title: Management of large vestibular schwannomas by combined surgical resection and gamma knife radiosurgery.
abstract: In this report, we evaluated the treatment results of a combination of surgery and radiosurgery for large vestibular schwannomas. The series of 8 patients included in this study underwent surgery followed by radiosurgical treatment between January 2000 and January 2006. The patients included 5 males and 3 females aged 24-78 years (mean age: 53 years). The average maximum diameter of the tumor was 40 (35-45) mm. At the time of radiosurgery, the treatment size became 18 (9-20) mm. The mean peripheral dose administered was 11.8 (range 11-13) Gy, and the mean dose administered in the centre of the tumor was 23.75 (22-26) Gy. The mean follow-up period was 46 months after radiosurgery. Excellent facial nerve function (House-Brackmann grade 1 or 2) was preserved in 7/8 patients (87.5%). In the case of large vestibular schwannomas, the combined management is one option for maintaining cranial nerve function and tumor growth control.
authors.affiliation: Service de Neurochirurgie Fonctionnelle et Stéréotaxique, Hôpital d'Adulte de la Timone, Marseille, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Fuentes
authors.forename: Yasser
authors.initials: Y
authors.lastname: Arkha
authors.forename: Grégoire
authors.initials: G
authors.lastname: Pech-Gourg
authors.forename: François
authors.initials: F
authors.lastname: Grisoli
authors.forename: Henry
authors.initials: H
authors.lastname: Dufour
authors.forename: Jean
authors.initials: J
authors.lastname: Régis
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D009464:Neuroma, Acoustic / Q000473:pathology* / Q000601:surgery*; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome