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

World Neurosurgery
Yoshiyasu IwaiKazuhiro Yamanaka

Abstract

The treatment goal for vestibular schwannomas (VS) has been changed from total removal of the tumor to functional preservation with long-term tumor growth control. The small- to medium-sized VS can be treated by stereotactic radiosurgery, but large VS require surgical decompression for the relief of cerebellar dysfunction and increased intracranial pressure. We have been performing planned partial surgical resections followed by gamma knife radiosurgery (GKS) for large VS. Here, we evaluate a recent series of such cases from the standpoint of functional outcomes. From January 2000 to May 2013, we treated 40 patients with large unilateral VS (maximum tumor diameter at least 25 mm) with planned partial tumor removal followed by GKS for functional preservation. The median maximum diameter of the tumors was 32.5 mm (range 25-52 mm). All patients underwent surgery via the retrosigmoid approach, and tumors situated on the ventral and in the internal auditory canal intentionally were not removed, thus preserving cranial nerve functions. GKS was performed 1-12 months after surgical resection (median interval 3 months). The median tumor volume at GKS was 3.3 cm(3) (range 0.4-10.4 cm(3)) and the median prescribed dose was 12 Gy (range 10...Continue Reading

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Citations

Jul 15, 2017·Journal of Neurosurgery·Cheng-Wei HuangChuan-Fu Huang
Sep 6, 2018·Singapore Medical Journal·Ru Xin WongDaniel Yat Harn Tan
Sep 11, 2019·Neuro-oncology·Roland GoldbrunnerJoerg-Christian Tonn
Jul 7, 2020·Laryngo- rhino- otologie·Ali HaratiThomas Deitmer
Feb 15, 2019·Frontiers in Neurology·Jiri BartekAsgeir Store Jakola
Jun 16, 2017·Acta neurochirurgica·Morten Lund-Johansen
Mar 11, 2020·Acta neurochirurgica·Johannes WachErdem Güresir
Apr 5, 2020·Cancers·Longping YaoKoos Hovinga
Jan 5, 2021·Frontiers in Oncology·Łukasz PrzepiórkaAndrzej Marchel
Mar 20, 2021·World Neurosurgery·Gang SongJiantao Liang

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