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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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| Published in: | Acta neurochirurgica 2025-02, Vol.167 (1), p.30, Article 30 |
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| container_title | Acta neurochirurgica |
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| creator | Hovis, Gabrielle E. A. Chandla, Anubhav Pandey, Aryan Teton, Zoe Yang, Isaac |
| description | 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 |
| doi_str_mv | 10.1007/s00701-024-06405-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11787209</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3162576538</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2713-3ac9e0a5de7c06f0a3bfd6242a42ff57e3a4c0cecc81f569f6e91734cf4a3c753</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi1ERUvhD3BAlrhwCfVX4oQLqlZ8SZW4tGdr1jvedXHsYidbLb8eQ0opHLiMLc8z7_jVS8gLzt5wxvRZqYXxhgnVsE6xtpGPyAkblGhqYY8f3I_J01KuGeNCK_mEHMuhH7jW_Qn5utpBBjth9t9h8inS5KgD6yHQiHmPNM2TTSMW6lII6dbHLc2w8anMeYv5UJ8z3WOZ_HoOkGmxu1uIMY3wlgIdcYIGIoRD8eUZOXIQCj6_O0_J1Yf3l6tPzcWXj59X5xeNFZrLRoIdkEG7QW1Z5xjItdt0QglQwrlWowRlmUVre-7abnAdVjNSWadAWt3KU_Ju0b2Z1yNuLMYpQzA32Y-QDyaBN393ot-ZbdobznWvBRuqwus7hZy-zdWcGX2xGAJETHMxknei1V0r-4q--ge9TnOujhdKyb4VvFJioWxOpWR097_hzPwM0yxhmhqm-RWmkXXo5UMf9yO_06uAXIBSW7Gm8Wf3f2R_AFr1rZM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3162438521</pqid></control><display><type>article</type><title>Characterization of facial nerve outcomes following radiosurgery for vestibular schwannoma: a meta-analysis</title><source>Springer Nature</source><creator>Hovis, Gabrielle E. A. ; Chandla, Anubhav ; Pandey, Aryan ; Teton, Zoe ; Yang, Isaac</creator><creatorcontrib>Hovis, Gabrielle E. A. ; Chandla, Anubhav ; Pandey, Aryan ; Teton, Zoe ; Yang, Isaac</creatorcontrib><description>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 < 2.5 cm
3
and 89.4% with larger volumes (
p
< 0.001). Doses ≤ 13 Gy were significantly associated with superior FN preservation (96.5%) compared to higher doses (
p
< 0.001). Tumor control and hearing preservation were not significantly associated with FN preservation.
Conclusion
This meta-analysis identifies tumor volume and radiation dose as prognostic factors for FN preservation. A FN preservation rate of 93% may be expected at five years after GKRS. This study provides a unique characterization of FN outcome that should be considered in the management of VS.</description><identifier>ISSN: 0942-0940</identifier><identifier>ISSN: 0001-6268</identifier><identifier>EISSN: 0942-0940</identifier><identifier>DOI: 10.1007/s00701-024-06405-3</identifier><identifier>PMID: 39891778</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>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</subject><ispartof>Acta neurochirurgica, 2025-02, Vol.167 (1), p.30, Article 30</ispartof><rights>The Author(s) 2025</rights><rights>2025. The Author(s).</rights><rights>Copyright Springer Nature B.V. Dec 2025</rights><rights>The Author(s) 2025 2025</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2713-3ac9e0a5de7c06f0a3bfd6242a42ff57e3a4c0cecc81f569f6e91734cf4a3c753</cites><orcidid>0000-0003-3744-5110</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39891778$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hovis, Gabrielle E. A.</creatorcontrib><creatorcontrib>Chandla, Anubhav</creatorcontrib><creatorcontrib>Pandey, Aryan</creatorcontrib><creatorcontrib>Teton, Zoe</creatorcontrib><creatorcontrib>Yang, Isaac</creatorcontrib><title>Characterization of facial nerve outcomes following radiosurgery for vestibular schwannoma: a meta-analysis</title><title>Acta neurochirurgica</title><addtitle>Acta Neurochir</addtitle><addtitle>Acta Neurochir (Wien)</addtitle><description>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 < 2.5 cm
3
and 89.4% with larger volumes (
p
< 0.001). Doses ≤ 13 Gy were significantly associated with superior FN preservation (96.5%) compared to higher doses (
p
< 0.001). Tumor control and hearing preservation were not significantly associated with FN preservation.
