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1. Ortigara L, Rosemberg N, Siqueira R, Neto F: Resection of a mediastinal schwannoma using video-assisted thoracoscopy. J Bras Pneumol; 2006 Mar-Apr;32(2):172-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Schwannomas are tumors that are typically benign.
  • They are derived from Schwann cells (glial cells of the peripheral nervous system that serve to separate and isolate nerve cells from adjacent structures).
  • The most common type of schwannoma is a benign tumor of cranial nerve VIII and is referred to as an acoustic neuroma.
  • When extradural, such tumors usually present as masses that can invade adjacent structures, thereby becoming symptomatic, as in the case of intrathoracic schwannomas (typically found in the posterior mediastinum).
  • [MeSH-major] Mediastinal Neoplasms / surgery. Neurilemmoma / surgery. Thoracic Surgery, Video-Assisted

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  • (PMID = 17273587.001).
  • [ISSN] 1806-3756
  • [Journal-full-title] Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia
  • [ISO-abbreviation] J Bras Pneumol
  • [Language] eng; por
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Brazil
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2. Chamadoira C, Cerejo A, Duarte F, Vaz R: [Trigeminal neuralgia caused by contra lateral cerebellopontine angle tumor. A case report]. Neurocirugia (Astur); 2010 Feb;21(1):50-2
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  • [Title] [Trigeminal neuralgia caused by contra lateral cerebellopontine angle tumor. A case report].
  • [Transliterated title] Neuralgia del trigémino provocada por un tumor del ángulo ponto-cerebeloso contralateral. Caso clínico.
  • In most cases, trigeminal neuralgia is due to compression of the trigeminal nerve in the zone of entrance at the pons by vascular structures.
  • Rarely, trigeminal neuralgia may be due to contralateral posterior fossa tumors.
  • We present a case of a 37-year- old patient who presented with right trigeminal neuralgia and harboured a left acoustic neuroma of significant dimension.
  • Facial pain completely disappeared after tumor removal.
  • [MeSH-major] Cerebellar Neoplasms / complications. Cerebellopontine Angle / pathology. Neuroma, Acoustic / complications. Trigeminal Neuralgia / etiology


3. Schoemaker MJ, Swerdlow AJ, Auvinen A, Christensen HC, Feychting M, Johansen C, Klaeboe L, Lönn S, Salminen T, Tynes T: Medical history, cigarette smoking and risk of acoustic neuroma: an international case-control study. Int J Cancer; 2007 Jan 1;120(1):103-10
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  • [Title] Medical history, cigarette smoking and risk of acoustic neuroma: an international case-control study.
  • Acoustic neuroma (vestibular schwannoma) is a benign tumor of the vestibulocochlear nerve.
  • Its recorded incidence is increasing but risk factors for this tumor have scarcely been investigated.
  • We conducted a population-based case-control study of risk factors for acoustic neuroma in the UK and Nordic countries, including 563 cases and 2,703 controls.
  • Tumor risk was analyzed in relation to medical history and cigarette smoking.
  • Risk of acoustic neuroma was significantly raised in parous compared with nulliparous women (OR = 1.7, 95% CI: 1.1-2.6), but was not related to age at first birth or number of children.
  • Risk was not associated with a history of allergic disease, past head injury, past diagnosis of a neoplasm or birth characteristics, but was significantly raised for past diagnosis of epilepsy (OR = 2.5, 95% CI: 1.3-4.9).
  • Tumor risk was significantly reduced in subjects who had ever regularly smoked cigarettes (OR = 0.7, 95% CI: 0.6-0.9), but the reduction applied only to current smokers (OR = 0.5, 95% CI: 0.4-0.6), not ex-smokers (OR = 1.0, 95% CI: 0.8-1.3).
  • The reduced risk of acoustic neuroma in smokers and raised risk in parous women might relate to sex hormone levels, or smoking might suppress tumor growth, but effects of parity and smoking on timing of diagnosis of the tumor are also a potential explanation.
  • The raised risk in relation to past diagnosis of epilepsy might be a surveillance artefact or imply that epilepsy and/or antiepileptic medication use predispose to acoustic neuroma.
  • [MeSH-major] Neuroma, Acoustic / etiology. Smoking / adverse effects


