Stereotactic Radiosurgery in Primary Treatment of Sporadic Small to Medium (<3 cm) Vestibular Schwannomas: A Systematic Review and Meta-Analysis

To analyze the literature regarding the use of stereotactic radiosurgery as the primary treatment of vestibular schwannoma to further evaluate efficacy and treatment-related neurologic deficits. Online databases were queried to identify relevant studies from January 2001 to December 2020. Full-text...

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Bibliographic Details
Published in:World neurosurgery 2025-02, Vol.194, p.123304, Article 123304
Main Authors: Bonin, Bryce J., Beckman, Scott, Mahmud, Sultan, Terrell, Danielle, Whipple, Stephen Garrett, Diaz, Ryan, Nobel Bhuiyan, Mohammad Alfrad, Kumbhare, Deepak, Wang, Chiachien Jake, Guthikonda, Bharat, Savardekar, Amey R.
Format: Article
Language:English
Subjects:
Acoustic neuroma
Hearing preservation
Radiosurgery
Vestibular schwannoma
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Summary:To analyze the literature regarding the use of stereotactic radiosurgery as the primary treatment of vestibular schwannoma to further evaluate efficacy and treatment-related neurologic deficits. Online databases were queried to identify relevant studies from January 2001 to December 2020. Full-text articles in English for sporadic vestibular schwannoma treated primarily with radiosurgery and documented hearing preservation data were reviewed. Studies that had a minimum follow-up period of less than 36 months, did not use radiosurgery for primary treatment, or included patients with neurofibromatosis type 2 were excluded. A total of 33 studies involving 4286 patients with an average follow-up of 62.5 months were included in the final analysis. All 33 studies included eligible hearing data; overall preservation of serviceable hearing was found to be 58.27%. Twenty-seven studies with 3822 eligible patients were analyzed for tumor control rates; overall, tumor control was reported in 92.98% of cases. Twenty-seven studies were analyzed for posttreatment facial nerve dysfunction, which was reported in 1.53% of cases. Stereotactic radiosurgery is a safe and effective primary treatment modality for sporadic vestibular schwannoma as shown by the present analysis. Radiosurgery is effective regarding tumor control and hearing preservation and offers a low rate of posttreatment facial nerve dysfunction.
ISSN:1878-8750
1878-8769
1878-8769
DOI:10.1016/j.wneu.2024.10.033