Systematic review and meta-analysis of the technique of subtotal resection and stereotactic radiosurgery for large vestibular schwannomas: a "nerve-centered" approach

Neurosurgical Focus
Daniele StarnoniMahmoud Messerer

Abstract

OBJECTIVE During the last decade, the primary objective for large vestibular schwannoma (VS) management has progressively shifted, from tumor excision to nerve preservation by using a combined microsurgical and radiosurgical approach. The aim of this study was to provide a systematic review and meta-analysis of the available literature regarding the combined strategy of subtotal resection (STR) followed by stereotactic radiosurgery (SRS) for large VSs. METHODS The authors performed a systematic review and meta-analysis in compliance with the PRISMA guidelines for article identification and inclusion using the PubMed, Embase, and Cochrane databases. Established inclusion criteria were used to screen all identified relevant articles published before September 2017 without backward date limit. RESULTS The authors included 9 studies (248 patients). With a weighted mean follow-up of 46 months (range 28-68.8 months), the pooled rate of overall tumor control was 93.9% (95% CI 91.0%-96.8%). Salvage treatment (second STR and/or SRS) was necessary in only 13 (5.24%) of 18 patients who experienced initial treatment failure. According to the House-Brackmann (HB) grading scale, functional facial nerve preservation (HB grade I-II) was achiev...Continue Reading

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Citations

Feb 23, 2019·Acta neurochirurgica·Constantin TuleascaMarc Levivier
Apr 25, 2020·Operative Neurosurgery·Julia R SchneiderAmir R Dehdashti
Mar 11, 2020·Acta neurochirurgica·Johannes WachErdem Güresir
Jan 5, 2021·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Alexandra E QuimbyJoseph Chen
Apr 29, 2019·Journal of the Neurological Sciences·Constantin TuleascaMarc Levivier
Apr 17, 2021·Neurosurgery·Nicholas J EricksonWinfield S Fisher
Jul 22, 2021·The New England Journal of Medicine·Matthew L Carlson, Michael J Link
Dec 3, 2021·The Laryngoscope·Katherine P WalleriusMatthew L Carlson

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Methods Mentioned

BETA
dissection
surgical resection

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OpenMeta ( Analyst

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