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4. Kalogeridi MA, Georgolopoulou P, Kouloulias V, Kouvaris J, Pissakas G: Long-term results of LINAC-based stereotactic radiosurgery for acoustic neuroma: the Greek experience. J Cancer Res Ther; 2009 Jan-Mar;5(1):8-13
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  • [Title] Long-term results of LINAC-based stereotactic radiosurgery for acoustic neuroma: the Greek experience.
  • PURPOSE: To estimate the value of LINAC-based stereotactic radiosurgery (SRS) for the long-term local control of unilateral acoustic neuromas.
  • MATERIALS AND METHODS: Twenty patients (median age 66; range 57-80 years) with unilateral acoustic neuroma underwent LINAC-based SRS from May 2000 through June 2004 with a dose of 11-12 Gy.
  • The follow-up consisted of repeat imaging studies and clinical examination for assessment of facial and trigeminal nerve function at 6-month intervals for the first year and yearly thereafter.
  • RESULTS: Eleven tumors (58%) decreased in size and eight (42%) remained stable.
  • One tumor showed a minor increase in size on the MRI done 6 months after SRS in comparison with the pretreatment MRI; however, a subsequent decrease was noticed on the next radiographic assessment and the tumor remained stable from then on.
  • None of the tumors increased in size in the long-term follow-up, thus giving an overall growth control of 100% for the patients in this study.
  • CONCLUSION: LINAC-based SRS with 11-12 Gy provides excellent tumor control in acoustic neuroma and has low toxicity even after long-term follow-up.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery

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  • (PMID = 19293482.001).
  • [ISSN] 1998-4138
  • [Journal-full-title] Journal of cancer research and therapeutics
  • [ISO-abbreviation] J Cancer Res Ther
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
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5. del Río L, Lassaletta L, Alfonso C, Sarriá MJ, Gavilán J: [Clinical tumoral size dissociation in acoustic neuroma: reality or measure distortion?]. Acta Otorrinolaringol Esp; 2006 Oct;57(8):345-9
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  • [Title] [Clinical tumoral size dissociation in acoustic neuroma: reality or measure distortion?].
  • [Transliterated title] Disociación clínica-tamaño tumoral en el neurinoma del acúistico: realidad o problema de medida?
  • INTRODUCTION: In this study we have analyzed (i) the audiometric frequencies more often affected in acoustic neuroma (AN), (ii) the percentage of patients presenting normal hearing and those with sudden hearing loss, (iii) if there is a correlation between tumor size and hearing loss, and (iv) the relationship between clinical and radiological parameters and audiological data.
  • RESULTS: The highest threshold in the tumor's ear was found at 8000 Hz, and the highest interaural difference at 4000 Hz.
  • No significant association was found between tumor size and hearing loss, preoperative facial palsy or Vth cranial nerve deficit.
  • There was a significant association between the degree of hearing loss and Vth cranial nerve deficit, and between hearing loss and preoperative facial palsy.
  • CONCLUSIONS: The association between hearing loss and Vth cranial nerve deficit, and between hearing loss and preoperative facial palsy is independent the size of the tumour.
  • [MeSH-major] Hearing Loss / etiology. Neuroma, Acoustic / complications. Neuroma, Acoustic / pathology

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  • (PMID = 17117690.001).
  • [ISSN] 0001-6519
  • [Journal-full-title] Acta otorrinolaringológica española
  • [ISO-abbreviation] Acta Otorrinolaringol Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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6. Koh ES, Millar BA, Ménard C, Michaels H, Heydarian M, Ladak S, McKinnon S, Rutka JA, Guha A, Pond GR, Laperriere NJ: Fractionated stereotactic radiotherapy for acoustic neuroma: single-institution experience at The Princess Margaret Hospital. Cancer; 2007 Mar 15;109(6):1203-10
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  • [Title] Fractionated stereotactic radiotherapy for acoustic neuroma: single-institution experience at The Princess Margaret Hospital.
  • BACKGROUND: The clinical outcome and toxicity of fractionated stereotactic radiotherapy (FSRT) was assessed for acoustic neuroma in 60 patients treated in a single institution.
  • METHODS: Between October 1996 and February 2005, 60 patients received FSRT for acoustic neuroma (AN).
  • The median irradiated tumor volume was 4.9 cm(3) (range, 0.3-49.0 cm(3)).
  • Five of 6 patients with initial cranial nerve V (CNV) numbness remained stable post-FSRT.
  • All 3 patients with nonsurgically related facial nerve weakness either improved or achieved stability in function.
  • There were no cases of new cranial nerve toxicity post-FSRT.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / adverse effects
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Cranial Nerves / surgery. Female. Hearing Loss / epidemiology. Humans. Magnetic Resonance Imaging. Male. Microsurgery / adverse effects. Microsurgery / methods. Middle Aged. Retrospective Studies. Treatment Outcome

