span style=\"color: #ff0000;\">\u5c0f\u3055\u306a\u524d\u5ead\u795e\u7d4c\u9798\u816b\u306f\u7d4c\u904e\u3092\u898b\u308b\u3068\uff13\u5272\u304f\u3089\u3044\u306e\u4eba\u3067\u6cbb\u7642\u304c\u5fc5\u8981\u306b\u306a\u308b\uff0c\u3042\u308b\u3044\u306f\uff17\u5272\u304f\u3089\u3044\u306e\u60a3\u8005\u3055\u3093\u3067\u306a\u306b\u3082\u3057\u306a\u3044\u307e\u307e\u7d4c\u904e\u304c\u898b\u308c\u308b<\/span><\/strong>\u3068\u53d7\u3051\u53d6\u3063\u3066\u3044\u3044\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u6cbb\u7642\u306e\u9078\u629e<\/h3>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u7d4c\u904e\u89b3\u5bdf\u3068\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u306f\u3069\u3061\u3089\u304c\u8074\u529b\u3092\u5b88\u308c\u308b\u304b\uff1f<\/strong><\/h4>\n\n\n\n<p>Maniakas A, et al.: Conservative management versus stereotactic radiation for vestibular schwannomas: a meta-analysis of patients with more than 5 years&#8217; follow-up. Otol Neurotol 33:230-238, 2012<br>\u904e\u53bb\u306e\u6587\u732e\u3092\u96c6\u3081\u3066\u7d71\u8a08\u5b66\u7684\u306b\u7d50\u8ad6\u3092\u63a8\u6e2c\u3059\u308b\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068\u3044\u3046\u65b9\u6cd5\u3067\u3059\u3002\uff15\u5e74\u4ee5\u4e0a\u7d4c\u904e\u89b3\u5bdf\u3055\u308c\u305f\u4f8b\u3067\uff0c<span style=\"color: #ff0000;\"><strong>\u4e21\u8005\u306b\u5dee\u304c\u306a\u304b\u3063\u305f<\/strong><\/span>\u3068\u3044\u3046\u7d50\u8ad6\u3067\u3059\u3002\u8074\u795e\u7d4c\u816b\u760d\u3092\u4f55\u3082\u3057\u306a\u3044\u3067\u653e\u7f6e\u3057\u3066\u3082\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3057\u3066\u3082\u9577\u671f\u6210\u7e3e\u306b\u5927\u5dee\u306f\u306a\u3044\u3002\u305f\u3060\u3057\uff0c\u5b9a\u4f4d\u7167\u5c04\u3057\u3066\u304a\u3044\u305f\u307b\u3046\u304c\u816b\u760d\u304c\u5897\u5927\u3059\u308b\u53ef\u80fd\u6027\u306f\u3082\u3061\u308d\u3093\u4f4e\u304f\u306a\u308a\u307e\u3059\u3002\u9006\u306b\uff0c\u5b9a\u4f4d\u7167\u5c04\u3092\u3057\u305f\u304b\u3089\u3068\u3044\u3063\u3066\u8074\u529b\u304c\u5b88\u308c\u308b\u308f\u3051\u3067\u306f\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u6458\u51fa\u624b\u8853\u3068\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u3092\u540c\u3058\u65bd\u8a2d\u3067\u6bd4\u3079\u305f\u3089<\/strong><\/h4>\n\n\n\n<p>Pollock BE, et al.: Patient outcomes after vestibular schwannoma management: a prospective comparison of microsugical resection and stereotactic radiosurgery. Neurosurgery 59: 77-85, 2006<br><span style=\"color: #000080;\"><strong>\u30e1\u30a4\u30e8\u30fb\u30af\u30ea\u30cb\u30c3\u30af\u3068\u3044\u3046\u7c73\u56fd\u3067\u3082\u540d\u9ad8\u3044\u75c5\u9662<\/strong><\/span>\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u8a08\u753b\u7684\u306b\u524d\u5411\u304d\u8a66\u9a13\u3067\u8abf\u67fb\u3055\u308c\u307e\u3057\u305f\u30023cm\u4ee5\u4e0b\u306e\u8074\u795e\u7d4c\u816b\u760d\u304c\u3042\u308b\u60a3\u8005\u3055\u3093\u3067\uff0c36\u4eba\u304c\u5916\u79d1\u6458\u51fa\u3092\u53d7\u3051\uff0c46\u4eba\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u89b3\u5bdf\u671f\u9593\u4e2d\u592e\u502442\u30f6\u6708\u3067\u3059\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u65b9\u304c\u9854\u9762\u795e\u7d4c\u3068\u8074\u529b\u306e\u6e29\u5b58\u306f\u660e\u3089\u304b\u306b\u826f\u597d\u3067\u3057\u305f (p&lt;0.001)\u3002\u307e\u305f\uff0c\u3075\u3089\u3064\u304d\uff0c\u3081\u307e\u3044\uff0c\u904b\u52d5\u80fd\u529b\uff0c\u75db\u307f\u306a\u3069\u69d8\u3005\u306a\u8eab\u4f53\u5408\u4f75\u75c7\u3082\u5916\u79d1\u624b\u8853\u306e\u65b9\u304c\u591a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u816b\u760d\u306e\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u7387\u306b\u5dee\u306f\u306a\u304f\uff0c\u7d50\u8ad6\u3068\u3057\u3066\uff0c\u77ed\u671f\u6210\u7e3e\u3092\u898b\u308b\u9650\u308a\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb\uff12\u3068\u3044\u3046\u9ad8\u3044\u4fa1\u5024\u3067<span style=\"color: #ff0000;\"><strong>\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u306e\u307b\u3046\u304c\u6458\u51fa\u624b\u8853\u3088\u308a\u3082\u512a\u308c\u3066\u3044\u308b<\/strong><\/span>\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong><span style=\"color: #000080;\">\u8074\u529b\u3092\u5b88\u308b\u305f\u3081\u306b\u306f<span class=\"style1\">\uff11\u56de\u7167\u5c04\uff08\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\uff09\u3068\u5206\u5272\u7167\u5c04\uff08\u30ea\u30cb\u30a2\u30c3\u30af\uff09\u306e\u3069\u3061\u3089\u304c\u826f\u3044\u304b<\/span>\uff1f<\/span><\/strong><\/h4>\n\n\n\n<p>\u60a3\u8005\u3055\u3093\u304b\u3089\u3057\u3070\u3057\u3070\u805e\u304b\u308c\u308b\u8cea\u554f\u3067\u3059\u3002\u6587\u732e\u3092\u8aad\u3093\u3067\u3082\u3069\u3061\u3089\u3082\u8074\u529b\u6e29\u5b58\u306f\u671f\u5f85\u3067\u304d\u308b\u3068\u66f8\u3044\u3066\u3042\u308a\u307e\u3059\u304b\u3089\uff0c\u3069\u3061\u3089\u304c\u826f\u3044\u306e\u304b\u5c02\u9580\u5bb6\u306b\u3082\u3088\u304f\u308f\u304b\u308a\u307e\u305b\u3093\u3002\u79c1\u306f\u8133\u5916\u79d1\u533b\u3067\u3059\u304b\u3089\u653e\u5c04\u7dda\u6cbb\u7642\u533b\u3088\u308a\u5ba2\u89b3\u7684\u306a\u7acb\u5834\u3067\u3053\u308c\u3092\u8a55\u4fa1\u3067\u304d\u308b\u306f\u305a\u306a\u306e\u3067\u3059\u304c\uff0c\u78ba\u4fe1\u3092\u6301\u3063\u3066\u5224\u65ad\u3067\u304d\u306a\u3044\u3067\u3059\u3002\u305d\u3053\u3067\u53c2\u8003\u306b\u306a\u308b\u8ad6\u6587\u304c\u3042\u308a\u307e\u3059\u3002<br>Andrew DW et al.: Stereotactic radiosurgery and fractinated stereotactic radiotherapy for the treatment of acoustic schwannomas: comparative observations of 125 patients treated at one institution. Int J Radiat Oncol Biol Phys 50: 1265-1278, 2001<br>\u30d5\u30a3\u30e9\u30c7\u30eb\u30d5\u30a3\u30a2\u306e\u30c8\u30fc\u30de\u30b9\u30b8\u30a7\u30d5\u30a1\u30fc\u30bd\u30f3\u75c5\u9662\u3067\uff0c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\uff08\uff11\u56de\u7167\u5c04\uff09\u3068\u30ea\u30cb\u30a2\u30c3\u30af\uff08\u591a\u6570\u56de\u5206\u5272\u7167\u5c04\uff09\u306e\u4e21\u65b9\u304c\u4f7f\u3048\u307e\u3059\u3002\u305d\u3053\u3067\uff0c69\u4eba\u306e\u60a3\u8005\u3055\u3093\u306f\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\uff0c56\u4eba\u306e\u60a3\u8005\u3055\u3093\u306f\u30ea\u30cb\u30a2\u30c3\u30af\u3067\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\u816b\u760d\u306e\u5897\u5927\u3092\u6b62\u3081\u308b\u52b9\u679c\u3084\u526f\u4f5c\u7528\u306b\u307b\u3068\u3093\u3069\u5dee\u304c\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u3057\u304b\u3057\uff0c\u6cbb\u7642\u524d\u306b\u826f\u3044\u8074\u529b\u3092\u6301\u3063\u3066\u3044\u305f\u4eba\u3067\u306f<strong><span style=\"color: #ff0000;\">\u5206\u5272\u7167\u5c04\u306e\u65b9\u304c2.5\u500d\u304f\u3089\u3044\u8074\u529b\u6e29\u5b58\u304c\u3067\u304d\u305f<\/span><\/strong>\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u3053\u308c\u306f\u4e00\u3064\u306e\u75c5\u9662\u3067\u540c\u3058\u30b0\u30eb\u30fc\u30d7\u304c\u4e21\u65b9\u306e\u624b\u6bb5\u3092\u4f7f\u3063\u3066\u6bd4\u8f03\u3057\u305f\u7d50\u679c\u306a\u306e\u3067\u304b\u306a\u308a\u4fe1\u7528\u3067\u304d\u307e\u3059\u3002\u4e00\u3064\u3060\u3051\u6ce8\u610f\u3057\u3066\u304a\u304b\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u5206\u5272\u7167\u5c04\u3067\u306f<strong><span style=\"color: #ff0000;\">\uff11\u65e5\u3042\u305f\u308a2\u30b0\u30ec\u30a4<\/span><\/strong>\u304c\u4f7f\u7528\u3055\u308c\u305f\u3053\u3068\u3067\u3059\u3002\u3053\u308c\u4ee5\u4e0a\u306e\uff11\u65e5\u7167\u5c04\u91cf\u3060\u3068\u3053\u306e\u6210\u7e3e\u306f\u51fa\u306a\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<p>\u7d50\u8ad6\u3068\u3057\u3066\uff0c<span style=\"color: #ff0000;\"><strong>\u5206\u5272\u7167\u5c04\u306e\u65b9\u304c\u8074\u529b\u3092\u5b88\u308c\u308b\u3068\u8003\u3048\u3089\u308c\u307e\u3059<\/strong><\/span>\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #000080;\"><strong><span class=\"style1\">\uff11\u56de\u7167\u5c04\uff08\u653e\u5c04\u7dda\u5916\u79d1\uff09\u3068\u5b9a\u4f4d\u5206\u5272\u7167\u5c04(\u591a\u6570\u56de\u5206\u5272\uff09\u306e\u3069\u3061\u3089\u304c\u826f\u3044\u304b<\/span>\uff1f<\/strong><\/span><\/h4>\n\n\n\n<p>Kopp C et al.: Stereotactic fractionated radiotherapy and LINAC radiosurgery in the treatment of vestibular schwannoma-report about both stereotactic methods from a single institution. Int J Radiat Oncol Biol Phys 80: 1485-1491, 2011<br>\u30df\u30e5\u30f3\u30d8\u30f3\u306e\u5927\u5b66\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u540c\u3058\u65bd\u8a2d\u3067\u653e\u5c04\u7dda\u5916\u79d1 (radiosurgery)\u3068\u5b9a\u4f4d\u5206\u5272\u7167\u5c04 (fractionated radiaiton therapy)\u309210\u5e74\u9593\u4f7f\u3044\u5206\u3051\u3066115\u4f8b\u306e\u60a3\u8005\u3055\u3093\u304c\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\u4f7f\u3044\u5206\u3051\u306e\u57fa\u6e96\u306f<strong><span style=\"color: #000080;\">\u6700\u5927\u5f84\u306715mm\u4ee5\u4e0b\u306e\u3082\u306e\u306f\u653e\u5c04\u7dda\u5916 SRS&nbsp;<\/span><\/strong>\uff0c<span style=\"color: #000080;\"><strong>15mm\u4ee5\u4e0a\u306e\u3082\u306e\u304c\u5206\u5272\u7167\u5c04 