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Acoustic neuromas, vestibular schwannoma

Luxin Yin, Zhenyu Ma, Chunde Li, Shiqi Luo
AIM: We investigated the clinical presentation and management issues of unilateral vestibular schwannomas in childhood without evidence of neurofibromatosis. MATERIAL AND METHODS: Ten pediatric patients with unilateral vestibular schwannomas and no evidence of neurofibromatosis were treated by the senior author at Tiantan Hospital from January 1994 to December 2014. The clinical manifestations, neuroimaging findings, treatment methods, and therapeutic results were retrospectively reviewed...
December 28, 2015: Turkish Neurosurgery
Daniele Marchioni, Marco Carner, Alessia Rubini, João Flávio Nogueira, Barbara Masotto, Matteo Alicandri-Ciufelli, Livio Presutti
Surgical approaches to vestibular schwannomas (VS) are widely known and extensively recorded. For the first time, an exclusive endoscopic approach to the internal acoustic canal (IAC) was described and used to safely remove a cochlear schwannoma involving IAC in March 2012. The aim of this article was to summarize indications and technique to treat intracanalicular VS by transcanal/transpromontorial endoscopic approach. Because management of intracanalicular VSs is complex and strongly debated, this kind of therapeutic option in the appropriate and selected cases could modify classic concepts of the management of this pathology...
October 2016: Otolaryngologic Clinics of North America
L Y Hu, Z Y Wang, Q Q Hua
It has been over 200 years since the acoustic neuroma(AN) was firstly reported. From simply describing its symptoms to the decline of surgical mortality, the protection of facial and acoustic nerve function, as well as the improvement of the patients' quality of life. Physicians made efforts on evolving the diagnostic techniques and treatment strategies, and a better understanding of AN's development. The current major managements of AN are microsurgery, stereotactic radiosurgery, and follow-up. We reviewed the AN's history and prospected its future managements...
June 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Giuseppina Apicella, Marina Paolini, Letizia Deantonio, Laura Masini, Marco Krengli
BACKGROUND: The management of vestibular schwannoma is still a quite controversial issue and can include wait and see policy, surgery and radiotherapy, mainly with stereotactic technique. The purpose of this study is to review the results of recent clinical series treated by radiotherapy. MATERIALS AND METHODS: Literature search was performed by Pubmed and Scopus by using the words "vestibular schwannoma, acoustic neuroma, radiotherapy, radiosurgery". RESULTS: Management options of VS include wait and see, surgery and radiotherapy...
July 2016: Reports of Practical Oncology and Radiotherapy
Or Cohen-Inbar
UNLABELLED: GENERAL: Treatment of vestibular schwannoma (VS) via microsurgery, radiosurgery (SRS), or fractionated radiotherapy (FRT), is advocated for symptomatic patients or those with rapid tumor growth, despite older age and comorbidities. VS growth rate >2.5 mm/year is associated with lower hearing preservation rates. Regardless of growth rate, conservative management is associated with a progressive hearing loss, ranging 2.77-5.39 dB/year. MICROSURGERY: The retrosigmoid approach is associated with higher hearing preservation and facial nerve function rates for VS >1...
March 2016: Harefuah
Kathryn Y Noonan, Cong Rang, Katherine Callahan, Nathan E Simmons, Kadir Erkmen, James E Saunders
OBJECTIVES: This study compares the functional outcomes of nevus intermedius impairment following surgery, radiation, or observation for the treatment of vestibular schwannoma. STUDY DESIGN: Retrospective cohort study. SETTINGS: Tertiary care medical center. SUBJECTS AND METHODS: We retrospectively examined 141 charts of patients with a vestibular schwannoma seen in the Dartmouth-Hitchcock Acoustic Neuroma Clinic between 2012 and 2014...
October 2016: Otolaryngology—Head and Neck Surgery
K A Peng, E P Wilkinson
OBJECTIVE: To undertake a systematic review of the role of microsurgery, in relation to observation and stereotactic radiation, in the management of small vestibular schwannomas with serviceable hearing. METHODS: The Medline database was searched for publications that included the terms 'vestibular schwannoma' and/or 'acoustic neuroma', occurring in conjunction with 'hearing'. Articles were manually screened to identify those concerning vestibular schwannomas under 1...
July 2016: Journal of Laryngology and Otology
Leire Alvarez, Ane Ugarte, Miren Goiburu, Iratxe Urreta Barallobre, Xabier Altuna
INTRODUCTION: Tinnitus is one of the primary symptoms of vestibular schwannoma (VS) and the effect of surgery is unpredictable. MATERIALS AND METHODS: We conducted a prospective study of the patients who underwent a translabyrinthine approach for the treatment of their VS (2009-2013) at our Hospital. Patients answered the Tinnitus Handicap Inventory (THI) questionnaire pre- and postoperatively. The clinical charts provided data such as age, gender, tumour size, preoperative audiometry and postoperative facial function...
April 8, 2016: Acta Otorrinolaringológica Española
Luciano Mastronardi, Guglielmo Cacciotti, Ettore Di Scipio, Giuseppe Parziale, Raffaelino Roperto, Maria Pia Tonelli, Ettore Carpineta
AIMS: We performed a retrospective non-randomized study to analyze the results of microsurgery of acoustic neuromas (AN) using two different flexible hand-held laser fibers, CO2 (Omniguide(®)) and 2μ-Thulium (Revolix jr(®)). METHODS: From September 2010 to June 2015, 84 patients suffering from AN have been operated on with microsurgical technique via retrosigmoid (RS) approach. In 42 cases tumor resection was performed with the assistance of hand-held flexible laser (L-group): in 8 cases CO2-fiber and in 34 2μ-Thulium-fiber...
June 2016: Clinical Neurology and Neurosurgery
Berkcan Akpinar, Seyed H Mousavi, Michael M McDowell, Ajay Niranjan, Amir H Faraji, John C Flickinger, L Dade Lunsford
PURPOSE: Vestibular schwannomas (VS) are increasingly diagnosed in patients with normal hearing because of advances in magnetic resonance imaging. We sought to evaluate whether stereotactic radiosurgery (SRS) performed earlier after diagnosis improved long-term hearing preservation in this population. METHODS AND MATERIALS: We queried our quality assessment registry and found the records of 1134 acoustic neuroma patients who underwent SRS during a 15-year period (1997-2011)...
June 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Ashkan Monfared, Carlton E Corrales, Philip V Theodosopoulos, Nikolas H Blevins, John S Oghalai, Samuel H Selesnick, Howard Lee, Richard K Gurgel, Marlan R Hansen, Rick F Nelson, Bruce J Gantz, Joe W Kutz, Brandon Isaacson, Peter S Roland, Richard Amdur, Robert K Jackler
BACKGROUND: Patients with large vestibular schwannomas are at high risk of poor facial nerve (cranial nerve VII [CNVII]) function after surgery. Subtotal resection potentially offers better outcome, but may lead to higher tumor regrowth. OBJECTIVE: To assess long-term CNVII function and tumor regrowth in patients with large vestibular schwannomas. METHODS: Prospective multicenter nonrandomized cohort study of patients with vestibular schwannoma ≥2...
August 2016: Neurosurgery
Stephen J Broomfield, Gerard M O'Donoghue
OBJECTIVE: To assess patient-reported outcomes and experience of vestibular schwannoma (VS) management. STUDY DESIGN: Survey of members of the British Acoustic Neuroma Association (BANA). METHODS: Members of the BANA were invited to complete an online survey. Questions were divided into five areas: Demographic details; symptoms at diagnosis; level of information received; treatment after-effects; and overall experience of diagnosis and/or treatment...
June 2016: British Journal of Neurosurgery
Sérgio Duarte-Costa, Rui Vaz, Débora Pinto, Fernando Silveira, António Cerejo
BACKGROUND: Despite routine use of intraoperative neuromonitoring in acoustic neuroma removal, its application in predicting long-term facial function is limited. METHODS: Prospective recording of facial nerve function and subsequent review of intraoperative neurophysiologic data. Stimulation of the facial nerve was performed proximal and distal to the tumor locus after tumor removal with measurement of amplitude and latency responses in the orbicularis oculi and oris muscles...
November 2015: Acta Neurochirurgica
George Scangas, Aaron Remenschneider, Felipe Santos
Objective Lipochoristomas comprise 0.1% of all cerebellopontine angle tumors and may be misdiagnosed as vestibular schwannomas. We describe a lipochoristoma of the internal auditory canal (IAC) and present the salient features of the evaluation, diagnosis, and management. Study Design and Methods Retrospective case review. Results (Case Report) A 51-year-old woman presented with left-sided severe hearing loss, tinnitus, mild episodic vertigo, and facial paresthesias progressive over 1 year. Magnetic resonance imaging (MRI) demonstrated a small (5 × 4 mm) T1 hyperintense lobulated lesion in the distal internal auditory canal...