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  • (PMID = 17318817.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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7. Wandong S, Meng L, Xingang L, Yuguang L, Shugan Z, Lei W, Chengyuan W: Cystic acoustic neuroma. J Clin Neurosci; 2005 Apr;12(3):253-5
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  • [Title] Cystic acoustic neuroma.
  • To define the clinical characteristics of cystic acoustic neuroma, we retrospectively analyzed 22 patients with cystic acoustic neuroma and reviewed the literature with regard to clinical manifestation, imaging features, diagnosis, surgical procedures and prognosis.
  • An acoustic neuroma was defined as cystic according to the following criteria: the presence of hypodense/hypointense areas on CT or MRI, the identification of cystic elements at operation and histological verification.
  • At the end of surgery, the facial nerve was anatomically intact in 86.4% of cystic acoustic neuromas.
  • Complete removal of the tumor was achieved in 18 cases (81.8%).
  • We conclude that patients with cystic acoustic neuroma need prompt surgery with special attention paid to the preservation of the facial nerve.
  • [MeSH-major] Neuroma, Acoustic / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Facial Nerve / surgery. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neurosurgical Procedures. Prognosis. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 15851076.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Scotland
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8. Hours M, Bernard M, Montestrucq L, Arslan M, Bergeret A, Deltour I, Cardis E: [Cell Phones and Risk of brain and acoustic nerve tumours: the French INTERPHONE case-control study]. Rev Epidemiol Sante Publique; 2007 Oct;55(5):321-32
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  • [Title] [Cell Phones and Risk of brain and acoustic nerve tumours: the French INTERPHONE case-control study].
  • To evaluate the relationship between the use of cell phones and the development of tumors of the head, a multicentric international study (INTERPHONE), coordinated by the International Agency for Research on Cancer, was carried out in 13 countries.
  • METHODS: INTERPHONE is a case-control study focused on tumors of the brain and central nervous system: gliomas, meningiomas and neuromas of cranial nerves.
  • Eligible cases were men and women, residents of Paris or Lyon, aged 30-59, newly diagnosed with a first primary tumor between February 2001 and August 2003.
  • [MeSH-major] Brain Neoplasms / etiology. Cell Phones. Neuroma, Acoustic / etiology
  • [MeSH-minor] Adult. Case-Control Studies. Central Nervous System Neoplasms / etiology. Cranial Nerve Neoplasms / etiology. Female. Glioblastoma / etiology. Glioma / etiology. Humans. Male. Meningioma / etiology. Middle Aged. Neuroma / etiology. Risk Factors. Time Factors

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  • (PMID = 17851009.001).
  • [ISSN] 0398-7620
  • [Journal-full-title] Revue d'épidémiologie et de santé publique
  • [ISO-abbreviation] Rev Epidemiol Sante Publique
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Multicenter Study
  • [Publication-country] France
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9. Hillman T, Chen DA, Arriaga MA, Quigley M: Facial nerve function and hearing preservation acoustic tumor surgery: does the approach matter? Otolaryngol Head Neck Surg; 2010 Jan;142(1):115-9
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  • [Title] Facial nerve function and hearing preservation acoustic tumor surgery: does the approach matter?
  • OBJECTIVE: The retrosigmoid and middle fossa approaches to acoustic tumor excision allow for hearing preservation but differ in the angle of approach to the facial nerve.
  • The authors comparatively examined facial nerve results of each approach.
  • SUBJECTS AND METHODS: The authors reviewed facial nerve outcomes of patients undergoing acoustic tumor excision at a single subspecialty practice that had used a hearing preservation approach for the past 15 years.
  • RESULTS: One hundred thirty-eight patients had adequate data for inclusion in this study.
  • There were more recurrent/residual tumors in the retrosigmoid group and better hearing preservation in the middle fossa group.
  • CONCLUSION: There are small but important functional outcome differences between the retrosigmoid and middle fossa approach for acoustic tumors.
  • [MeSH-major] Facial Nerve / physiology. Hearing. Neuroma, Acoustic / surgery

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  • (PMID = 20096234.001).
  • [ISSN] 1097-6817
  • [Journal-full-title] Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • [ISO-abbreviation] Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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10. Brackmann DE, Green JD Jr: Translabyrinthine approach for acoustic tumor removal. 1992. Neurosurg Clin N Am; 2008 Apr;19(2):251-64, vi
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  • [Title] Translabyrinthine approach for acoustic tumor removal. 1992.
  • It is the preferred approach for removal of all tumors in patients with poor hearing and for large tumors when the likelihood of hearing preservation is slight.
  • This approach offers the advantages of minimum cerebellar retraction, identification of the facial nerve proximally and medially, and the ability to repair immediately the facial nerve if it is severed during acoustic tumor removal.
  • [MeSH-major] Neuroma, Acoustic / history. Neurosurgical Procedures / history. Otologic Surgical Procedures / history