SRT&nbsp;<\/strong><\/span>\u306e\u76ee\u5b89\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u3082\u3061\u308d\u3093\u5c0f\u3055\u306a\u3082\u306e\u306b\u3082\u5206\u5272\u7167\u5c04\u306f\u4f7f\u3048\u307e\u3059\u304c\uff0c\u9006\u306b\u5927\u304d\u306a\u3082\u306e\u306b\u306f\u653e\u5c04\u7dda\u5916\u79d1\uff081\u56de\u7167\u5c04\uff09\u306f\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u3068\u306e\u8003\u3048\u306b\u57fa\u3065\u304f\u3082\u306e\u3067\u3059\u3002\u7279\u306b<span style=\"color: #000080;\"><strong>\u6210\u7e3e\u306e\u9055\u3044\u304c\u306a\u3044<\/strong><\/span>\u3068\u306e\u7d50\u8ad6\u3067\u3059\u304c\uff0c\u4e09\u53c9\u795e\u7d4c\u969c\u5bb3\u306f\u653e\u5c04\u7dda\u5916\u79d1\u306e\u307b\u3046\u304c\u591a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading style1\"><span style=\"color: #000080;\"><strong>SRT \u591a\u5206\u5272\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u6210\u7e3e<\/strong><\/span><\/h4>\n\n\n\n<p>Combs SE et al.: Management of acoustic neuromas with fractionated stereotactic radiotherapy (FSRT): long-term results in 106 patients treated in a single institution. Int J Radiat Oncol Biol Phys 63:75-81, 2005<br>\u30c9\u30a4\u30c4\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002106\u4eba\u306e\u60a3\u8005\u3055\u3093\u3092\uff11\u65e51.8\u30b0\u30ec\u30a4\uff0c\uff11\u9031\u9593\u306b\uff15\u56de\u306e\u7167\u5c04\u3067\uff0c\u7dcf\u7dda\u91cf57.6\u30b0\u30ec\u30a4\u3067\u6cbb\u7642\u3057\u305f\u6210\u7e3e\u3067\u3059\u3002\uff15\u5e74\u306e\u6642\u70b9\u3067\u816b\u760d\u304c\u5927\u304d\u304f\u306a\u3089\u306a\u304b\u3063\u305f\u5272\u5408\u306f93%\u3067\u3057\u305f\u3002\u6709\u7528\u8074\u529b\u306e\u3042\u3063\u305f\u60a3\u8005\u3055\u3093\u3067\uff15\u5e74\u5f8c\u306b\u8074\u529b\u6e29\u5b58\u304c\u3067\u304d\u305f\u306e\u306f94%\u3068\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002\u795e\u7d4c\u7dda\u7dad\u816b\u75c7\uff12\u578bNF-2\u306e\u60a3\u8005\u3055\u3093\u3067\u306e\u8074\u529b\u6e29\u5b58\u7387\u306f\u4f4e\u304f\u306664%\u3067\u3057\u305f\u3002\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u304c2.3%\uff0c\u4e09\u53c9\u795e\u7d4c\u969c\u5bb3\u304c3.4%\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002NF-2\u306e\u60a3\u8005\u3055\u3093\u3092\u9664\u3051\u3070\uff0cGardner-Robertson\u306e\u5206\u985e\u3067\u30af\u30e9\u30b91\u30682\u306e\u60a3\u8005\u3055\u3093\u3067\uff0c<span style=\"color: #ff0000;\"><strong>\uff15\u5e74\u5f8c\u306b\u6709\u7528\u8074\u529b\u304c98%\u3082\u6b8b\u3063\u305f\u3068\u3042\u308a\u307e\u3059\u304b\u3089\uff0c\u3061\u3087\u3063\u3068\u4fe1\u3058\u3089\u308c\u306a\u3044\u304f\u3089\u3044\u826f\u3044\u6210\u7e3e\u3067\u3059\uff1f\u3000<\/strong><\/span>\u307b\u3093\u3068\u304b\u306a\uff1f<\/p>\n\n\n\n<p>Kapoor S, et al.: Long-term outcomes of vestibular schwannomas treated with fractionated stereotactic radiotherapy: an institutional experience. Int J Radiat Oncol Biol Phys 81: 647-653, 2011<br>\u30b8\u30e7\u30f3\u30ba\u30db\u30d7\u30ad\u30f3\u30b9\u75c5\u9662\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30021995\u5e74\u304b\u3089385\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u5b9a\u4f4d\u5206\u5272\u7167\u5c04\u3067\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u300211\u4eba(3\uff05)\u306e\u60a3\u8005\u3055\u3093\u304c\u816b\u760d\u5897\u5927\u3067\u624b\u8853\u6458\u51fa\u3092\u53d7\u3051\u307e\u3057\u305f\u300230\uff05\u306e\u60a3\u8005\u3055\u3093\u3067\u4e00\u6642\u7684\u306b\u3067\u3042\u308c\u816b\u760d\u5897\u5927\u306f\u751f\u3058\u305f\u305d\u3046\u3067\u3059\u30028\u4f8b (1.8%)\u3067\u9854\u9762\u9ebb\u75fa\u304c\u767a\u751f\u3057\uff0c12\u4f8b (2.8%)\u3067\u4e09\u53c9\u795e\u7d4c\u969c\u5bb3\u304c\u51fa\u3066\u3044\u307e\u3059\u3002\u6c34\u982d\u75c7\u306b\u306a\u3063\u305f\u306e\u306f\u305f\u3063\u305f\u306e4\u4f8b (0.9%)\u3068\u3044\u3046\u304b\u3089\u9a5a\u304d\u3067\u3059\u3002\u5916\u6765\u3067\u304d\u3061\u3093\u3068\u8a8d\u77e5\u6a5f\u80fd\u306e\u7d4c\u904e\u89b3\u5bdf\u3055\u308c\u3066\u3044\u306a\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u3057\u304b\u3057\uff0c<span style=\"color: #ff0000;\"><strong>97\uff05\u306e\u60a3\u8005\u3055\u3093\u306f\u5b9a\u4f4d\u5206\u5272\u7167\u5c04\u3060\u3051\u3067\uff0c\u30ea\u30b9\u30af\u306e\u9ad8\u3044\u958b\u982d\u624b\u8853\u3092\u53d7\u3051\u306a\u3044\u3067\u6e08\u3093\u3067\u3044\u308b<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>SRS \u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u3067\u306e\u8074\u529b\u6e29\u5b58<\/strong><\/h4>\n\n\n\n<p>Carlson ML, et al.: Long-term hearing outcomes following stereotactic radiosurgery for vestibular schwannoma: patterns of hearing loss and variables influencing audiometric decline. J Neurosurg 118:579-587, 2013<br>\u30e1\u30a4\u30e8\u30af\u30ea\u30cb\u30c3\u30af\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u6709\u7528\u8074\u529b\u306e\u3042\u308b44\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\uff0c\u4f4e\u8fba\u7e01\u7dda\u91cf 12-13\u30b0\u30ec\u30a4\u3067\uff11\u56de\u7167\u5c04 SRS\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u5024\u306f9\u5e74\u3067\u3059\u300236\u4eba(82%)\u306e\u60a3\u8005\u3055\u3093\u304c\u6709\u7528\u8074\u529b\u3092\u5931\u3044\u307e\u3057\u305f\u3002\u5e73\u5747\u671f\u9593\u306f\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u5f8c4.2\u5e74\u3067\u3059\u3002<span style=\"color: #ff0000;\"><strong>10\u5e74\u9593\u6709\u7528\u8074\u529b\u3092\u7dad\u6301\u3067\u304d\u308b\u78ba\u7387\u306f23%\u3068\u63a8\u5b9a\u3055\u308c\u307e\u3057\u305f\u3002<br><\/strong><\/span>\u300c\u89e3\u8aac\u300d\u30e1\u30a4\u30e8\u30af\u30ea\u30cb\u30c3\u30af\u304b\u3089\u306e\u3068\u3066\u3082\u6b63\u76f4\u3067\u6b63\u78ba\u306a\u5206\u6790\u3067\u3059\u304b\u3089\uff0c\u4fe1\u983c\u3059\u308b\u306b\u5024\u3059\u308b\u30c7\u30fc\u30bf\u3067\u3059\u3002\u3067\u3082\u3053\u306e\u6210\u7e3e\u306e\u4f4e\u3055\u306b\u306f\u9a5a\u304d\u307e\u3057\u305f\u3002\u3053\u306e\u3088\u3046\u306a\u7814\u7a76\u3067\u6b63\u78ba\u306b\u9577\u3044\u671f\u9593\u3092\u8ffd\u8de1\u3059\u308c\u3070\u3059\u308b\u307b\u3069\uff0c\u6210\u7e3e\u306f\u4f4e\u4e0b\u3059\u308b\u3068\u3044\u3046\u306e\u304c\u5b9f\u611f\u3067\u304d\u308b\u3088\u3046\u306a\u8ad6\u6587\u3067\u3059\u3002\u9006\u306b\u82f1\u8a9e\u306e\u8ad6\u6587\u3067\u3082\uff0c\u4e2d\u9014\u534a\u7aef\u306b\u826f\u3044\u6210\u7e3e\u306f\u4fe1\u7528\u3067\u304d\u306a\u3044\u3067\u3059\uff08\u7279\u306b\u624b\u8853\u6210\u7e3e\u306e\u8ad6\u6587\u306b\u591a\u3044\uff09\u3002<\/p>\n\n\n\n<p>Yomo S, et al.: Longitudinal analysis of hearing before and after radiosurgery for vestibular schwannoma. J Neurosurg 117: 877-885, 2012<br>\u30de\u30eb\u30bb\u30a4\u30e6\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002154\u4eba\u306e\u60a3\u8005\u3055\u3093\u3067\u3059\u304c\uff0c\u5c11\u306a\u304f\u3068\u30826\u30f6\u6708\u9593\u4ee5\u4e0a\u306e\u7d4c\u904e\u89b3\u5bdf\u3092\u3055\u308c\uff0c\u305d\u306e\u5f8c\u306b\u8fba\u7e01\u7dda\u91cf12.1\u30b0\u30ec\u30a4\u306e\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u304c\u3055\u308c\u3066\u3044\u307e\u3059\u30021\u5e74\u9593\u306e\u8074\u529b\u4f4e\u4e0b\u5272\u5408\u306f\u7d4c\u904e\u89b3\u5bdf\u671f\u9593\u30675.39 dB\/year\uff0c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u5f8c\u30673.77 dB\/year\u3067\u3042\u308a\uff0c\u6709\u610f\u5dee\u3092\u3082\u3063\u3066\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u5f8c\u306e\u8074\u529b\u306e\u65b9\u304c\u4f4e\u4e0b\u7387\u304c\u4f4e\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u307b\u3068\u3093\u3069<strong><span style=\"color: #ff0000;\">\u8074\u529b\u304c\u6b63\u5e38\u3067\u3042\u3063\u305f\u60a3\u8005\u3055\u3093(GR class I)\u3067\u306f\u9006\u306b\uff0c\u7d4c\u904e\u89b3\u5bdf\u671f\u9593\u3067-0.57 dB\/year\uff0c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u5f8c\u30673.59 dB\/year\u3067\u3042\u308a\uff0c\u6709\u610f\u5dee\u3092\u3082\u3063\u3066\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u5f8c\u306e\u8074\u529b\u306e\u4f4e\u4e0b\u7387\u304c\u9ad8\u304b\u3063\u305f<\/span><\/strong>\u3068\u306e\u3053\u3068\u3067\u3059\u3002<br>\u300c\u89e3\u8aac\u300d\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u304c\u8074\u529b\u6e29\u5b58\u306b\u5bc4\u4e0e\u3059\u308b\u304b\u3069\u3046\u304b\u306e\u7d50\u8ad6\u306f\u51fa\u3066\u3044\u306a\u3044\u3068\u3057\u3066\u307e\u3059\u3002\u3053\u306e\u8ad6\u6587\u3067\u3082\u975e\u5e38\u306b\u826f\u3044\u8074\u529b\u3092\u6301\u3063\u3066\u3044\u308b\u8074\u795e\u7d4c\u816b\u760d\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u3057\u305f\u65b9\u304c\uff0c\u7d4c\u904e\u89b3\u5bdf\u3088\u308a\u3082\u8074\u529b\u4f4e\u4e0b\u306f\u65e9\u307e\u308b\u3068\u3044\u3046\u3053\u3068\u3092\u6697\u793a\u3057\u3066\u3044\u308b\u30c7\u30fc\u30bf\u3067\u3059\u3002<\/p>\n\n\n\n<p>Kondziolka D, et al.: The newly diagnosed vestibular schwannoma: radiosurgery, resection, or observation? Neurosurg Focu 33: 2012<br>\u30d4\u30c3\u30c4\u30d0\u30fc\u30b0\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u304c\uff0c\u4e0a\u306e\u4e8c\u3064\u306e\u8ad6\u6587\u3068\u306f\u610f\u898b\u304c\u7570\u306a\u308a\u307e\u3059\u3002\u7d4c\u904e\u89b3\u5bdf