Cystic vestibular schwannoma – a subgroup analysis from a comparative study between radiosurgery and microsurgery

Some vestibular schwannoma (VS) show cystic morphology. It is known that these cystic VS bear different risk profiles compared to solid VS in surgical treatment. Still, there has not been a direct comparative study comparing both SRS and SURGERY effectiveness in cystic VS. This retrospective bi-cent...

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Bibliographic Details
Published in:Neurosurgical review 2024-06, Vol.47 (1), p.291, Article 291
Main Authors: Wang, Sophie Shih-Yüng, Rizk, Ahmed, Ebner, Florian H., van Eck, Albertus, Naros, Georgios, Horstmann, Gerhard, Tatagiba, Marcos
Format: Article
Language:English
Subjects:
Adult
Aged
Cysts - surgery
Female
Humans
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Microsurgery - methods
Middle Aged
Neuroma, Acoustic - surgery
Neurosurgery
Radiosurgery - methods
Retrospective Studies
Treatment Outcome
Young Adult
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Summary:Some vestibular schwannoma (VS) show cystic morphology. It is known that these cystic VS bear different risk profiles compared to solid VS in surgical treatment. Still, there has not been a direct comparative study comparing both SRS and SURGERY effectiveness in cystic VS. This retrospective bi-center cohort study aims to analyze the management of cystic VS compared to solid VS in a dual center study with both microsurgery ( SURGERY ) and stereotactic radiosurgery ( SRS ). Cystic morphology was defined as presence of any T2-hyperintense and Gadolinium-contrast-negative cyst of any size in the pre-interventional MRI. A matched subgroup analysis was carried out by determining a subgroup of matched  SURGERY- treated solid VS and SRS -treated solid VS. Functional status, and post-interventional tumor volume size was then compared. From 2005 to 2011, N  = 901 patients with primary and solitary VS were treated in both study sites. Of these, 6% showed cystic morphology. The incidence of cystic VS increased with tumor size: 1.75% in Koos I, 4.07% in Koos II, 4.84% in Koos III, and the highest incidence with 15.43% in Koos IV. Shunt-Dependency was significantly more often in cystic VS compared to solid VS ( p  = 0.024) and patients with cystic VS presented with significantly worse Charlson Comorbidity Index (CCI) compared to solid VS ( p  
ISSN:1437-2320
0344-5607
1437-2320
DOI:10.1007/s10143-024-02495-w