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  • (PMID = 18534338.001).
  • [ISSN] 1558-1349
  • [Journal-full-title] Neurosurgery clinics of North America
  • [ISO-abbreviation] Neurosurg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Biography; Classical Article; Historical Article; Journal Article
  • [Publication-country] United States
  • [Personal-name-as-subject] Brackmann DE; Green JD Jr
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11. Patni AH, Kartush JM: Staged resection of large acoustic neuromas. Otolaryngol Head Neck Surg; 2005 Jan;132(1):11-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Staged resection of large acoustic neuromas.
  • OBJECTIVE: Surgical removal of large (>3 cm) acoustic neuromas is associated with poor long-term facial nerve function results and higher complication rates.
  • This study analyzes whether long term facial nerve function and the incidence of neurological and vascular complications is improved by resection of large acoustic neuromas in 2 or 3 stages.
  • PATIENTS AND METHODS: Among 660 patients who underwent surgical resection of acoustic neuromas between 1989 and 2002 by the senior author (J.M.K.
  • ), 34 (5%) patients underwent a staged resection of their large-sized tumors: stage I via a retrosigmoid craniotomy and stage II via a translabyrinthine approach.
  • Tumor size, completeness of tumor removal, tumor recurrence, facial nerve function, and any complications were noted.
  • RESULTS: The average tumor size was 4.4 cm with a mean postoperative length of follow-up of 6 years after the last surgery.
  • There were no tumor recurrences on follow-up MRI scans.
  • CONCLUSION: In conjunction with the reported technical refinements, staged resection of large tumors significantly reduces morbidity and improves long-term facial nerve function.
  • [MeSH-major] Neuroma, Acoustic / surgery
  • [MeSH-minor] Facial Nerve / physiology. Facial Nerve Diseases / prevention & control. Female. Follow-Up Studies. Humans. Male. Otologic Surgical Procedures / adverse effects. Otologic Surgical Procedures / methods. Postoperative Complications / epidemiology. Postoperative Complications / etiology. Retrospective Studies

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  • (PMID = 15632903.001).
  • [ISSN] 0194-5998
  • [Journal-full-title] Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • [ISO-abbreviation] Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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12. Lei T, Li L: [Prevention of facial nerve injury in acoustic neuroma microsurgery]. Zhonghua Wai Ke Za Zhi; 2008 Jan 1;46(1):58-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Prevention of facial nerve injury in acoustic neuroma microsurgery].
  • OBJECTIVE: To summarize and analyse the techniques of avoiding facial nerve injury during acoustic neuroma microsurgery.
  • METHODS: One hundred and eighty patients with large acoustic neuroma (> or =4 cm) and 70 patients with medium acoustic neuroma (2.4-4.0 cm) were diagnosed by MRI/ CT scan before operation and confirmed by postoperative pathologic examination.
  • All of patients were treated by sub-occipital retrosigmoid approach for tumor removal and facial nerve reservation during operation.
  • The relationships among the bone, arachnoid, nerve and vascular anatomy were particularly observed during the operation.
  • After decompression of the tumor, the origination and location of the facial nerve as well as the relationship between the tumor and the facial nerve should be identified.
  • The patients were followed-up from 6 months to 1 year postoperatively and assessed by House-Brackmann facial nerve function grading system.
  • RESULTS: Total tumor resection was achieved in 240 of 250 cases (96%) and subtotal in 10 cases including 1 case died because of cerebellar encephalomalacia after operation.
  • According to the House-Brackmann facial nerve function grading, recovery of normal function (grade I) was achieved in 214 cases (85.6%), grade II in 25 cases (10%), grade III in 5 cases (2.09%) and grade IV in 5 cases (2.09%).
  • CONCLUSION: Microneurosurgical techniques are helpful for total resection of acoustic neuroma and keeping facial nerve anatomic intact.
  • [MeSH-major] Facial Nerve Injuries / prevention & control. Intraoperative Complications / prevention & control. Microsurgery / methods. Neuroma, Acoustic / surgery

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  • (PMID = 18510007.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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13. Cohen NL: Retrosigmoid approach for acoustic tumor removal. 1992. Neurosurg Clin N Am; 2008 Apr;19(2):239-50, vi
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Retrosigmoid approach for acoustic tumor removal. 1992.
  • This approach may be used for acoustic neuromas of all sizes, from intracanalicular, to more than 4 cm from the porus acusticus.
  • The facial nerve is readily visualized at the lateral end of the IAC and is at no greater risk than in the translabyrinthine operation.
  • The authors use this approach for all hearing preservation surgery as well as for tumors of more than 3 cm, regardless of hearing.
  • [MeSH-major] Craniotomy / history. Neuroma, Acoustic / history

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  • (PMID = 18534337.001).
  • [ISSN] 1558-1349
  • [Journal-full-title] Neurosurgery clinics of North America
  • [ISO-abbreviation] Neurosurg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Biography; Classical Article; Historical Article; Journal Article
  • [Publication-country] United States
  • [Personal-name-as-subject] Cohen NL
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14. van Eck AT, Horstmann GA: Increased preservation of functional hearing after gamma knife surgery for vestibular schwannoma. J Neurosurg; 2005 Jan;102(s_supplement):204-206
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Increased preservation of functional hearing after gamma knife surgery for vestibular schwannoma.
  • OBJECT: Gamma knife surgery (GKS) for vestibular schwannoma is still associated with an additional hearing loss of approximately 30%.
  • METHODS: Seventy-eight of 95 patients who entered a prospective protocol with a follow up of at least 12 months (mean 22 months) were evaluated.
  • The mean tumor volume was 2.28 cm<sup>3</sup>.
  • After a mean follow-up duration of 22 months, the magnetic resonance imaging-based tumor control rate was 87%.
  • One patient suffered transient facial nerve impairment.
  • CONCLUSIONS: Reducing the maximum dose to 20 Gy seems to be an effective treatment, which probably increases preservation of functional hearing without sacrificing the high tumor control rates achieved in radiosurgery.
  • Post-radiosurgery tumor swelling occurred in 25% of the cases and was not correlated with hearing deterioration.