wait and scan\u3092\u9078\u629e\u3057\u305f\u307b\u3068\u3093\u3069\u306e\u60a3\u8005\u3055\u3093\u3067\u6709\u7528\u8074\u529b\u304c5\u5e74\u4ee5\u5185\u306b\u306a\u304f\u306a\u308b\u306e\u306b\u5bfe\u3057\u3066\uff0c<strong><span style=\"color: #ff0000;\">\u30ac\u30f3\u30de\u30ca\u30a4\u30d5 SRS\u3092\u884c\u306a\u3063\u305f\u60a3\u8005\u3055\u3093\u3067\u306f61-80%\u3067\uff0c3\u304b\u30895\u5e74\u5f8c\u3067\u3082\u6709\u7528\u8074\u529b&nbsp;(\u8a9e\u97f3\u5f01\u5225 &gt; 50%, \u7d14\u97f3\u8074\u529b &lt; 50dB)\u304c\u6e29\u5b58\u3055\u308c\u3066\u3044\u308b<\/span><\/strong>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u5c0f\u3055\u306a\u8074\u795e\u7d4c\u816b\u760d\u3067\u8074\u529b\u3092\u5b88\u308a\u305f\u3044\u5834\u5408\u306b\u306f\u65e9\u3081\u306e\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u304c\u826f\u3044\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<br>\u300c\u89e3\u8aac\u300d\u4e16\u754c\u3067\u3082\u6700\u3082\u591a\u3044\u75c7\u4f8b\u6570\u3092\u8a87\u308b\u5927\u5b66\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u6c17\u3092\u3064\u3051\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u306e\u306f\u30ac\u30f3\u30de\u30ca\u30a4\u30d53\u5e74\u4ee5\u4e0a\u7d4c\u3063\u3066\u3082\u8074\u529b\u4f4e\u4e0b\u306f\u3042\u308a\u5f97\u308b\u3053\u3068\u3067\u3059\u3002\u3084\u306f\u308a\u7d50\u8ad6\u306f\u3044\u307e\u3060\u306a\u304f\uff0c\u5c0f\u3055\u306a\u8074\u795e\u7d4c\u816b\u760d\u3067\u826f\u3044\u8074\u529b\u3092\u3082\u3063\u3066\u3044\u308b\u60a3\u8005\u3055\u3093\u306b\uff0c\u65e9\u3081\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u304b\u3069\u3046\u304b\u306f\uff0c\u60a3\u8005\u3055\u3093\u306e\u9078\u629e\u80a2\u3068\u3044\u3048\u307e\u3059\u3002<\/p>\n\n\n\n<p>Baschnagel AM, et al.: Hearing preservation in patients with vestibular schwannoma treated with Gamma Knife surgery. J Neurosurg. 118: 571-578, 2013<br>\u97f3\u306f\u8778\u725b\u3068\u3044\u3046\u5668\u5b98\u3067\u805e\u3053\u3048\u3066\u304b\u3089\u8074\u795e\u7d4c\uff08\u8778\u725b\u795e\u7d4c\uff09\u3067\u8133\u306b\u4f1d\u308f\u308a\u307e\u3059\u3002\u8074\u795e\u7d4c\u816b\u760d\u3092\u6cbb\u7642\u3059\u308b\u3068\u304d\uff0c\u816b\u760d\u8fba\u7e01\u7dda\u91cf12.5\u30b0\u30ec\u30a4\u306e\u307e\u307e\uff0c<span style=\"color: #ff0000;\"><strong>\u8778\u725b\u306e\u88ab\u66dd\u7dda\u91cf\u30922.7\u30b0\u30ec\u30a4\u307e\u3067\u843d\u3068\u3059\u3068\uff0c\uff17\u5272\u304f\u3089\u3044\u306e\u60a3\u8005\u3055\u3093\u3067\u30ac\u30f3\u30de\u30ca\u30a4\u30d53\u5e74\u5f8c\u3067\u3082\u6709\u7528\u8074\u529b\u304c\u6e29\u5b58<\/strong><\/span>\u3067\u304d\u305f\u3068\u3044\u3046\u7d50\u679c\u3067\u3059\u3002<br>\u300c\u89e3\u8aac\u300d\u3053\u306e\u6210\u7e3e\u3067\u3088\u3046\u3084\u304f\u5206\u5272\u7167\u5c04\u3068\u540c\u3058\u304f\u3089\u3044\u3067\u3057\u3087\u3046\u3002\u554f\u984c\u306f\u3084\u306f\u308a3\u5e74\u4ee5\u964d\u3067\u3082\u8074\u529b\u4f4e\u4e0b\u306f\u7d9a\u304f\u3053\u3068\u3067\u3059\u3002\u3082\u3063\u3068\u7d4c\u904e\u3092\u898b\u308b\u3068\u6700\u7d42\u7684\u306b\u306f\uff15\u5272\u304f\u3089\u3044\u306e\u6e29\u5b58\u7387\u304b\u305d\u308c\u4ee5\u4e0b\u306b\u306a\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002 \u3057\u304b\u3057\uff0c\u8778\u725b\u306e\u88ab\u66dd\u7dda\u91cf\u3092\u4e0b\u3052\u308c\u3070\u3088\u308a\u826f\u304f\u8074\u529b\u304c\u6e29\u5b58\u3067\u304d\u308b\u3068\u3044\u3046\u306e\u306f\u91cd\u8981\u306a\u4e8b\u5b9f\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong><span style=\"color: #ff0000;\">\u8074\u795e\u7d4c\u816b\u760d\u306e\u624b\u8853\u6b7b\u4ea1\u7387 0.3%<\/span>\uff0c\u7c73\u56fd\u306e\u958b\u982d\u79d1\u624b\u8853\u306f\u6e1b\u3063\u3066\u3044\u308b<\/strong><\/h4>\n\n\n\n<p>Patel S, et al.: Trends in Surgical Use and Associated Patient Outcomes in the Treatment of Acoustic Neuroma. World Neurosurg. 2012 Jun 19. [Epub ahead of print]<br>Center for Neurosurgical Outcomes Research\uff08\u7c73\u56fd\u306e\u8133\u795e\u7d4c\u5916\u79d1\u306e\u6cbb\u7642\u7d50\u679c\u306e\u96c6\u8a08\u30bb\u30f3\u30bf\u30fc\u307f\u305f\u3044\u306a\u3068\u3053\u308d\uff09\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30022000\u5e74\u304b\u30892007\u5e74\u307e\u3067\u306b14.928\u4eba\u306e\u8074\u795e\u7d4c\u816b\u760d\u306e\u60a3\u8005\u3055\u3093\u304c\u624b\u8853\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u5927\u304d\u306a\u75c5\u9662\u3067\u306e\u5e74\u9593\u4ef6\u6570\u306f\uff0c2000\u5e74\u304c2,054\u4f8b\uff0c2007\u5e74\u304c1,467\u4f8b\u306829%\u6e1b\u5c11\u3057\u3066\u3044\u307e\u3057\u305f\u3002<span style=\"color: #000080;\"><strong>\u624b\u8853\u6b7b\u4ea1\u7387\u306f0.3%<\/strong><\/span>\u3067\u3053\u306e\u671f\u9593\u3067\u5909\u5316\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u3057\u304b\u3057\uff0c\u5408\u4f75\u75c7\u7387\u304c21.5%\u304b\u308923.3%\u3068\u5897\u52a0\u3044\u3066\u3044\u307e\u3057\u305f\u3002\u75c7\u4f8b\u6570\u306e\u591a\u3044\u65bd\u8a2d\u3067\u306f\u5408\u4f75\u75c7\u7387\u304c10%\u3082\u4f4e\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>\u6570\u5e74\u9593\u306b41%\u3082\u624b\u8853\u4ef6\u6570\u304c\u6e1b\u3063\u3066\u3044\u3066\uff0c\u3053\u308c\u306f\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u5272\u5408\u304c\u5897\u3048\u3066\u3044\u308b\u304b\u3089<\/strong><\/span>\u3060\u305d\u3046\u3067\uff0c\u958b\u982d\u624b\u8853\u306e\u5408\u4f75\u75c7\u304c\u591a\u304f\u306a\u3063\u3066\u3044\u308b\u7406\u7531\u306f\uff0c\u3088\u308a\u5927\u304d\u306a\u816b\u760d\u3067\u624b\u8853\u9069\u5fdc\u3068\u306a\u3063\u3066\u3044\u308b\u304b\u3089\u3060\u3068\u63a8\u5b9a\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #ff0000;\"><strong>\u624b\u8853\u95a2\u9023\u306e\u6b7b\u4ea1\u7387\u306f\uff0c3% ?\u30000.3%?<\/strong><\/span><\/h4>\n\n\n\n<p><a href=\"http:\/\/thejns.org\/doi\/full\/10.3171\/2012.6.FOCUS12200\">Thakur JD, et al.: Do cystic vestibular schwannomas have worse surgical outcomes? Systematic analysis of the literature. Neurosurg Focus. 2012 Sep;33<\/a><br>\u305d\u3082\u305d\u3082\u306f\uff0c1990\u5e74\u304b\u30892011\u5e74\u306e\u8ad6\u6587\u5831\u544a\u3067\uff0c\u306e\u3046\u80de\u6027\u8074\u795e\u7d4c\u816b\u760d(CVS 428\u4f8b)\u3068\u5145\u5b9f\u6027\u8074\u795e\u7d4c\u816b\u760d(SVS 1,287\u4f8b)\u306e\u624b\u8853\u7d50\u679c\u3092\u5206\u6790\u3057\u305f\u8ad6\u6587\u3067\u3059\u3002\u306e\u3046\u80de\u6027\u8074\u795e\u7d4c\u816b\u760d cystic vestibular schwannoma\u306e\u65b9\u304c\u9854\u9762\u795e\u7d4c\u5408\u4f75\u75c7\u306e\u5272\u5408\u304c\u9ad8\u3044\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<p>\u9a5a\u304f\u3053\u3068\u306b\uff0cThe perioperative mortality rates for CVSs and SVSs were not significantly different (3% and 3.8%, respectively; p = 0.6).\u3068\u66f8\u304b\u308c\u3066\u3042\u308a\u307e\u3057\u305f\u30021,000\u4f8b\u304f\u3089\u3044\u306e\u624b\u8853\u7d50\u679c\u304b\u3089\uff0c<span style=\"color: #ff0000;\"><strong>\u624b\u8853\u95a2\u9023\u6b7b\u4ea1\u7387\u306f3\uff05\u7a0b\u5ea6\u3067\u3042\u3063\u305f<\/strong><\/span>\u3068\u306e\u3053\u3068\u3067\u3059\uff3c(\u25ce\u2220\u25ce)\uff0f<br>\u3053\u306e\u8ad6\u6587\u306f\u7c73\u56fd\u8133\u795e\u7d4c\u5916\u79d1\u5b66\u4f1a\u306e\u6a5f\u95a2\u8a8c\u306b2012\u5e74\u306b\u63b2\u8f09\u3055\u308c\u305f\u3082\u306e\u3067\u3059\u3002\u307b\u3093\u3068\u304b\u306a? &nbsp;\u304a\u305d\u3089\u304f\u4e00\u6841\u3061\u304c\u3046\u306e\u304b\u3082\uff1f \u3067\u3082\u5927\u304d\u304f\u5916\u308c\u3066\u306f\u3044\u306a\u3044\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u30fe(\uffe30\uffe3;\uff89\u3000\u5916\u79d1\u624b\u8853\u306e\u6210\u7e3e\u306f\u3042\u307e\u308a\u6b63\u76f4\u306a\u30c7\u30fc\u30bf\u304c\u3067\u3066\u304d\u307e\u305b\u3093\u304b\u3089\uff0c\u3082\u3057\u304b\u3059\u308b\u3068\u307b\u3093\u3068\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"color: #000080;\"><strong>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u3092\u3057\u3066\u3082\u816b\u760d\u306f\u60aa\u6027\u5316\u3057\u306a\u3044<\/strong><\/span><\/h4>\n\n\n\n<p>Rowe J, Grainger A, Walton L, Silcocks P, Radatz M, Kemeny A. Risk of malignancy after gammaknife stereotactic radiosurgery. Neurosurgery 60: 60-66, 2007<br>\u30a4\u30ae\u30ea\u30b9\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30025,000\u4eba\u306e\u826f\u6027\u8133\u816b\u760d\u306e\u60a3\u8005\u3055\u3093\u304c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u3092\u53d7\u3051\uff0c1,200\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c10\u5e74\u4ee5\u4e0a\u8ffd\u8de1\u3055\u308c\u307e\u3057\u305f\u3002\u7d50\u679c\u306f\uff0c\u305f\u3060\u4e00\u4eba\u306e\u60a3\u8005\u3055\u3093\u3067\u661f\u7d30\u80de\u816b\u304c\u767a\u751f\u3057\u307e\u3057\u305f\u3002\u7167\u5c04\u6cbb\u7642\u5f8c\u81ea\u7136\u767a\u751f\u7387\u3092\u63a8\u8a08\u3059\u308b\u30682.47\u4eba (?) \u767a\u751f\u3057\u305f\u306f\u305a\u3067\u3057\u305f\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c<span style=\"color: #ff0000;\"><strong>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u3067\u826f\u6027\u8133\u816b\u760d\u304c\u60aa\u6027\u5316\u3059\u308b\u3042\u308b\u3044\u306f\u60aa\u6027\u816b\u760d\u304c\u767a\u751f\u3059\u308b\u3068\u306f\u8a00\u3048\u306a\u3044<\/strong><\/span>\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u3088\u308b\u60aa\u6027\u816b\u760d\u306e\u767a\u751f<\/strong><\/h4>\n\n\n\n<p>Tanbouzi Husseini S, &nbsp;et al.: Malignancy in vestibular schwannoma after stereotactic radiotherapy: a case report and review of the literature. Laryngoscope 121:923-928, 2011<br>\u8074\u795e\u7d4c\u816b\u760d\u3078\u306e\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u305f\u60a3\u8005\u3055\u3093\u3067\uff0c2011\u5e74\u307e\u3067\u306b26\u4f8b\u306e\u60aa\u6027\u8133\u816b\u760d\u306e\u767a\u751f\u304c\u5831\u544a\u3055\u308c\u3066\u3044\u308b\u305d\u3046\u3067\u3059\u3002\u305d\u306e\u5185\u306e13\u4f8b (50%)\u304c\u795e\u7d4c\u7dda\u7dad\u816b\u75c72\u578b\u306e\u60a3\u8005\u3055\u3093\u3067\u3057\u305f\u3002\u901a\u5e38\u306e\u8074\u795e\u7d4c\u816b\u760d\u3067\u306f\u4e16\u754c\u306713\u4f8b\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u60aa\u6027\u816b\u760d\u306e\u767a\u751f\u306e\u6642\u671f\u306f\u5e73\u57475.8\u5e74\u3067\u3042\u3063\u305f\u305d\u3046\u3067\u3059\u3002\u7279\u7b46\u3059\u3079\u304d\u3053\u3068\u306b\u306f\uff0c2.5cm\u4ee5\u4e0b\u306e\u816b\u760d\u3067\u306f\u4e00\u4f8b\u3082\u60aa\u6027\u816b\u760d\u306e\u767a\u751f\u304c\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n<p>\u300c\u89e3\u8aac\u300d\u4e16\u754c\u4e2d\u3067\u3082\u306e\u3059\u3054\u3044\u6570\u306e\u8074\u795e\u7d4c\u816b\u760d\u304c\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u6cbb\u7642\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u305d\u308c\u306713\u4f8b\u3067\u3059\u304b\u3089\u304b\u306a\u308a\u4f4e\u3044\u30ea\u30b9\u30af\u3068\u8a00\u3048\u307e\u3059\u3002\u816b\u760d\u3092\u75c5\u7406\u8a3a\u65ad\u3059\u308b\u3053\u3068\u306a\u304f\u653e\u5c04\u7dda\u6cbb\u7642\u3055\u307e\u3059\u304b\u3089\uff0c\u6cbb\u7642\u524d\u304b\u3089\u60aa\u6027\u306e\u8074\u795e\u7d4c\u816b\u760d\u3067\u3042\u3063\u305f\u3068\u3044\u3046\u3053\u3068\u3092\u8003\u3048\u308c\u3070\u66f4\u306b\u4f4e\u3044\u78ba\u7387\u3068\u306a\u308b\u3067\u3057\u3087\u3046\u3002\u307e\u305f\uff0c\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3055\u308c\u308b\u307b\u3068\u3093\u3069\u306e\u8074\u795e\u7d4c\u816b\u760d\u306f2.5cm\u4ee5\u4e0b\u306e\u5927\u304d\u3055\u3067\u3057\u3087\u3046\u304b\u3089\uff0c<span style=\"color: #ff0000;\"><strong>\u8074\u795e\u7d4c\u816b\u760d\u306e\u60aa\u6027\u5316\u3068\u3044\u3046\u306e\u306f\u73fe\u5b9f\u306b\u306f\u9650\u308a\u306a\u304f\u30bc\u30ed\u306b\u8fd1\u3044\u6570\u5b57<\/strong><\/span>\u3060\u3068\u63a8\u6e2c\u3055\u308c\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u5f8c\u306e\u8074\u795e\u7d4c\u816b\u760d\u306e\u60aa\u6027\u5316<\/strong><\/h4>\n\n\n\n<p>Yanamadala V, et al.: Malignant transformation of a vestibular schwannoma after gamma knife radiosurgery. World Neurosurg 79: 593, 2013<br>\u30cf\u30fc\u30d0\u30fc\u30c9\u5927\u5b66\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u5f8c59\u30f6\u6708\u3067\u8074\u795e\u7d4c\u816b\u760d\u304c\u60aa\u6027\u5316\u3057\u305f\u3068\u306e\u75c7\u4f8b\u5831\u544a\u3067\u3059\u30022013\u5e74\u306e\u5831\u544a\u3067\u3059\u304c\uff0c\u305d\u308c\u307e\u3067\u306b\u60aa\u6027\u8074\u795e\u7d4c\u816b\u760d\u306e\u6587\u732e\u5831\u544a\u306f18\u4f8b\u3057\u304b\u306a\u3044\u304b\u3089\u6975\u3081\u3066\u307e\u308c\u3067\uff0c\u75c5\u7406\u5b66\u7684\u306b\u8a3c\u660e\u3055\u308c\u3066\u3044\u308b\u306e\u306f6\u4f8b\u306b\u904e\u304e\u306a\u3044\u3068\u3042\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<p>\u300c\u89e3\u8aac\u300d\u3053\u306e\u8ad6\u6587\u3067\u3082<span style=\"color: #ff0000;\"><strong>\u4e16\u754c\u3067\u5341\u6570\u4eba\u306e\u5831\u544a\u3057\u304b\u306a\u3044<\/strong><\/span>\u3068\u307e\u3068\u3081\u3066\u3044\u307e\u3059\u3002\u82f1\u8a9e\u306e\u8ad6\u6587\u306b\u5b9f\u969b\u306b\u5831\u544a\u3055\u308c\u308b\u306e\u306f\u6c37\u5c71\u306e\u4e00\u89d2\u3067\u3059\u304b\u3089\uff0c\u5b9f\u6570\u306f100\u500d\u304f\u3089\u3044\u3042\u308b\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u3067\u3082\u4f55\u5343\u4eba\u3067\u3059\u3002\u8074\u795e\u7d4c\u816b\u760d\u306e\u624b\u8853\u3067\u306e\u6b7b\u4ea1\u5831\u544a\u306f\u6ec5\u591a\u306b\u3055\u308c\u307e\u305b\u3093\u306e\u3067\uff0c\u4e16\u754c\u4e2d\u3067\u624b\u8853\u95a2\u9023\u6b7b\u3059\u308b\u60a3\u8005\u3055\u3093\u306f\u66f4\u306b\u305d\u306e10\u500d\u304f\u3089\u3044\u306f\u3044\u305f\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u3092\u3059\u308b\u306820%\u304f\u3089\u3044\u306e\u78ba\u7387\u3067\u4e00\u6642\u7684\u306b\u816b\u760d\u304c\u5927\u304d\u304f\u306a\u308b<\/strong><\/h4>\n\n\n\n<p>Hayhurst C, et al.: Tumor pseudoprogression following radiosurgery for vestibular schwannoma. Neuro Oncol 14:87-92, 2012<br>\u30c8\u30ed\u30f3\u30c8\u5927\u5b66\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u5f8c\u306b&nbsp;<span style=\"color: #ff0000;\"><strong>23%\u3067\u4e00\u6642\u7684\u306a\u816b\u760d\u306e\u5897\u5927\u50be\u5411 pseudoprogression&nbsp;<\/strong><\/span>\u304c\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u3053\u308c\u306f\u6cbb\u7642\uff16\u30f6\u6708\u5f8c\u304f\u3089\u3044\u304b\u3089\u751f\u3058\u305f\u305d\u3046\u3067\u3059\u3002\u4e00\u6642\u7684\u3067\u306f\u306a\u3044\u5897\u5927\u306f12%\u306b\u751f\u3058\u307e\u3057\u305f\u3002\u7d50\u679c\u7684\u306b\uff0c75\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u3046\u30613\u4eba (4%)\u3067\u958b\u982d\u624b\u8853\u306b\u3088\u308b\u6458\u51fa\u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3057\u305f\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c<span style=\"color: #000080;\"><strong>\u6cbb\u7642\u5f8c24\u30f6\u6708\u306e\u9593\u306f\u3082\u3057\u816b\u760d\u304c\u5897\u5927\u3057\u3066\u3082\uff0c\u6cbb\u7642\u304c\u5931\u6557\u3057\u305f\u3068\u5224\u65ad\u3057\u3066\u306f\u306a\u3089\u306a\u3044<\/strong><\/span>\u3068\u8ff0\u3079\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>40\u6b73\u4ee5\u4e0b\u306e\u82e5\u3044\u60a3\u8005\u3055\u3093\u3067\u306e\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u306f<\/strong><\/h4>\n\n\n\n<p>Lobato-Polo J, et al.: Gamma knife radiosurgery in younger patients with vestibular schwannomas. Neurosurgery 65:294-300, 2009<br>13\u6b73\u304b\u308940\u6b73\u306e55\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u8ffd\u8de1\u6a5f\u9593\u4e2d\u592e\u50245\u5e74\u3067\uff0c\uff12\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u518d\u7167\u5c04\u3092\u53d7\u3051\u307e\u3057\u305f\u300296\uff05\u306e\u60a3\u8005\u3055\u3093\u304c\uff11\u5ea6\u306e\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u3067\u6e08\u3093\u3060\u3068\u3053\u306e\u3068\u3067\u3057\u305f\u3002\u30ac\u30fc\u30c9\u30ca\u30fc\u30fb\u30ed\u30d0\u30fc\u30c8\u30bd\u30f3\u306e\u8074\u529b\u8a55\u4fa1\u3067\u306f\uff0c\u6cbb\u764210\u5e74\u5f8c\u306b87%\u306e\u60a3\u8005\u3055\u3093\u3067\u8074\u529b\u304c\u4f4e\u4e0b\u3059\u308b\u3053\u3068\u306a\u304f\u540c\u3058\u30ec\u30d9\u30eb\u306b\u7559\u307e\u3063\u3066\u3044\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<span style=\"color: #ff0000;\"><strong>\u7279\u306b\u826f\u3044\u8074\u529b\u3092\u6709\u3057\u3066\u3044\u305f\u60a3\u8005\u3055\u3093\u306e93\uff05\u306710\u5e74\u5f8c\u306b\u3082\u8074\u529b\u304c\u6e29\u5b58\u3067\u304d\u307e\u3057\u305f\u3002<\/strong><\/span>\u4e2d\u7b49\u5ea6\u306e\u9854\u9762\u9ebb\u75fa\u304c\u4e00\u4eba\u306e\u60a3\u8005\u3055\u3093\u306b\u51fa\u307e\u3057\u305f\u304c\uff0c\u3053\u308c\u306f\u816b\u760d\u5468\u8fba\u7dda\u91cf\u304c20Gy\u5165\u3063\u305f\u305f\u3081\u3060\u3068\u5206\u6790\u3055\u308c\u307e\u3057\u305f\u3002\u5168\u54e1\u304c\u5143\u306e\u751f\u6d3b\u306b\u623b\u308c\u3066\u3044\u307e\u3059\u3002<strong><span style=\"color: #ff0000;\">\u816b\u760d\u8fba\u7e01\u7dda\u91cf\u304c13\u30b0\u30ec\u30a4\u672a\u6e80\u3060\u3068\u795e\u7d4c\u969c\u5bb3\u304c\u307b\u3068\u3093\u3069\u306a\u3044<\/span><\/strong>\u3068\u5f37\u8abf\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<p><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">\u300c\u89e3\u8aac\u300d<\/span><strong>\u30d4\u30c3\u30c4\u30d0\u30fc\u30b0\u5927\u5b66\u304b\u3089\u306e\u6975\u3081\u3066\u30ec\u30d9\u30eb\u306e\u9ad8\u3044\u6cbb\u7642\u6210\u7e3e<\/strong><\/span>\u3067\u3059\u3002\u3053\u308c\u306b\u3082\u3068\u3065\u3051\u3070\u5916\u79d1\u624b\u8853\u306e\u51fa\u308b\u5e55\u306f\u5168\u304f\u3042\u308a\u307e\u305b\u3093\u3002\u82e5\u3044\u5e74\u9f62\u5c64\u306a\u306e\u3067\u653e\u5c04\u7dda\u8a98\u767a\u4e8c\u6b21\u816b\u760d\u3082\u8abf\u3079\u3089\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u767a\u751f\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306e\u8d85\u9577\u671f\u6210\u7e3e<\/strong><\/h4>\n\n\n\n<p>Hasegawa T, et al.: Long-term safety and efficacy of stereotactic radiosurgery for vestibular schwannomas: evaluation of 440 patients more than 10 years after treatment with Gamma Knife surgery. J Neurosurg 