Radiosurgery for vestibular schwannomas.
BACKGROUND
Radiosurgery has been established as an important alternative to microsurgery. We report our experience with radiosurgery for tumor control and the complications of unilateral vestibular schwannomas.


METHODS
We reviewed our early experience regarding clinical presentation, management and outcomes in 45 patients with acoustic schwannomas who underwent gamma knife stereotactic radiosurgery. The median follow-up period was 25 months (range, 6-48 months). Thirteen patients had undergone 1 or more previous resections before radiosurgery; 32 underwent radiosurgery as the first procedure. Median tumor volume was 4.5 mL (range, 0.5-30.0), and median radiotherapy dose was 11.5 Gy (range, 10.5-14.0 Gy).


RESULTS
Tumor control was achieved in 43 patients (95.6%). Loss of central contrast enhancement was a characteristic change and was noted in 29 patients (64.4%). Reduction in tumor size was shown in 15 patients (33.3%). Thirteen patients (28.9%) had good or serviceable hearing preoperatively, and in all of these, the preoperative status was retained immediately after radiosurgery. At follow-up, however, 10 patients (76.9%) had preserved hearing and 3 (23.1%) had reduced hearing on the treated side. Hearing in 1 patient that was not serviceable preoperatively later improved to a serviceable level. No patients had delayed facial palsy or lower cranial nerve dysfunction, but one had delayed trigeminal sensory loss.


CONCLUSIONS
Radiosurgery achieved a high tumor control rate and a relatively low post-radiosurgical complication rate for acoustic neuromas.
Huang
Chuan-Fu
CF
Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung, Taiwan, R.O.C. gamma@csh.org.tw
Tu
Hsien-Tang
HT
Lo
Hsiu-Kuan
HK
Wang
Kao-Lun
KL
Liu
Wen-Shan
WS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003391:Cranial Nerves / Q000503:physiopathology; D006309:Hearing; D006801:Humans; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000503:physiopathology / Q000601:surgery*; D016634:Radiosurgery