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  • (PMID = 28306452.001).
  • [ISSN] 1933-0693
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Keywords] NOTNLM ; acoustic neurinoma / gamma knife surgery / hearing preservation / tumor swelling / vestibular schwannoma
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15. House WF, Shelton C: Middle fossa approach for acoustic tumor removal. 1992. Neurosurg Clin N Am; 2008 Apr;19(2):279-88, vi
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Middle fossa approach for acoustic tumor removal. 1992.
  • The middle fossa approach is useful for the removal of small acoustic tumors when hearing preservation is possible.
  • This approach provides complete exposure of the contents of the internal auditory canal and positive facial nerve identification.
  • Because access to the posterior fossa is limited, the middle fossa approach is most appropriate for tumors with less than 5 mm extension into the cerebellopontine angle.
  • With the introduction of gadolinium-enhanced magnetic resonance imaging, very small acoustic tumors are diagonosed more frequently, and the middle fossa approach is well-suited for the removal of these tumors.
  • [MeSH-major] Craniotomy / history. Neuroma, Acoustic / history
  • [MeSH-minor] Cranial Fossa, Middle. History, 20th Century. Humans

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  • (PMID = 18534340.001).
  • [ISSN] 1558-1349
  • [Journal-full-title] Neurosurgery clinics of North America
  • [ISO-abbreviation] Neurosurg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Biography; Classical Article; Historical Article; Journal Article
  • [Publication-country] United States
  • [Personal-name-as-subject] House WF; Shelton C
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16. Mazzoni A, Dubey SP, Poletti AM, Colombo G: Sporadic acoustic neuroma in pediatric patients. Int J Pediatr Otorhinolaryngol; 2007 Oct;71(10):1569-72
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Sporadic acoustic neuroma in pediatric patients.
  • OBJECTIVE: Sporadic acoustic neuroma, usually occur between the ages of 40 and 70 years, are very rare in children.
  • We review the experiences of 10 cases of sporadic (non-NF2) acoustic neuromas in pediatric patients.
  • Among these almost 900 cases were acoustic neuromas.
  • Deafness were the commonest presentation and were seen in eight patients.
  • Among these eight cases, two patients have sudden onset of hearing loss.
  • The diameter of the tumors varied widely with minimum of 10 mm to maximum up to 60 mm.
  • Five patients each underwent resection of the tumor by translabyrinthine and retrosigmoid approach, respectively.
  • Postoperatively seven cases the facial nerve recovered to grade I, and one each to grade II and grade VI of House-Brackmann classification.
  • The youngest patient with largest tumor diameter of 60 mm developed transient hemiparesis in the immediate postoperative period and he recovered fully in due course.
  • CONCLUSION: We found preservation of facial nerve function is more easier than hearing in this group of patients.
  • [MeSH-major] Neuroma, Acoustic / epidemiology
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Female. Hearing Loss, Sensorineural / diagnosis. Hearing Loss, Sensorineural / epidemiology. Humans. Incidence. Male. Paresis / diagnosis. Paresis / epidemiology. Paresis / etiology. Postoperative Complications. Prevalence. Tomography, X-Ray Computed

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  • (PMID = 17643497.001).
  • [ISSN] 0165-5876
  • [Journal-full-title] International journal of pediatric otorhinolaryngology
  • [ISO-abbreviation] Int. J. Pediatr. Otorhinolaryngol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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17. Chang SD, Gibbs IC, Sakamoto GT, Lee E, Oyelese A, Adler JR Jr: Staged stereotactic irradiation for acoustic neuroma. Neurosurgery; 2005 Jun;56(6):1254-61; discussion 1261-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Staged stereotactic irradiation for acoustic neuroma.
  • OBJECTIVE: Stereotactic radiosurgery has proven effective in the treatment of acoustic neuromas.
  • Prior reports using single-stage radiosurgery consistently have shown excellent tumor control, but only up to a 50 to 73% likelihood of maintaining hearing at pretreatment levels.
  • Staged, frame-based radiosurgery using 12-hour interfraction intervals previously has been shown by our group to achieve excellent tumor control while increasing the rate of hearing preservation at 2 years to 77%.
  • The arrival of CyberKnife (Accuray, Inc., Sunnyvale, CA) image-guided radiosurgery now makes it more practical to treat acoustic neuroma with a staged approach.
  • We hypothesize that such factors may further minimize injury of adjacent cranial nerves.
  • In this retrospective study, we report our experience with staged radiosurgery for managing acoustic neuromas.
  • METHODS: Since 1999, the CyberKnife has been used to treat more than 270 patients with acoustic neuroma at Stanford University.
  • Among the treated patients, the mean transverse tumor diameter was 18.5 mm, whereas the total marginal dose was either 18 or 21 Gy using three 6- or 7-Gy fractions.
  • Only one treated tumor (2%) progressed after radiosurgery; 29 (48%) of 61 decreased in size and 31 (50%) of the 61 tumors were stable.
  • In no patients did new trigeminal dysfunction develop, nor did any patient experience permanent injury to their facial nerve; two patients experienced transient facial twitching that resolved in 3 to 5 months.
  • CONCLUSION: Although still preliminary, these results indicate that improved tumor dose homogeneity and a staged treatment regimen may improve hearing preservation in acoustic neuroma patients undergoing stereotactic radiosurgery.
  • [MeSH-major] Cranial Nerve Neoplasms / surgery. Neuroma, Acoustic / surgery. Radiosurgery / methods