118: 557-65, 2013<br>\u5c0f\u7267\u5e02\u6c11\u75c5\u9662\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30021991\u5e74\u304b\u30892000\u5e74\u307e\u3067\u306b\u6cbb\u7642\u3092\u53d7\u3051\u305f440\u4eba\u306e\u7d50\u679c\u3067\u3059\u3002\u816b\u760d\u4f53\u7a4d\u4e2d\u592e\u5024 2.8cc\uff0c\u8fba\u7e01\u7dda\u91cf\u4e2d\u592e\u5024 12.8\u30b0\u30ec\u30a4\u3068\u6bd4\u8f03\u7684\u4f4e\u3044\u5024\u3067\u3059\u3002\u6cbb\u7642\u5f8c10\u5e74\u3067\u306e\u816b\u760d\u304c\u5927\u304d\u304f\u306a\u3089\u306a\u304b\u3063\u305f\u5272\u5408\u306f92\uff05\u3067\u3057\u305f\u300210\u5e74\u4ee5\u4e0a\u7d4c\u3063\u3066\u816b\u760d\u304c\u5897\u5927\u3057\u305f\u30b1\u30fc\u30b9\u306f\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u6cbb\u7642\u6642\u306b\u8133\u5e79\u90e8\u306e\u5909\u5f62\u304c\u5f37\u304b\u3063\u305f\u4f8b\uff0c\u8fba\u7e01\u7dda\u91cf\u304c13\u30b0\u30ec\u30a4\u4ee5\u4e0b\u3067\u3042\u3063\u305f\u4f8b\u3067\u6cbb\u7642\u5f8c\u306e\u60aa\u5316\uff08progression)\u304c\u591a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u300210\u5e74\u306e\u6642\u70b9\u3067\u306e\u9854\u9762\u795e\u7d4c\u6a5f\u80fd\u304c\u5b88\u308c\u305f\u5272\u5408\u306f\uff0c13\u30b0\u30ec\u30a4\u4ee5\u4e0b\u3067100\uff05\uff0c13\u30b0\u30ec\u30a4\u4ee5\u4e0a\u306797\uff05\u3067\u3057\u305f\u3002\u4e00\u4eba\u306e\u60a3\u8005\u3055\u3093 (0.3%) \u3067\u816b\u760d\u306e\u60aa\u6027\u5316\u304c\u751f\u3058\u307e\u3057\u305f\u3002<br>\u300c\u89e3\u8aac\u300d<span style=\"color: #ff0000;\"><strong>\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u3067\u306f\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u306e\u30ea\u30b9\u30af\u306f1%\u4ee5\u4e0b<\/strong><\/span>\u3067\u3042\u308b\u3068\u3044\u3046\u5f93\u6765\u306e\u6210\u7e3e\u3092\u78ba\u8a8d\u3067\u304d\u308b\u3082\u306e\u3067\u3059\u3002\u4e00\u65b9\u306e\u958b\u982d\u624b\u8853\u3067\u306f\u6570\uff05\u3092\u8d85\u3048\u308b\u3067\u3057\u3087\u3046\u3002\u8074\u795e\u7d4c\u816b\u760d\u306e\u624b\u8853\u306b\u6163\u308c\u3066\u3044\u306a\u3044\u8133\u5916\u79d1\u533b\u306e\u6210\u7e3e\u3067\u306f\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u304c20-30%\u304f\u3089\u3044\u51fa\u73fe\u3059\u308b\u3068\u3044\u3046\u610f\u898b\u3082\u3042\u308a\u307e\u3059\u3002\u307e\u305f0.3\uff05\uff081\u4f8b\u3057\u304b\u306a\u3044\u306e\u3067\u3053\u306e\u6570\u5b57\u306f\u4e0d\u78ba\u304b\uff09\u3067\u816b\u760d\u306e\u60aa\u6027\u5316\u304c\u3042\u308b\u3068\u306e\u5831\u544a\u3067\u3059\u304c\uff0c\u958b\u982d\u5916\u79d1\u624b\u8853\u3067\u306e\u624b\u8853\u95a2\u9023\u6b7b\u4ea1\u4f8b\u306f\u5831\u544a\u3055\u308c\u307e\u305b\u3093\u304c\u5c11\u306a\u3044\u3082\u306e\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u30028%\u3067\u816b\u760d\u5897\u5927\u306a\u3069\u304c\u751f\u3058\u3066\u3044\u307e\u3059\u304c\uff0c\u958b\u982d\u5916\u79d1\u624b\u8853\u3067\u306e\u518d\u767a\uff08\u518d\u71c3\uff09\u5272\u5408\u306f10\uff05\u3092\u8d85\u3048\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u7dcf\u3058\u3066\uff0c\u5916\u79d1\u624b\u8853\u6210\u7e3e\u306f\u3053\u306e\u3088\u3046\u306a\u89b3\u70b9\u304b\u3089\u3082\u653e\u5c04\u7dda\u5916\u79d1\u306e\u6210\u7e3e\u306b\u52a3\u308b\u3068\u8a00\u308f\u3056\u308b\u3092\u5f97\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<p>Sun S, et al.: Long-term follow-up studies of Gamma Knife surgery with a low margin dose for vestibular schwannoma. J Neurosurg 117: 57-62, 2012<br>\u5317\u4eac\u306e\u5929\u58c7\u75c5\u9662\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002190\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u6cbb\u7642\u3055\u308c\uff0c\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u5024\u306f\uff19\u5e74\u3067\u3059\u3002\u816b\u760d\u4f53\u7a4d\u4e2d\u592e\u5024\u306f3.6cc\u3067\uff0c\u8fba\u7e01\u7dda\u91cf\u4e2d\u592e\u5024\u306f13\u30b0\u30ec\u30a4\u3067\u3057\u305f\u3002\u816b\u760d\u5897\u5927\u306f20\u4eba(10.5%)\u3067\u751f\u3058\u307e\u3057\u305f\u3002\u816b\u760d\u306e\u5236\u5fa1\u7387\u306f10\u5e74\u306786%\uff0c15\u5e74\u306779%\u3068\u8a18\u8f09\u3055\u308c\u3066\u3044\u3066\uff0c\u6cbb\u764210\u5e74\u3092\u904e\u304e\u3066\u3082\u5897\u5927\u3059\u308b\u3053\u3068\u304c\u793a\u5506\u3055\u308c\u307e\u3059\u304b\u3089\uff0c\u5c0f\u7267\u5e02\u6c11\u75c5\u9662\u304b\u3089\u306e\u5831\u544a\u3068\u306f\u7570\u306a\u308a\u307e\u3059\u3002\u8074\u529b\u6e29\u5b58\u5272\u5408\u306f5\u5e74\u306792%\uff0c10\u5e74\u306770%\u3067\u3059\u304c\uff0c\u3053\u306e\u60aa\u5316\u306f\u52a0\u9f62\u306b\u3088\u308b\u8074\u529b\u4f4e\u4e0b\u3092\u8003\u616e\u306b\u5165\u308c\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u30022\u4f8b (1.1%)\u3067\u8efd\u5ea6\u306e\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u304c\u6b8b\u5b58\u3057\u307e\u3057\u305f\u3002\u3072\u3069\u3044\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u3084\u9854\u9762\u75db\u306f\u4e00\u4f8b\u3082\u751f\u3058\u306a\u304b\u3063\u305f\u305d\u3046\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u624b\u8853\u306e\u65b9\u6cd5\u3068\u5408\u4f75\u75c7<\/strong><\/h4>\n\n\n\n<p>Ansari SF, et al.: Surgery for vestibular schwannomas: a systematic review of complications by approach. Neurosurg Focus. 2012 Sep; 33<br>\u624b\u8853\u65b9\u6cd5\u3068\u624b\u8853\u5408\u4f75\u75c7\u3092\u307e\u3068\u3081\u305f\u7dcf\u8ad6\u3067\uff0c5,064\u4eba\u306e\u60a3\u8005\u3055\u3093\u5206\u6790\u3067\u3059\u30021.5cm\u4ee5\u4e0b\u306e\u5c0f\u3055\u306a\u816b\u760d\u306b\u9650\u3063\u3066\u306f\uff0c\u4e2d\u982d\u84cb\u7aa9\u6cd5\u306743.6%\u306e\u60a3\u8005\u3055\u3093\u3067\u8074\u529b\u4f4e\u4e0b\u304c\u3057\u3087\u3046\u3058\uff0c<span style=\"color: #ff0000;\"><strong>\u5916\u5074\u5f8c\u982d\u4e0b\u958b\u982d (lateral suboccipital approach, retrosigmoid approach)<\/strong><\/span> \u3067\u306f64.3%\u306e\u60a3\u8005\u3055\u3093\u3067\u8074\u529b\u4f4e\u4e0b\u304c\u751f\u3058\u305f\u305d\u3046\u3067\u3059\u3002\u9006\u306b\uff0c\u5185\u8033\u9053\u306a\u3044\u306b\u9650\u5c40\u3059\u308b\u5c0f\u3055\u306a\u816b\u760d\u3067\u306f\uff0c\u4e2d\u982d\u84cb\u7aa9\u6cd5 (16%) \u306e\u65b9\u304c\u5916\u5074\u5f8c\u982d\u4e0b\u958b\u982d (4%) \u3088\u308a\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u306e\u983b\u5ea6\u304c\u9ad8\u304b\u3063\u305f\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u30021.5cm\u4ee5\u4e0b\u306e\u3082\u306e\u3067\u306f\uff0c\u7d4c\u8ff7\u8def\u6cd5\u3068\u3044\u3046\u624b\u8853\u6cd5\u3067\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u306e\u983b\u5ea6\u304c\u9ad8\u304f\u306a\u308a\u307e\u3059\u30021.5cm\u304b\u30893cm\u306e\u3082\u306e\u3067\u306f\uff0c\u5916\u5074\u5f8c\u982d\u4e0b\u958b\u982d\u3067\u9854\u9762\u795e\u7d4c\u640d\u50b7\u306e\u5272\u5408 (6.1%) \u306f\u6700\u3082\u4f4e\u304f\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u5916\u5074\u5f8c\u982d\u4e0b\u958b\u982d\u3067\u76ee\u7acb\u3063\u305f\u5408\u4f75\u75c7\u306f\u8853\u5f8c\u306e\u9ac4\u6db2\u6f0f\u3067\u3057\u305f\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c\u5916\u5074\u5f8c\u982d\u4e0b\u958b\u982d\u304c\u3082\u3063\u3068\u3082\u7528\u9014\u304c\u5e83\u304f (versatile corridor)\u9854\u9762\u795e\u7d4c\u306e\u6e29\u5b58\u7387\u304c\u9ad8\u3044\u3068\u8ff0\u3079\u3089\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<p>\u300c\u89e3\u8aac\u300d\u5b9f\u969b\u306b\u8fd1\u5e74\u3067\u306f\uff0c\u307b\u3068\u3093\u3069\u306e\u8074\u795e\u7d4c\u816b\u760d\u306e\u624b\u8853\u306f\u5916\u5074\u5f8c\u982d\u4e0b\u958b\u982d&nbsp;(lateral suboccipital approach, retrosigmoid approach) \u3067\u884c\u306a\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u304b\u306a\u308a\u5de8\u5927\u306a\u8074\u795e\u7d4c\u816b\u760d\u3067\u3082\u79c1\u306f\u3053\u306e\u624b\u8853\u65b9\u6cd5\u3057\u304b\u3057\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u816b\u760d\u3092\u5168\u90e8\u6458\u51fa\u3057\u3088\u3046\u3068\u3059\u308b\u3068\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u304f\u306a\u308b<\/strong><\/h4>\n\n\n\n<p>Gurgel RK, et al.:&nbsp;Facial nerve outcomes after surgery for large vestibular schwannomas: do surgical approach and extent of resection matter?