Conclusion
This meta-analysis identifies tumor volume and radiation dose as prognostic factors for FN preservation. A FN preservation rate of 93% may be expected at five years after GKRS. This study provides a unique characterization of FN outcome that should be considered in the management of VS.</description><subject>Cranial nerves</subject><subject>Facial nerve</subject><subject>Facial Nerve - surgery</subject><subject>Facial Nerve Injuries - etiology</subject><subject>Facial Nerve Injuries - prevention & control</subject><subject>Female</subject><subject>Humans</subject><subject>Interventional Radiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgery</subject><subject>Neurology</subject><subject>Neuroma, Acoustic - pathology</subject><subject>Neuroma, Acoustic - radiotherapy</subject><subject>Neuroma, Acoustic - surgery</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Preservation</subject><subject>Radiation</subject><subject>Radiosurgery</subject><subject>Radiosurgery - methods</subject><subject>Review</subject><subject>Review Article</subject><subject>Schwann cells</subject><subject>Surgical Orthopedics</subject><subject>Treatment Outcome</subject><subject>Tumor – Schwannoma</subject><subject>Tumors</subject><subject>Vestibular system</subject><issn>0942-0940</issn><issn>0001-6268</issn><issn>0942-0940</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNp9kU1v1DAQhi1ERUvhD3BAlrhwCfVX4oQLqlZ8SZW4tGdr1jvedXHsYidbLb8eQ0opHLiMLc8z7_jVS8gLzt5wxvRZqYXxhgnVsE6xtpGPyAkblGhqYY8f3I_J01KuGeNCK_mEHMuhH7jW_Qn5utpBBjth9t9h8inS5KgD6yHQiHmPNM2TTSMW6lII6dbHLc2w8anMeYv5UJ8z3WOZ_HoOkGmxu1uIMY3wlgIdcYIGIoRD8eUZOXIQCj6_O0_J1Yf3l6tPzcWXj59X5xeNFZrLRoIdkEG7QW1Z5xjItdt0QglQwrlWowRlmUVre-7abnAdVjNSWadAWt3KU_Ju0b2Z1yNuLMYpQzA32Y-QDyaBN393ot-ZbdobznWvBRuqwus7hZy-zdWcGX2xGAJETHMxknei1V0r-4q--ge9TnOujhdKyb4VvFJioWxOpWR097_hzPwM0yxhmhqm-RWmkXXo5UMf9yO_06uAXIBSW7Gm8Wf3f2R_AFr1rZM</recordid><startdate>20250201</startdate><enddate>20250201</enddate><creator>Hovis, Gabrielle E. A.</creator><creator>Chandla, Anubhav</creator><creator>Pandey, Aryan</creator><creator>Teton, Zoe</creator><creator>Yang, Isaac</creator><general>Springer Vienna</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3744-5110</orcidid></search><sort><creationdate>20250201</creationdate><title>Characterization of facial nerve outcomes following radiosurgery for vestibular schwannoma: a meta-analysis</title><author>Hovis, Gabrielle E. A. ; Chandla, Anubhav ; Pandey, Aryan ; Teton, Zoe ; Yang, Isaac</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2713-3ac9e0a5de7c06f0a3bfd6242a42ff57e3a4c0cecc81f569f6e91734cf4a3c753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Cranial nerves</topic><topic>Facial nerve</topic><topic>Facial Nerve - surgery</topic><topic>Facial Nerve Injuries - etiology</topic><topic>Facial Nerve Injuries - prevention & control</topic><topic>Female</topic><topic>Humans</topic><topic>Interventional Radiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgery</topic><topic>Neurology</topic><topic>Neuroma, Acoustic - pathology</topic><topic>Neuroma, Acoustic - radiotherapy</topic><topic>Neuroma, Acoustic - surgery</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Preservation</topic><topic>Radiation</topic><topic>Radiosurgery</topic><topic>Radiosurgery - methods</topic><topic>Review</topic><topic>Review Article</topic><topic>Schwann cells</topic><topic>Surgical Orthopedics</topic><topic>Treatment Outcome</topic><topic>Tumor – Schwannoma</topic><topic>Tumors</topic><topic>Vestibular system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hovis, Gabrielle E. A.</creatorcontrib><creatorcontrib>Chandla, Anubhav</creatorcontrib><creatorcontrib>Pandey, Aryan</creatorcontrib><creatorcontrib>Teton, Zoe</creatorcontrib><creatorcontrib>Yang, Isaac</creatorcontrib><collection>Springer Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Acta neurochirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hovis, Gabrielle E. A.</au><au>Chandla, Anubhav</au><au>Pandey, Aryan</au><au>Teton, Zoe</au><au>Yang, Isaac</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characterization of facial nerve outcomes following radiosurgery for vestibular schwannoma: a meta-analysis</atitle><jtitle>Acta neurochirurgica</jtitle><stitle>Acta Neurochir</stitle><addtitle>Acta Neurochir (Wien)</addtitle><date>2025-02-01</date><risdate>2025</risdate><volume>167</volume><issue>1</issue><spage>30</spage><pages>30-</pages><artnum>30</artnum><issn>0942-0940</issn><issn>0001-6268</issn><eissn>0942-0940</eissn><abstract>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 < 2.5 cm
3
and 89.4% with larger volumes (
p
< 0.001). Doses ≤ 13 Gy were significantly associated with superior FN preservation (96.5%) compared to higher doses (
p
< 0.001). Tumor control and hearing preservation were not significantly associated with FN preservation.
Conclusion
This meta-analysis identifies tumor volume and radiation dose as prognostic factors for FN preservation. A FN preservation rate of 93% may be expected at five years after GKRS. This study provides a unique characterization of FN outcome that should be considered in the management of VS.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><pmid>39891778</pmid><doi>10.1007/s00701-024-06405-3</doi><orcidid>https://orcid.org/0000-0003-3744-5110</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Acta neurochirurgica, 2025-02, Vol.167 (1), p.30, Article 30 |
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| source | Springer Nature |
| 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 |
| title | Characterization of facial nerve outcomes following radiosurgery for vestibular schwannoma: a meta-analysis |
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