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  • (PMID = 15918941.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] United States
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18. Zhang X, Fei Z, Chen YJ, Fu LA, Zhang JN, Liu WP, He XS, Jiang XF: Facial nerve function after excision of large acoustic neuromas via the suboccipital retrosigmoid approach. J Clin Neurosci; 2005 May;12(4):405-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Facial nerve function after excision of large acoustic neuromas via the suboccipital retrosigmoid approach.
  • We review our results for facial nerve preservation in 105 patients with large acoustic neuromas (diameter 4.0 cm or larger) undergoing excision via the suboccipital retrosigmoid approach.
  • Microneurosurgical techniques and facial nerve monitoring were used.
  • Complete tumor removal was achieved in 91 cases (86.7%) and subtotal removal in 14 (13.3%).
  • The facial nerve was preserved anatomically in 83 (79.1%) patients.
  • Using the House-Brackmann grading system, facial nerve function was assessed immediately after surgery, at the time of discharge and 1 year after surgery.
  • The suboccipital retrosigmoid approach resulted in good anatomical and functional preservation of the facial nerve during excision of large acoustic neuromas, with minimal other morbidity and low mortality.
  • We recommend this approach for excision of large acoustic neuromas.
  • [MeSH-major] Facial Nerve / physiopathology. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods. Occipital Bone / surgery. Otologic Surgical Procedures / methods

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  • (PMID = 15925770.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Scotland
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19. Zhao X, Wang Z, Ji Y, Wang C, Yu R, Ding X, Wei S: Long-term facial nerve function evaluation following surgery for large acoustic neuromas via retrosigmoid transmeatal approach. Acta Neurochir (Wien); 2010 Oct;152(10):1647-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term facial nerve function evaluation following surgery for large acoustic neuromas via retrosigmoid transmeatal approach.
  • PURPOSE: By evaluating the postoperative facial nerve function of large acoustic neuromas, the purpose of this study was to analyze the factors that influence the facial nerve function outcome and to explore the surgical strategy for large acoustic neuromas.
  • METHODS: A retrospective study of surgical outcome was performed on 89 patients with large acoustic neuromas.
  • The facial nerve was anatomically intact at the end of surgery in 83 (93.3%) patients.
  • At 1 year after surgery, 48 (53.9%) patients had good facial nerve function (House-Brackmann (HB) Grades I-II), 23 (25.8%) patients had regular facial nerve function (HB Grades III-IV), and 18 (20.2%) patients had poor facial nerve function (HB Grades V-VI).
  • CONCLUSIONS: For large acoustic neuromas, the goal of complete tumor resection and preservation of acceptable facial nerve function can be attained via the retrosigmoid transmeatal approach, using the intraoperative facial nerve monitoring.
  • The surgical strategy of near total resection is indicated for the large acoustic neuromas with severe adherence or inclusion in order to preserve facial nerve function.
  • [MeSH-major] Craniotomy / methods. Facial Nerve / surgery. Facial Nerve Injuries / physiopathology. Facial Nerve Injuries / prevention & control. Neuroma, Acoustic / physiopathology. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods. Postoperative Complications / physiopathology

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  • (PMID = 20544362.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Austria
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20. Brackmann DE, Fisher LM, Hansen M, Halim A, Slattery WH: The effect of famciclovir on delayed facial paralysis after acoustic tumor resection. Laryngoscope; 2008 Sep;118(9):1617-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The effect of famciclovir on delayed facial paralysis after acoustic tumor resection.
  • STUDY DESIGN: Prospective evaluation of facial nerve grade for two groups (treated and untreated) with famciclovir before and after surgery.
  • METHODS: In a tertiary neurotologic private practice, the percentage of 1,023 patients with delayed facial paresis after undergoing microsurgical removal of unilateral acoustic tumor with no preoperative treatment was compared to the percentage of 530 patients with preoperative famciclovir treatment.
  • The House-Brackmann Facial Nerve Grade was assessed prospectively at preoperative, immediate postoperative, and discharge from the hospital in both groups.
  • We are continuing the routine use of famciclovir in perioperative acoustic tumor management and recommend that others do so.
  • [MeSH-major] 2-Aminopurine / analogs & derivatives. Cochlear Nerve. Cranial Nerve Neoplasms / surgery. Craniotomy / methods. Facial Paralysis / prevention & control. Microsurgery / methods