&nbsp;Neurosurg Focus 33: 2012<br>\u30b9\u30bf\u30f3\u30d5\u30a9\u30fc\u30c9\u5927\u5b66\u304b\u3089\u306e\u5831\u544a\u3067\uff0c2.5cm\u4ee5\u4e0a\u306e\u5927\u304d\u3055\u306e\u8074\u795e\u7d4c\u816b\u760d\u304c\u5bfe\u8c61\u3067\u3059\u3002\u6587\u732e\u5831\u544a\u3055\u308c\u305f1,688\u4f8b\u306e\u624b\u8853\u7d50\u679c\u3092\u5206\u6790\u3057\u307e\u3057\u305f\u3002\u9854\u9762\u795e\u7d4c\u304c\u6e29\u5b58\u3067\u304d\u305f\u7387 (House-Blackman Grade 1\u30682)\u306f\uff0c\u7d4c\u8ff7\u8def\u6cd5 translabyrinthine\u306762.5%\uff0c\u5916\u5074\u5f8c\u982d\u4e0b\u958b\u982d retrosigmoid\u306765.2%\u3067\u3057\u305f\u3002\u816b\u760d\u306e\u6458\u51fa\u7387\u3068\u9854\u9762\u795e\u7d4c\u306e\u6e29\u5b58\u7387\u306f\u95a2\u9023\u304c\u3042\u308a\uff0c\u5168\u6458\u51fa gross total\u3059\u308b\u306847%\u3057\u304b\u9854\u9762\u795e\u7d4c\u304c\u5b88\u308c\u307e\u305b\u3093\u304c\uff0c\u4e9c\u5168\u6458\u51fa near-total\u3067\u306f75%\uff0c\u305d\u308c\u4ee5\u4e0b\u306e\u6458\u51fa\u7387 subtotal\u3067\u306f93%\u3067\u9854\u9762\u795e\u7d4c\u6a5f\u80fd\u304c\u6b8b\u3063\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<br>\u300c\u89e3\u8aac\u300d\u4ed6\u306e\u6587\u732e\u306e\u8a18\u8ff0\u306b\u3082\u591a\u3044\u306e\u3067\u3059\u304c\uff0c<span style=\"color: #000080;\"><strong>\u7121\u7406\u306b\u5168\u6458\u51fa\u3057\u3088\u3046\u3068\u3059\u308b\u3068\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u304c\u304b\u306a\u308a\u9ad8\u7387\u306b\u51fa\u3066\u3057\u307e\u3046<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u624b\u8853\u306f\u7121\u7406\u3057\u306a\u3044\u3067\u9854\u9762\u795e\u7d4c\u3092\u5b88\u308b\u3068\u3044\u3046\u65b9\u91dd\u304c\u5927\u5207\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u5927\u304d\u306a\u8074\u795e\u7d4c\u816b\u760d\u306f<span style=\"color: #ff0000;\">\u624b\u8853\u3067\u90e8\u5206\u3067\u65e2\u51fa\u3057\u3066\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642<\/span>\u3092\u4f7f\u3046<\/strong><\/h4>\n\n\n\n<p>Pan HC, et al.: Intracapsular decompression or radical resection followed by Gamma Knife surgery for patients harboring a large vestibular schwannoma. J Neurosurg 117 Suppl: 69-77, 2012<br>\u53f0\u6e7e\u306e\u53f0\u4e2d\u75c5\u9662\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30023cm\u4ee5\u4e0a\u306e\u5927\u304d\u306a\u8074\u795e\u7d4c\u816b\u760d\u306e\u60a3\u8005\u3055\u309335\u4eba\u3092\uff0c\u90e8\u5206\u6458\u51fa\uff08\u304a\u3088\u305d\u534a\u5206\u304f\u3089\u3044\u306e\u6458\u51fa\uff09\u3068\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u6cbb\u7642\u306e\u7d44\u307f\u5408\u308f\u305b\uff0c\u3042\u308b\u3044\u306f\u7a4d\u6975\u7684\u306a\u6458\u51fa\u8853\u306e\u307f\u3067\u6cbb\u7642\u304c\u3055\u308c\u307e\u3057\u305f\u3002\u90e8\u5206\u6458\u51fa\u3068\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u3067\u6cbb\u7642\u3057\u305f\u60a3\u8005\u3055\u3093\u306f\u9854\u9762\u795e\u7d4c\u6a5f\u80fd\u3068\u8074\u529b\u304c\u6e29\u5b58\u3067\u304d\u307e\u3057\u305f\u304c\uff0c\u624b\u8853\u306e\u307f\u3067\u6cbb\u7642\u3092\u8a66\u307f\u305f\u7fa4\u306e\u6210\u7e3e\u306f\u60aa\u304f\uff0c\u9854\u9762\u9ebb\u75fa\u304c65\uff05\u306b\u51fa\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<br>\u300c\u89e3\u8aac\u300d\u5927\u3057\u305f\u8ad6\u6587\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3057\uff0c\u3053\u306e\u8003\u3048\u65b9\u306f\u305a\u3063\u3068\u4ee5\u524d\u304b\u3089\u3042\u308b\u3082\u306e\u3067\u3059\u3002\u5927\u304d\u306a\u8074\u795e\u7d4c\u816b\u760d\u3092\u7121\u7406\u3057\u3066\u5168\u6458\u51fa\u3057\u3088\u3046\u3068\u3059\u308b\u8003\u3048\u65b9\u306f\u3059\u3067\u306b\u6368\u3066\u3089\u308c\u3066\u3044\u308b\u3068\u601d\u3044\u307e\u3059\u3002\u3057\u304b\u3057\uff0c\u3053\u306e\u8ad6\u6587\u3092\u9d5c\u5451\u307f\u306b\u3057\u306a\u3044\u3088\u3046\u306b\uff0c\u4ee5\u4e0b\u306e\u70b9\u306b\u6ce8\u610f\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><span style=\"color: #000080;\"><strong>\u90e8\u5206\u6458\u51fa\u5f8c\u306b<span style=\"color: #ff0000;\">\u6b8b\u5b58\u816b\u760d\u304b\u3089\u8853\u5f8c\u51fa\u8840<\/span>\u304c\u751f\u3058\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/strong><\/span><\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>3\u5206\u306e\uff12\uff0c\u534a\u5206\u304f\u3089\u3044\u306e\u6458\u51fa\u3067\u306f\u816b\u760d\u304c\u7e2e\u307f\u307e\u305b\u3093<\/strong><\/span><\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong><span style=\"color: #ff0000;\">\u816b\u760d\u3092\u8584\u304f\u3057\u3066\u6975\u308f\u305a\u304b\u306b\u6b8b\u3059<\/span>\u304f\u3089\u3044\u306e\u6458\u51fa\u304c\u3067\u304d\u308b\u3068\uff0c\u816b\u760d\u304c\u7e2e\u3093\u3067\u8133\u5e79\u90e8\u306e\u5727\u8feb\u304c\u3068\u308c\u307e\u3059<\/strong><\/span><\/li>\n\n\n\n<li><span style=\"color: #000080;\"><strong>\u305d\u308c\u3067\u3042\u308c\u3070\u8853\u5f8c\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u3088\u308a\u5b89\u5168\u3067\u3059<\/strong><\/span><\/li>\n\n\n\n<li><strong><span style=\"color: #000080;\">\u672c\u5f53\u306b\u3054\u304f\u308f\u305a\u304b\u306e\u6b8b\u5b58\u816b\u760d\u306a\u3089\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u306a\u3044\u3067\u307b\u3063\u3066\u304a\u3044\u3066\u3082\u518d\u767a\uff08\u518d\u71c3\uff09\u3057\u306a\u3044\u3053\u3068\u3082\u591a\u3044\u3067\u3059<\/span><\/strong><\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\">\u305f\u3068\u3048\u3070\u90e8\u5206\u6458\u51fa\u3068\u306f\u3069\u3093\u306a\u611f\u3058\uff1f<\/h5>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy1.jpg\" rel=\"attachment wp-att-8962\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy1-200x200.jpg\" alt=\"vestschiy1\" class=\"wp-image-8962\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy1-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy2.jpg\" rel=\"attachment wp-att-8963\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy2-200x200.jpg\" alt=\"vestschiy2\" class=\"wp-image-8963\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy2-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy2-550x549.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy2-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy2.jpg 567w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy3.jpg\" rel=\"attachment wp-att-8964\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy3-200x200.jpg\" alt=\"vestschiy3\" class=\"wp-image-8964\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy3-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vestschiy3-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p>\u816b\u760d\u306e\u90e8\u5206\u6458\u51fa\u3067\u3059\u3002\u624b\u8853\u7fcc\u65e5\u306eMRI\u3067\u3059\u3002\u9ec4\u8272\u306e\u77e2\u5370\u306e\u5148\u306b\u767d\u304f\u5199\u3063\u3066\u3044\u308b\u306e\u304c\u3054\u304f\u308f\u305a\u304b\u306a\u6b8b\u5b58\u816b\u760d\u3067\uff0c\u539a\u3055\u6570mm\u304f\u3089\u3044\u3067\u3059\u3002\u306a\u305c\u3053\u306e\u90e8\u4f4d\u3060\u3051\u6b8b\u3059\u304b\u3068\u3044\u3046\u3068\u9854\u9762\u795e\u7d4c\u304c\u30da\u30e9\u30da\u30e9\u306b\u306a\u3063\u3066\u3044\u3066\u816b\u760d\u304c\u5916\u305b\u306a\u3044\u304b\u3089\u3067\u3059\u3002\u3053\u306e\u304f\u3089\u3044\u53d6\u308c\u308b\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u306a\u3044\u3067\u7d4c\u904e\u89b3\u5bdf\u3057\u307e\u3059\u3002\u5927\u304d\u306a\u584a\u304c\u6b8b\u3063\u3066\u3057\u307e\u3046\u3088\u3046\u306a\u90e8\u5206\u6458\u51fa\u3067\u306f\u3060\u3081\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong><span style=\"color: #000080;\">\u6c34\u982d\u75c7\u304c\u3042\u308b\u3068\u304d<\/span><\/strong><\/h4>\n\n\n\n<p>Gerganov VM, et al.: Hydrocephalus associated with vestibular schwannomas: management options and factors predicting the outcome. J Neurosurg 114:1209-1215, 2011<br>\u30cf\u30ce\u30fc\u30d0\u30fc\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u3042\u308b\u4e00\u5b9a\u671f\u9593\u306b\u6cbb\u7642\u3092\u53d7\u3051\u305f400\u4eba\u306e\u60a3\u8005\u3055\u3093\u3092\u8abf\u3079\u308b\u306853\u4eba(13%)\u306e\u60a3\u8005\u3055\u3093\u3067\u6c34\u982d\u75c7\u304c\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u305d\u306e\u5185\u306e48\u4eba\u304c\u816b\u760d\u306e\u6458\u51fa\u3092\u53d7\u3051\u307e\u3057\u305f\u300242\u4eba (87.5%)\u3067\u6c34\u982d\u75c7\u306b\u5bfe\u3059\u308b\u6cbb\u7642\u306f\u5fc5\u8981\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u6b8b\u308a\u306e6\u4eba\u304c\u6c34\u982d\u75c7\u306b\u5bfe\u3059\u308b\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\uff08V-P\u30b7\u30e3\u30f3\u30c8\u624b\u8853\u306f3\u4eba\uff09\u3002\u816b\u760d\u304c\u5927\u304d\u304f\u3066\u816b\u760d\u5883\u754c\u304c\u304c\u4e0d\u6574\u3067\uff0c\u6c34\u982d\u75c7\u306e\u7a0b\u5ea6\u304c\u3072\u3069\u304b\u3063\u305f\u60a3\u8005\u3055\u3093\u3067\u3042\u3063\u305f\u305d\u3046\u3067\u3059\u3002<br>\u300c\u89e3\u8aac\u300d\u79c1\u304c2003\u5e74\u306b\u540c\u3058\u96d1\u8a8c (J Neurosurg)\u306b\u5831\u544a\u3057\u305f\u30b7\u30ea\u30fc\u30ba\u3067\u306f\uff0c\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306b\u6c34\u982d\u75c7\u304c\u9032\u884c\u3057\u3066\u30b7\u30e3\u30f3\u30c8\u624b\u8853\u3092\u8981\u3057\u305f\u60a3\u8005\u3055\u3093\u304c11%\u3082\u3044\u307e\u3057\u305f\u3002\u30cf\u30ce\u30fc\u30d0\u30fc\u304b\u3089\u306e\u3053\u306e\u5831\u544a\u3067\u306f0.75%\u3067\u3059\u3002\u6bcd\u96c6\u56e3\u304c\u9055\u3046\u306e\u3067\u3059\u304c\uff0c<span style=\"color: #000080;\"><strong>\u9ac4\u6db2\u5438\u53ce\u969c\u5bb3\uff08\u4ea4\u901a\u6027\u6c34\u982d\u75c7\uff09\u304c\u3042\u308b\u5927\u304d\u306a\u8074\u795e\u7d4c\u816b\u760d\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u958b\u982d\u624b\u8853\u3092\u9078\u629e\u3057\u305f\u65b9\u304c\u3044\u3044\u3068\u7d50\u8ad6\u3067\u304d\u307e\u3059<\/strong>\u3002<strong>\u305f\u3060\u3057\uff0c\u5c0f\u3055\u306a\u816b\u760d\u3067\u3068\u3066\u3082\u8efd\u5ea6\u306e\u8133\u5ba4\u62e1\u5927\uff08\u6c34\u982d\u75c7\uff09\u3057\u304b\u306a\u3044\u816b\u760d\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u53ef\u80fd\u3067\u3059\u3002<\/strong><\/span><\/p>\n\n\n\n<h4 