Functional Preservation After Planned Partial Resection Followed by Gamma Knife Radiosurgery for Large Vestibular Schwannomas

Iwai, Yoshiyasu; Ishibashi, Keiichiro; Watanabe, Yûsuke; Uemura, Go; Yamanaka, Kazuhiro

doi:10.1016/j.wneu.2015.03.012

Cited by 113 publications

(82 citation statements)

References 57 publications

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“…Our experience supports the concept reported in the literature that a combined treatment regimen provides both sufficient local tumor control and excellent preservation of facial nerve function [11,12,13,14,15,16,17,20,21]. Although the extent of the influence of tumor removal on postoperative facial nerve function remains controversial, the conclusion that reduced intraoperative mechanical stress during STR might help maintain neural function appears feasible.…”

Section: Discussionsupporting

confidence: 87%

“…In 2/11 patients (18%) the residual tumor increased in size 2 and 3 years after surgery [6,24,31,32]. In a recently published article the 5-year tumor control rate reached 86% in a series of 54 patients who underwent planned STR with adjuvant SRS [21]. These outcomes underscore the importance of utilizing adjuvant SRS in the treatment of residual tumors.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes in Patients with Vestibular Schwannoma after Subtotal Resection and Adjuvant Radiosurgery

Radwan

Eisenberg²,

Knisely³

et al. 2016

Stereotact Funct Neurosurg

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Background: The debate continues with a limited number of publications describing outcomes in patients with vestibular schwannoma (VS) treated with planned subtotal resection (STR) plus stereotactic radiosurgery (SRS). Here we present our experience. Methods: This is a retrospective review of 22 patients with VS Koos grade III and IV who were treated with STR followed by SRS. Tumor volumes, facial nerve function, hearing preservation, and the presence of trigeminal neuropathy were noted. Spearman's rank test was used to correlate facial nerve grade with postoperative tumor residual tumor volume. Results: Tumor control was achieved in all patients with a mean follow-up of 28 months. No patient required other treatment beyond the original surgery and adjuvant SRS during this period. After a mean postoperative period of 28 months, 19/22 patients had excellent (House-Brackmann I or II) facial nerve function grading. Improved facial nerve function was positively correlated with larger residual tumor volume (r_s = 0.63). Kaplan-Meier curve showed around 80% probability for regaining facial nerve function after initial deterioration. Four patients reported postoperative facial numbness at the side of surgery, with 3 cases showing improvement within a month. Temporary postoperative caudal cranial nerve dysfunction was observed in 2 patients. Conclusion: Hybrid strategy of STR and adjuvant SRS provides patients with large VS excellent tumor control and a good clinical outcome.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Outcomes in Patients with Vestibular Schwannoma after Subtotal Resection and Adjuvant Radiosurgery

Radwan

Eisenberg²,

Knisely³

et al. 2016

Stereotact Funct Neurosurg

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show abstract

“…All patients underwent our standard surgical procedures for the partial removal of large VSs for functional preservation 8,10) . The surgery was performed via the retrosigmoid approach.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…Long-term follow-up outcomes of radiosurgery for small to medium sized VSs revealed tumor growth control in 92 to 97% of patients up to 10 years following GKS 6,17) . However, a small percent of the patients still requires salvage surgery after radiosurgery, and about 1.57 to 5% of patients received surgical resection after radiosurgery 10,14,22,26) .…”

Section: Introductionmentioning

confidence: 99%

Functional Outcomes of Salvage Surgery for Vestibular Schwannomas after Failed Gamma Knife Radiosurgery

et al. 2016

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“…Subtotal resection may lead to tumour recurrence and hearing loss later on, similar to what is reported for radiosurgery. One recently published strategy is to do a subtotal resection followed by radiosurgery [4,8]. It remains to be seen if any of the two strategies will gain widespread use.…”

mentioning

confidence: 99%

Awake craniotomy for vestibular schwannoma

Lund‐Johansen

2017

Acta Neurochir

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Functional Preservation After Planned Partial Resection Followed by Gamma Knife Radiosurgery for Large Vestibular Schwannomas

Cited by 113 publications

References 57 publications

Outcomes in Patients with Vestibular Schwannoma after Subtotal Resection and Adjuvant Radiosurgery

Outcomes in Patients with Vestibular Schwannoma after Subtotal Resection and Adjuvant Radiosurgery

Functional Outcomes of Salvage Surgery for Vestibular Schwannomas after Failed Gamma Knife Radiosurgery

Awake craniotomy for vestibular schwannoma

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