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  • (PMID = 18596563.001).
  • [ISSN] 1531-4995
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antiviral Agents; 0 / Prodrugs; 104227-87-4 / famciclovir; 452-06-2 / 2-Aminopurine
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21. Durko M, Jankowski A, Durko T, Gajewicz W, Pajor A: [Coexistence of acoustic neuroma and pineal region tumor in patient with sudden deafness]. Otolaryngol Pol; 2008;62(2):204-8
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  • [Title] [Coexistence of acoustic neuroma and pineal region tumor in patient with sudden deafness].
  • INTRODUCTION: Acoustic neuroma usually presents as an unilateral tumor, seldom - bilateral and rarely in coexistence with other central nervous system neoplasms.
  • Audiometry revealed moderate sensorineural hearing loss in left ear (for low and middle frequencies), brainstem auditory evoked potentials were absent on the left side and ENG examination showed left peripheral vestibular impairment.
  • MRI study revealed in the left internal acoustic meatus mass (7 x 7 x 14 mm) suggesting acoustic neuroma and an oval mass (7 x 9 x 14 mm) in the pineal gland presenting radiological features of pinealoma.
  • Acoustic neuroma has been removed by suboccipital approach and pinealoma has been left for further observation as it was found incidentally.
  • Histopathological examination confirmed diagnosis of left VIII nerve schwannoma.
  • The postoperative course shows no evidence of acoustic neuroma recurrence.
  • [MeSH-major] Deafness / etiology. Neoplasms, Second Primary / diagnosis. Neuroma, Acoustic / diagnosis. Pinealoma / diagnosis
  • [MeSH-minor] Adult. Audiometry, Pure-Tone. Hearing Loss, Sensorineural / diagnosis. Hearing Loss, Sensorineural / etiology. Humans. Male. Tinnitus / diagnosis. Tinnitus / etiology. Treatment Outcome. Vertigo / diagnosis. Vertigo / etiology


22. Chopra R, Kondziolka D, Niranjan A, Lunsford LD, Flickinger JC: Long-term follow-up of acoustic schwannoma radiosurgery with marginal tumor doses of 12 to 13 Gy. Int J Radiat Oncol Biol Phys; 2007 Jul 1;68(3):845-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term follow-up of acoustic schwannoma radiosurgery with marginal tumor doses of 12 to 13 Gy.
  • PURPOSE: To define long-term tumor control and clinical outcomes of radiosurgery with marginal tumor doses of 12 to 13 Gy for unilateral acoustic schwannoma.
  • METHODS AND MATERIALS: A total of 216 patients with previously untreated unilateral acoustic schwannoma underwent Gamma Knife radiosurgery between 1992 and 2000 with marginal tumor doses of 12 to 13 Gy (median, 13 Gy).
  • Three patients required tumor resection: 2 for tumor growth and 1 partial resection for an enlarging adjacent subarachnoid cyst.
  • For 25 of these patients with intracanalicular tumors, the respective rates for preserving the same Gardner-Robertson level, serviceable hearing, and testable hearing were 80%, 88%, and 96%.
  • Ten-year actuarial rates for preserving the same Gardner-Robertson hearing levels, serviceable hearing, any testable hearing, and unchanged facial and trigeminal nerve function were 44.0% +/- 11.7%, 44.5% +/- 10.5%, 85.3% +/- 6.2%, 100%, and 94.9% +/- 1.8%, respectively.
  • CONCLUSIONS: Acoustic schwannoma radiosurgery with 12 to 13 Gy provides high rates of long-term tumor control and cranial nerve preservation after long-term follow-up.
  • [MeSH-major] Cranial Nerve Diseases / epidemiology. Hearing Disorders / epidemiology. Neuroma, Acoustic / mortality. Neuroma, Acoustic / surgery. Radiation Injuries / mortality. Radiosurgery / mortality. Risk Assessment / methods


23. Liu BY, Tian YJ, Liu W, Liu SL, Qiao H, Zhang JT, Jia GJ: Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma. Chin Med J (Engl); 2007 Feb 20;120(4):323-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma.
  • The aim of this study was to investigate the effect of intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation on preservation of facial nerve function.
  • METHOD: From January to November 2005, 19 patients with large acoustic neuroma were treated using intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation (TCEMEP) for preservation of facial nerve function.
  • The relationship between the decrease of MEP amplitude after tumor removal and the postoperative function of the facial nerve was analyzed.
  • CONCLUSIONS: Intraoperative TCEMEP can be used to predict postoperative function of the facial nerve.
  • [MeSH-major] Electric Stimulation Therapy. Evoked Potentials, Motor. Facial Nerve / physiopathology. Monitoring, Intraoperative. Neuroma, Acoustic / physiopathology