class=\"wp-block-heading style1\"><span style=\"color: #000080;\"><strong>\u5927\u304d\u306a\u816b\u760d\u3092\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3057\u305f\u3089\u6210\u7e3e\u304c\u60aa\u304b\u3063\u305f<\/strong><\/span><\/h4>\n\n\n\n<p>Mandl ES et al. :Stereotactic radiation therapy for large vestibular schwannomas. Radiother Oncol 95: 94-98, 2010<br>\u30aa\u30e9\u30f3\u30c0\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u300230mm\u4ee5\u4e0a\u3042\u308b\u5927\u304d\u306a\u524d\u5ead\u795e\u7d4c\u9798\u816b\u3092\u3082\u3063\u305f25\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\u5b9f\u969b\u306b5\u4f8b\u3067\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\u304c\u51fa\u3066\uff0c5\u5e74\u76ee\u304f\u3089\u3044\u306720\uff05\u306e\u60a3\u8005\u3055\u3093\u3067\u9854\u9762\u9ebb\u75fa\u306e\u51fa\u73fe\u5272\u5408\u3067\u3042\u308a\uff0c\u816b\u760d\u306e\u9032\u884c\u306f4\u4f8b (16%)\u3067\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u5f93\u6765\u5831\u544a\u3055\u308c\u3066\u3044\u305f\u6210\u7e3e\u3088\u308a\u3082\uff0c\u5927\u304d\u306a\u524d\u5ead\u795e\u7d4c\u9798\u816b\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u6210\u7e3e\u306f\u60aa\u3044\u306e\u3067\u3042\u308b\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<br><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">\u300c\u89e3\u8aac\u300d<\/span><strong>\u3053\u306e\u8ad6\u6587\u306e\u8457\u8005\u306f\u5927\u304d\u306a\u52d8\u9055\u3044\u3092\u3057\u3066\u3044\u307e\u3059\u3002<\/strong><\/span>\u5927\u304d\u306a\u524d\u5ead\u795e\u7d4c\u9798\u816b\u306b\u306fSRS (\u5b9a\u4f4d\u653e\u5c04\u7dda\u5916\u79d1\uff09\u306f\u9069\u3055\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u306f\u308f\u304b\u308a\u304d\u3063\u3066\u3044\u308b\u306e\u306b\uff0c\u5927\u304d\u306a\u816b\u760d\u306b\u5b9a\u4f4d\u5206\u5272\u7167\u5c04\u3068\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\u3092\u307e\u305c\u3053\u305c\u306b\u4f7f\u3063\u3066\u7d50\u679c\u3092\u5206\u6790\u3057\u3066\u3044\u308b\u304b\u3089\u3067\u3059\u3002SRT\u3092\u7528\u3044\u308b\u3079\u304d\u3067\u3057\u305f\u3002<\/p>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"\/sawamura\/braintumors\/acoustictumor\/#top2\"><img decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/navi\/pagetop.gif\" alt=\"\u3053\u306e\u30da\u30fc\u30b8\u306e\u30c8\u30c3\u30d7\u306b\u623b\u308b\"\/><\/a><\/figure>\n\n\n\n<p class=\"centering\"><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"font-size: medium;\"><strong>\u795e\u7d4c\u9798\u816b schwannoma<\/strong><\/span><\/h4>\n\n\n\n<p>\u795e\u7d4c\u9798\u816b\u306f\u672b\u68a2\u795e\u7d4c\u306e\u30b7\u30e5\u30ef\u30f3\u7d30\u80de\u3088\u308a\u767a\u751f\u3059\u308b\u816b\u760d\u3067\uff0c\u539f\u767a\u6027\u8133\u816b\u760d\u4e2d\u304a\u3088\u305d10\uff05\u3068\u983b\u5ea6\u306e\u9ad8\u3044\u816b\u760d\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>20\u301c50\u6b73\u4ee3\u306e\u6210\u4eba<\/strong><\/span>\u306b\u591a\u3044\u3082\u306e\u3067\uff0c\u5b50\u3069\u3082\u306b\u306f\u3068\u3066\u3082\u73cd\u3057\u3044\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>\u524d\u5ead\u795e\u7d4c\uff08\u7b2c\uff18\u8133\u795e\u7d4c\u3044\u308f\u3086\u308b\u8074\u795e\u7d4c\uff09<\/strong><\/span>\u306b\u6700\u3082\u591a\u304f\uff0c\u6b21\u3044\u3067<span style=\"color: #000080;\"><strong>\u4e09\u53c9\u795e\u7d4c<\/strong><\/span>\uff0c\u7a00\u306b\u9854\u9762\u795e\u7d4c\uff0c\u820c\u4e0b\u795e\u7d4c\uff0c\u8ff7\u8d70\u795e\u7d4c\uff08\u981a\u9759\u8108\u5b54\u816b\u760d\uff09\u306b\u3082\u767a\u751f\u3057\u307e\u3059\u3002\u810a\u67f1\u7ba1\u5185\u3067\u306f\uff0c\u9838\u90e8\u3084\u8170\u90e8\u306e\u810a\u9ac4\u5f8c\u6839\u306b\u3082\u767a\u751f\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u4e21\u5074\u306e\u7b2c\uff18\u8133\u795e\u7d4c\uff08\u8074\u795e\u7d4c\uff09\u306b\u816b\u760d\u304c\u3042\u308b\u5834\u5408\u3084\u591a\u767a\u6027\u795e\u7d4c\u9798\u816b\u3067\u306f\uff0c<a title=\"\u795e\u7d4c\u7dda\u7dad\u816b\u75c7\" href=\"\/sawamura\/braintumors\/neurofibromatosis\/\"><span style=\"color: #000080;\"><strong>\u795e\u7d4c\u7dda\u7dad\u816b\u75c7\uff12\u578b<\/strong><\/span> neurofibromatosis type 2 (NF-2)\u3067\u3059\uff08\u5225\u30da\u30fc\u30b8\u306b\u66f8\u3044\u3066\u3044\u307e\u3059\uff09<\/a>\u3002<\/p>\n\n\n\n<p>\u8074\u795e\u7d4c\u816b\u760d\uff08\u524d\u5ead\u795e\u7d4c\u9798\u816b\uff09\u306f\uff0c\u8133\u30c9\u30c3\u30af\u306a\u3069\u3067\u5076\u7136\u767a\u898b\u3055\u308c\u308b\u3053\u3068\u304c\u591a\u304f\u306a\u3063\u3066\u3044\u307e\u3059\u30022005\u5e74\u306eLin\u3089\u306e\u5831\u544a\u3067\u306fMRI\u691c\u67fb46,414\u4f8b\u30678\u4f8b (0.02%) \u306e\u8074\u795e\u7d4c\u816b\u760d incidental acoustic neuroma \u304c\u767a\u898b\u3055\u308c\u305f\u3068\u3042\u308a\u307e\u3059\u304c\uff0c\u5256\u691c\u4f8b\u3067\u306e\u5831\u544a\u306f\u3055\u3089\u306b\u9ad8\u304f\uff0c\u9ad8\u89e3\u50cf\u5ea6\u306eMRI\u3067\u306f\u3082\u3063\u3068\u983b\u5ea6\u306e\u9ad8\u3044\u3082\u306e\u3067\u3042\u308b\u3068\u3044\u3046\u5831\u544a\u3082\u3042\u308a\u307e\u3059\u3002<strong><span style=\"color: #000080;\">\u4eba\u53e310,000\u3042\u305f\u308a2-7\u4eba\u306e\u6709\u75c5\u7387\uff082,000\u4eba\u306b\u4e00\u4eba\u304f\u3089\u3044\u306f\u6301\u3063\u3066\u3044\u308b\uff09<\/span><\/strong>\u3068\u6349\u3048\u3089\u308c\u307e\u3059\u304b\u3089\u3068\u3066\u3082\u591a\u3044\u816b\u760d\u3067\u3059\u3002<\/p>\n\n\n\n<p>\u75c5\u7406\u7d44\u7e54\u5b66\u7684\u306b\u306f\uff0c\u7d21\u9310\u578b\u306e\u6838\u3092\u6709\u3059\u308b\u816b\u760d\u7d30\u80de\u3067\u69cb\u6210\u3055\u308c\u308b\u826f\u6027\u816b\u760d\u3067\u3059\u3002\u53e4\u5178\u7684\u75c5\u7406\u6240\u898b\u3068\u3057\u3066\uff0c\u675f\u72b6 fascicular \u306b\u914d\u5217\u3059\u308b\u5bc6\u306a\u7d44\u7e54\u3067\u3042\u308b Antoni A Type \u3068\u7db2\u72b6 reticular \u3067\u758e\u306a\u7d44\u7e54\u3067\u3042\u308b Antoni B Type \u304c\u6df7\u5728\u3059\u308b\u30d1\u30bf\u30fc\u30f3\u304c\u7279\u5fb4\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>\u96a3\u308a\u5408\u3046\u7d30\u80de\u6838\u306e\u67f5\u72b6\u914d\u5217 palisade arrangement<\/strong><\/span> \u306f\uff0c\u7d44\u7e54\u8a3a\u65ad\u4e0a\u306e\u5927\u5207\u306a\u6240\u898b\u3067\u3059\u3002\u795e\u7d4c\u9798\u816b\u3067\u306f\u591a\u5c11\u306e\u6838\u306e\u7570\u578b\u6027\u304c\u307f\u3089\u308c\u3066\u3082\u60aa\u6027\u50cf\u3068\u306f\u3044\u3048\u307e\u305b\u3093\u3002\u56a2\u80de\u3092\u5f62\u6210\u3057\u305f\u308a\uff0c\u6642\u306b\u306f\u6bdb\u7d30\u8840\u7ba1\u62e1\u5f35\u3092\u601d\u308f\u305b\u308b\u3088\u3046\u306a\u8457\u660e\u306a\u8840\u7ba1\u306e\u5897\u751f\u304c\u3042\u308a\u816b\u760d\u5185\u51fa\u8840\u3092\u304d\u305f\u3059\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u795e\u7d4c\u9798\u816b\u306e\u4e00\u90e8\u306f\uff0c\u7b2c22\u67d3\u8272\u4f53\u9577\u8155\u4e0a\u306eNF-2\u907a\u4f1d\u5b50\u306e\u6b20\u5931\u3042\u308b\u3044\u306f\u5909\u7570\u306b\u3088\u3063\u3066\u767a\u751f\u3059\u308b\u3068\u3055\u308c\u3066\u3044\u3066\uff0c\u3053\u306e\u7d30\u80de\u9aa8\u683c\u3092\u5f62\u6210\u3059\u308b\u86cb\u767d merlin\u3092\u30b3\u30fc\u30c9\u3059\u308bNF-2\u907a\u4f1d\u5b50\u306f\uff0c\u9ac4\u819c\u816b\u3084\u810a\u9ac4\u4e0a\u8863\u816b\u306e\u767a\u751f\u306b\u3082\u95a2\u4e0e\u3057\u307e\u3059\u3002<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlpair.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"550\" height=\"396\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlpair-550x396.jpg\" alt=\"\" class=\"wp-image-3278\" title=\"owlpair\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlpair-550x396.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlpair-300x216.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlpair.jpg 945w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p class=\"has-text-align-center\"><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span style=\"font-size: medium;\"><strong>\u6587\u732e\u3067\u3059<\/strong><\/span><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ansari SF, et al.: Surgery for vestibular schwannomas: a systematic review of complications by approach. Neurosurg Focus. 2012 Sep; 33<\/li>\n\n\n\n<li>Aoyama H, Onodera S, Takeichi N, Onimaru R, Terasaka S, Sawamura Y, Shirato H: \u00a0Symptomatic outcomes in relation to tumor expansion after fractionated stereotactic radiation therapy for vestibular schwannomas: single-institutional long-term experience. Int J Radiat Oncol Biol Phys 85: 329-34, 2013<\/li>\n\n\n\n<li>Andrew DW et al.: Stereotactic radiosurgery and fractinated stereotactic radiotherapy for the treatment of acoustic schwannomas: comparative observations of 125 patients treated at one institution. Int J Radiat Oncol Biol Phys 50: 1265-1278, 2001<\/li>\n\n\n\n<li>Bakkouri WE, et al.: Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequence for treatment. J Neurosurg 2008 (Epub)<\/li>\n\n\n\n<li>Baschnagel AM, et al.: Hearing preservation in patients with vestibular schwannoma treated with Gamma Knife surgery. J Neurosurg. 