Functional outcome after gamma knife treatment in vestibular schwannoma

Radiosurgery (RS) is a noninvasive, ambulatory special neurosurgical procedure for the treatment of vestibular schwannoma (VS). We treated 123 patients with unilateral schwannomas between 1994 and 2000 at the gamma knife (GK) center in Munich using a primary stereotactic procedure. These patients we...

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Bibliographic Details
Published in:European archives of oto-rhino-laryngology 2006-08, Vol.263 (8), p.714-718
Main Authors: HEMPEL, J. M, HEMPEL, E, WOWRA, B, SCHICHOR, Ch, MUACEVIC, A, RIEDERER, A
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Audiometry, Pure-Tone
Auditory Threshold
Biological and medical sciences
Facial Nerve Injuries
Female
Follow-Up Studies
Hearing Loss
Humans
Incidence
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Neurology
Neuroma, Acoustic - surgery
Otorhinolaryngology. Stomatology
Postoperative Complications
Radiosurgery - methods
Retrospective Studies
Tinnitus
Treatment Outcome
Trigeminal Nerve - physiopathology
Trigeminal Nerve Injuries
Trigeminal Neuralgia - etiology
Trigeminal Neuralgia - physiopathology
Tumors of the nervous system. Phacomatoses
Vertigo
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Summary:Radiosurgery (RS) is a noninvasive, ambulatory special neurosurgical procedure for the treatment of vestibular schwannoma (VS). We treated 123 patients with unilateral schwannomas between 1994 and 2000 at the gamma knife (GK) center in Munich using a primary stereotactic procedure. These patients were followed up until June 2004 in respect to audiological, neurological, neurootological and radiological features before and after radiosurgical intervention. The actual tumor control rate of 8.2 years (mean) after GK surgery for all patients and a single treatment was calculated to be 96.7%. The impairment of hearing was on average 18% after GK, ranking from 0% gain of hearing loss up to 90%. Facial nerve function, graded according to the House-Brackmann scale, deteriorated in none of the patients; 5.8% reported a trigeminal neuralgia. Tinnitus developed in 4.1% of the patients after RS; 13.3% had vertigo for the first time after the treatment, age apparently being a predisposing factor. Radiosurgical treatment for VS is an alternative to microsurgery (MS). It is associated with a lower rate of facial and trigeminal neuropathy, postoperative complications and hospital stay. The hearing preservation rate is equivalent to MS.
ISSN:0937-4477
1434-4726
DOI:10.1007/s00405-006-0054-6