Characterization of facial nerve outcomes following radiosurgery for vestibular schwannoma: a meta-analysis

Purpose Gamma Knife radiosurgery (GKRS) is a precise and efficacious treatment modality for vestibular schwannoma (VS) with favorable cranial nerve preservation rates. This study aims to better characterize facial nerve (FN) outcomes in VS after GKRS. Methods A query of six medical databases was con...

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Bibliographic Details
Published in:Acta neurochirurgica 2025-02, Vol.167 (1), p.30, Article 30
Main Authors: Hovis, Gabrielle E. A., Chandla, Anubhav, Pandey, Aryan, Teton, Zoe, Yang, Isaac
Format: Article
Language:English
Subjects:
Cranial nerves
Facial nerve
Facial Nerve - surgery
Facial Nerve Injuries - etiology
Facial Nerve Injuries - prevention & control
Female
Humans
Interventional Radiology
Male
Medicine
Medicine & Public Health
Meta-analysis
Middle Aged
Minimally Invasive Surgery
Neurology
Neuroma, Acoustic - pathology
Neuroma, Acoustic - radiotherapy
Neuroma, Acoustic - surgery
Neuroradiology
Neurosurgery
Preservation
Radiation
Radiosurgery
Radiosurgery - methods
Review
Review Article
Schwann cells
Surgical Orthopedics
Treatment Outcome
Tumor – Schwannoma
Tumors
Vestibular system
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Summary:Purpose Gamma Knife radiosurgery (GKRS) is a precise and efficacious treatment modality for vestibular schwannoma (VS) with favorable cranial nerve preservation rates. This study aims to better characterize facial nerve (FN) outcomes in VS after GKRS. Methods A query of six medical databases was conducted following PRISMA guidelines. Eligible studies exclusively reported VS managed with single-fraction GKRS and included House-Brackmann (HB) scale assessments prior to and following GKRS. Data was analyzed using random-effects modeling, and FN preservation was defined as HB I or II at last follow-up. Results Data was analyzed from 15 articles with 3,155 patients at an mean age of 55.0 years. Mean tumor volume, radiation dose, follow-up, tumor control, and hearing preservation were 4.28 cm 3 , 13.3 Gy, 59.4 months, 92.7%, and 62.6%, respectively. The pooled FN preservation rate was 92.9%. Mean preoperative tumor volume > 2.5 cm 3 and age > 60 years were significantly associated with worse preoperative FN function ( p  = 0.019, p  = 0.023, respectively). Normal FN function (HB = 1) at last follow up was 95.8% for VS volume 
ISSN:0942-0940
0001-6268
0942-0940
DOI:10.1007/s00701-024-06405-3