118: 571-578, 2013<\/li>\n\n\n\n<li>Carlson ML, et al.: Long-term hearing outcomes following stereotactic radiosurgery for vestibular schwannoma: patterns of hearing loss and variables influencing audiometric decline. J Neurosurg 118:579-587, 2013<\/li>\n\n\n\n<li>Combs SE et al.: Management of acoustic neuromas with fractionated stereotactic radiotherapy (FSRT): long-term results in 106 patients treated in a single institution. Int J Radiat Oncol Biol Phys 63:75-81, 2005<\/li>\n\n\n\n<li>Elsmore AJ, Mendoza ND: The operative learning curve for vestibular schwannoma excision via the retrosigmoid approach. Br J Neurosurg 16: 448-455, 2002<\/li>\n\n\n\n<li>Gerganov VM, et al.: Hydrocephalus associated with vestibular schwannomas: management options and factors predicting the outcome. J Neurosurg 114:1209-1215, 2011<\/li>\n\n\n\n<li>Gerganov VM, et al.: Surgical treatment of patients with vestibular schwannomas after failed previous radiosurgery. J Neurosurg 116: 713-720, 2012<\/li>\n\n\n\n<li>Gurgel RK, et al.: Facial nerve outcomes after surgery for large vestibular schwannomas: do surgical approach and extent of resection matter? Neurosurg Focus 33: 2012<\/li>\n\n\n\n<li>Hasegawa T, et al.: Long-term safety and efficacy of stereotactic radiosurgery for vestibular schwannomas: evaluation of 440 patients more than 10 years after treatment with Gamma Knife surgery. J Neurosurg 118: 557-65, 2013<\/li>\n\n\n\n<li>Hayhurst C, et al.: Tumor pseudoprogression following radiosurgery for vestibular schwannoma. Neuro Oncol 14:87-92, 2012<\/li>\n\n\n\n<li>Kagei K, Shirato H, Suzuki K, Isu T, Sawamura Y, Sakamoto T, Fukuda S, Nishioka T, Hashimoto S, Miyasaka K.Small-field fractionated radiotherapy with or without stereotactic boost for vestibular schwannoma. Radiother Oncol 50: 341-347, 1999<\/li>\n\n\n\n<li>Kapoor S, et al.: Long-term outcomes of vestibular schwannomas treated with fractionated stereotactic radiotherapy: an institutional experience. Int J Radiat Oncol Biol Phys 81: 647-653, 2011<\/li>\n\n\n\n<li>Kondziolka D, et al.: The newly diagnosed vestibular schwannoma: radiosurgery, resection, or observation? Neurosurg Focu 33: 2012<\/li>\n\n\n\n<li>Kopp C et al.: Stereotactic fractionated radiotherapy and LINAC radiosurgery in the treatment of vestibular schwannoma-report about both stereotactic methods from a single institution. Int J Radiat Oncol Biol Phys 80: 1485-1491, 2011<\/li>\n\n\n\n<li>Lin D, et al.: The prevalence of incidental atoustic neuroma. Arch Otolaryngol Head Neck Surg 131: 241-244, 2005<\/li>\n\n\n\n<li>Lobato-Polo J, et al.: Gamma knife radiosurgery in younger patients with vestibular schwannomas. Neurosurgery 65:294-300, 2009<\/li>\n\n\n\n<li>Mandl ES et al. :Stereotactic radiation therapy for large vestibular schwannomas. Radiother Oncol 95: 94-98, 2010<\/li>\n\n\n\n<li>Maniakas A, et al.: Conservative management versus stereotactic radiation for vestibular schwannomas: a meta-analysis of patients with more than 5 years&#8217; follow-up. Otol Neurotol 33:230-238, 2012<\/li>\n\n\n\n<li>Myrseth E et. al.: Treatment of vestibular schwannomas. Why, when and how? Acta Neurochir 149: 647-660, 2007<\/li>\n\n\n\n<li>Patel S, et al.: Trends in Surgical Use and Associated Patient Outcomes in the Treatment of Acoustic Neuroma. World Neurosurg. 2012 Jun 19. [Epub ahead of print]<\/li>\n\n\n\n<li>Pollock BE, et al.: Patient outcomes after vestibular schwannoma management: a prospective comparison of microsugical resection and stereotactic radiosurgery. Neurosurgery 59: 77-85, 2006<\/li>\n\n\n\n<li>Rowe J, Grainger A, Walton L, Silcocks P, Radatz M, Kemeny A. Risk of malignancy after gammaknife stereotactic radiosurgery. Neurosurgery 60: 60-66, 2007<\/li>\n\n\n\n<li>Sakamoto T, Shirato H, Sato N, Kagei K, Sawamura Y, Suzuki K, Takizawa H, Hokunan K, Isu T, Fukuda S, Inuyama Y, Miyasaka K. Audiological assessment before and after fractionated stereotactic irradiation for vestibular schwannoma. Radiother Oncol 49: 185-190, 1998<\/li>\n\n\n\n<li>Sawamura Y, Shirato H, Sakamoto T, Aoyama H, Suzuki K, Onimaru R, Isu T, Fukuda S, Miyasaka K: Management of vestibular schwannoma by fractionated stereotactic radiotherapy and associated cerebrospinal fluid malabsorption. J Neurosurg 99:685-92, 2003<\/li>\n\n\n\n<li>Shirato H, Sakamoto T, Takeichi N, Aoyama H, Suzuki K, Kagei K, Nishioka T, Fukuda S, Sawamura Y, Miyasaka K: Fractionated stereotactic radiotherapy for vestibular schwannoma (VS): comparison between cystic-type and solid-type VS. Int J Radiat Oncol Biol Phys 48:1395-1401, 2000<\/li>\n\n\n\n<li>Shirato H, Sakamoto T, Sawamura Y, Kagei K, Isu T, Kato T, Fukuda S, Suzuki K, Soma S, Inuyama Y, Miyasaka K. Comparison between observation policy and fractionated stereotactic radiotherapy (SRT) as an initial management for vestibular schwannoma. Int J Radiat Oncol Biol Phys 44: 545-550, 1999<\/li>\n\n\n\n<li>Sun S, et al.: Long-term follow-up studies of Gamma Knife surgery with a low margin dose for vestibular schwannoma. J Neurosurg 117: 57-62, 2012<\/li>\n\n\n\n<li>Tanbouzi Husseini S, \u00a0et al.: Malignancy in vestibular schwannoma after stereotactic radiotherapy: a case report and review of the literature. Laryngoscope 121:923-928, 2011<\/li>\n\n\n\n<li>Thakur JD, et al.: Do cystic vestibular schwannomas have worse surgical outcomes? Systematic analysis of the literature. Neurosurg Focus. 2012 Sep;33<\/li>\n\n\n\n<li>Yanamadala V, et al.: Malignant transformation of a vestibular schwannoma after gamma knife radiosurgery. World Neurosurg 79: 593, 2013<\/li>\n\n\n\n<li>Yomo S, et al.: Longitudinal analysis of hearing before and after radiosurgery for vestibular schwannoma. J Neurosurg 117: 877-885, 2012<\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\">\u4ed8\u9332<\/h5>\n\n\n\n<h4 class=\"wp-block-heading\">\u6c34\u982d\u75c7\u306e\u81ea\u7136\u5bdb\u89e3<\/h4>\n\n\n\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/spontaneous3.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/acousti\/spontaneous3.png\" alt=\"\" width=\"491\" height=\"190\"><br><\/a>\uff18\u5e74\u9593\u89b3\u5bdf\u3057\u305f\u3089\u81ea\u7136\u306b\u826f\u304f\u306a\u3063\u305f\u8074\u795e\u7d4c\u816b\u760d\u306b\u5408\u4f75\u3059\u308b\u6c34\u982d\u75c7\u3067\u3059\u3002\u3057\u304b\u3057\uff0c\u6c34\u982d\u75c7\u304c\u81ea\u7136\u5bdb\u89e3\u3059\u308b\u3053\u3068\u306f\u307b\u3068\u3093\u3069\u306a\u3044\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306e\u816b\u760d\u5185\u51fa\u8840\u3068\u8840\u7ba1\u816b\u767a\u751f<\/h4>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomash18.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"294\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomash18-300x294.jpg\" alt=\"\" class=\"wp-image-16055\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomash18-300x294.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomash18-550x538.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomash18.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomasht22.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" 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href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomasht23.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"293\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomasht23-300x293.jpg\" alt=\"\" class=\"wp-image-16057\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomasht23-300x293.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomasht23-550x537.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomasht23-768x750.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomasht23.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair2.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"290\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair2-300x290.jpg\" alt=\"\" class=\"wp-image-16058\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair2-300x290.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair2-550x531.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair2-768x742.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair2.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashgd1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashgd1-300x300.jpg\" alt=\"\" class=\"wp-image-16059\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashgd1-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashgd1-550x552.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashgd1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashgd1-768x771.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashgd1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"293\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair1-300x293.jpg\" alt=\"\" class=\"wp-image-16060\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair1-300x293.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair1-550x537.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair1-768x750.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/schwannomashflair1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" 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