July 2015: Journal of Neurological Surgery Reports
Marlon M Maducdoc, Yaser Ghavami, Mark E Linskey, Hamid R Djalilian
OBJECTIVE: To critically analyze each reported case of malignant transformation of vestibular schwannoma (VS) after either stereotactic radiosurgery (SRS) or microsurgery (MS). DATA SOURCES: We searched the Pubmed/Medline database using the relevant key words vestibular schwannoma, acoustic neuroma, malignant, transformation, radiation, induced, stereotactic, radiosurgery, malignancy, GammaKnife, and CyberKnife and combinations thereof. STUDY SELECTION: Inclusion criteria for malignant transformation of VS after SRS included histopathology of initially benign VS, subsequent histopathology confirming malignant VS, reasonable latency period between malignancy and benign diagnoses...
September 2015: Otology & Neurotology
Andrea P Sponghini, Francesca Platini, David Rondonotti, Riccardo Soffietti
PURPOSE: Neurofibromatosis type 2 (NF2) is a dominantly inherited genetic condition that clinically manifests through the appearance of multiple meningiomas, ependymomas and bilateral vestibular schwannomas (acoustic neuromas) which lead to progressive hearing loss. Neovascularization is necessary for tumor growth and is driven by tumor-produced angiogenic factors such as vascular endothelial growth factor (VEGF). Bevacizumab is a humanized monoclonal antibody that neutralizes the activity of VEGF...
November 2015: Tumori
Bibian M van Leeuwen, Jasmijn M Herruer, Hein Putter, Andel G L van der Mey, Adrian A Kaptein
OBJECTIVES/HYPOTHESIS: Drawings made by patients are an innovative way to assess the perceptions of patients on their illness. The objective of this study, at a university tertiary referral center, on patients who have recently been diagnosed with vestibular schwannoma, was to examine whether patients' illness perceptions can be assessed by drawings and are related to their quality of life. STUDY DESIGN: Cross-sectional study. METHODS: Patients diagnosed with vestibular schwannoma (mean age [range], 55...
December 2015: Laryngoscope
Daniel E Roos, Sandy G Patel, Andrew E Potter, Andrew C Zacest
INTRODUCTION: Because acoustic neuroma (AN), also termed vestibular schwannoma, constitutes by far the commonest intracranial schwannoma and cerebello-pontine angle (CPA) tumour, there is a risk of overlooking rarer alternative diagnoses with similar clinical and/or radiological features. The purpose of this article is to highlight to radiosurgeons the potentially serious implications of this problem through illustrative case studies. METHODS: Our linac stereotactic radiosurgery (SRS) technique has been previously described, with stereotactic headring fixation and treatment delivered via cones or micro-multileaf collimators using multiple arcs or static beams...
August 2015: Journal of Medical Imaging and Radiation Oncology
Matthew L Carlson, Øystein Vesterli Tveiten, Kathleen J Yost, Christine M Lohse, Morten Lund-Johansen, Michael J Link
OBJECTIVE: Several studies have demonstrated small but statistically significant differences in quality-of-life (QOL) scores among vestibular schwannoma (VS) treatment modalities. However, does a several-point difference on a 100-point scale really matter? The minimal clinically important difference (MCID)-defined as the smallest difference in scores that patients perceive as important and that could lead to a change in management-was developed to answer this important question. While the MCID has been determined for QOL measures used in other diseases, it remains undefined in the VS literature...
August 2015: Otolaryngology—Head and Neck Surgery
Andre Giacomelli Leal, Erasmo Barros da Silva, Ricardo Ramina
OBJECTIVE: Evaluate the feasibility of an adequate exposure with anatomical preservation of labyrinth structures through retrosigmoid transmeatal approach (RSA) in surgeries for resection of acoustic neuromas/vestibular schwannomas (VS). METHOD: Thirty patients underwent surgical resection and were preoperatively evaluated with fine slice high definition CT scans and 3D-MRI volumetric reconstructions. Extension of internal auditory canal (IAC) opening during surgery was measured using 3 mm right-angle calibrated hook and neuronavigation parameters...
May 2015: Arquivos de Neuro-psiquiatria
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