title: Radiosurgery of vestibular schwannomas: a minimally invasive alternative to microsurgery.
abstract: From April 1992 till December 1998 stereotactic radiosurgery (Gamma Knife) was applied to 192 patients with vestibular schwannomas. 56 of them had radiosurgery as primary treatment modality and were followed-up for at least 4 years (48-80 months, median 62). Without fatal complications, control of tumour growth was achieved in all but three cases, useful hearing being preserved in more than one half of the patients (62%). The neurological state improved in 30 patients (54%). Irradiation-associated adverse effects (18%) comprised neurological signs (incomplete facial palsy, four cases (two recovered completely), and mild trigeminal neuropathy, three cases, respectively) and morphological changes (three patients) marked by an enlargement of pre-existing cystic components calling for additional surgical treatment: Microsurgical decompression was performed in two cases, the third patient underwent a shunting procedure because of hydrocephalus formation. Based on the present data, radiosurgery represents an effective treatment for vestibular schwannomas associated with an exceptionally low mortality rate and a good quality of life. With respect to the preservation of cranial nerve function, results are comparable to microsurgical resection. A short duration of hospitalization and a quick return to normal activities constitute further advantages and contribute to cost effectiveness in public health care.
authors.affiliation: Department of Neurosurgery, Karl-Franzens University, Graz, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Unger
authors.forename: C
authors.initials: C
authors.lastname: Walch
authors.forename: K
authors.initials: K
authors.lastname: Haselsberger
authors.forename: G
authors.initials: G
authors.lastname: Papaefthymiou
authors.forename: M
authors.initials: M
authors.lastname: Trummer
authors.forename: S
authors.initials: S
authors.lastname: Eustacchio
authors.forename: G
authors.initials: G
authors.lastname: Pendl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009460:Neurologic Examination; D009464:Neuroma, Acoustic / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D016634:Radiosurgery; D012086:Reoperation; D014057:Tomography, X-Ray Computed