24. Lin VY, Houlden D, Bethune A, Nolan M, Pirouzmand F, Rowed D, Nedzelski JM, Chen JM: A novel method in predicting immediate postoperative facial nerve function post acoustic neuroma excision. Otol Neurotol; 2006 Oct;27(7):1017-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A novel method in predicting immediate postoperative facial nerve function post acoustic neuroma excision.
  • To determine whether the percentage calculated by dividing the amplitude of postexcision direct facial nerve stimulus responses (at pontomedullary junction) by the amplitude of distal ipsilateral transcutaneous (stylomastoid region) maximal stimulus responses and response amplitude progression by increasing stimulus intensities have predictive value for determining normal or near-normal (House-Brackmann Grade 1 or 2) immediate postoperative facial nerve function.
  • Postexcision direct facial nerve stimulation at the pontomedullary junction and transcutaneous maximal facial nerve stimulation at the ipsilateral stylomastoid region and their associated response amplitudes were recorded.
  • PATIENTS AND METHODS: Patients who underwent acoustic neuroma surgery from January 2004 to March 2006 with intraoperative facial nerve monitoring and an intact facial nerve after tumor excision were included.
  • CONCLUSION: The percentage of the response amplitude of direct facial nerve stimulation at the pontomedullary junction when compared with the maximum response amplitude of ipsilateral transcutaneous stimulation at the stylomastoid foramen is a good predictor of normal to near-normal immediate postoperative facial nerve function.
  • Progression of amplitude response also seems to be a good predictor of normal to near-normal immediate postoperative facial nerve function.
  • [MeSH-major] Facial Nerve / physiopathology. Monitoring, Intraoperative. Neuroma, Acoustic / surgery
  • [MeSH-minor] Adult. Aged. Electric Stimulation. Facial Nerve Injuries / prevention & control. Facial Paralysis / prevention & control. Female. Humans. Male. Middle Aged. Predictive Value of Tests. Treatment Outcome

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  • (PMID = 17006353.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Yang SM, Yu LM, Han DY, Guo WW, Hu YY, Sun JH, Yang WY: [Relevance between clinical behavior and bionomical findings of acoustic neuromas]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2008 Feb;43(2):125-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Relevance between clinical behavior and bionomical findings of acoustic neuromas].
  • OBJECTIVE: To evaluate the relationship between labeling index (LI) Ki-67, proliferating cell nuclear antigen (PCNA) and transforming growth factor-beta1 (TGF-beta1) with the clinical behavior of acoustic neuroma.
  • METHODS: Expression of Ki-67, PCNA and TGF-beta1 was detected by immunohistochemistry in 53 specimens of acoustic neuromas.
  • The relationship among tumor proliferation, histological representation, size of tumor, clinical proliferation index of tumor and tumor proliferation activity were analyzed.
  • Cystic degeneration often occurred in large-size tumor (Z = 4.44, P < 0.05).
  • CONCLUSIONS: Ki-67 and PCNA are reflected proliferation activities of tumor cells in acoustic neuromas.
  • TGF-beta1 might participate in the biological behavior of acoustic neuroma.
  • Cystic degeneration was one of special pattern of acoustic neuroma, however, tumor enlargement might due to the volume of the cystic but unrelated to fast proliferation of parenchyma cell.
  • [MeSH-major] Ki-67 Antigen / metabolism. Neuroma, Acoustic / metabolism. Proliferating Cell Nuclear Antigen / metabolism. Transforming Growth Factor beta1 / metabolism. Vestibulocochlear Nerve

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  • (PMID = 18510217.001).
  • [ISSN] 1673-0860
  • [Journal-full-title] Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
  • [ISO-abbreviation] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 0 / Proliferating Cell Nuclear Antigen; 0 / Transforming Growth Factor beta1
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26. Gal TJ, Shinn J, Huang B: Current epidemiology and management trends in acoustic neuroma. Otolaryngol Head Neck Surg; 2010 May;142(5):677-81
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Current epidemiology and management trends in acoustic neuroma.
  • OBJECTIVE: The objective of this study was to assess the epidemiology of acoustic neuroma and determine current trends in therapy using tumor registry techniques.
  • SUBJECTS AND METHODS: The Surveillance Epidemiology and End Results (SEER) database is a national tumor registry that began to identify and abstract benign and borderline tumors of the brain and central nervous system in the year 2004.
  • Coding for International Classification of Diseases for Oncology (ICD-O-3) codes for schwannoma (9560/0) with collaborative staging (CS) coding for acoustic nerve (72.4) was used to identify acoustic neuromas.
  • Demographic data, tumor size, and treatment data were analyzed.
  • RESULTS: A total of 1621 patients with acoustic neuroma were identified, for an incidence rate of 1.1/100,000.
  • Tumors were equally distributed across gender and tumor laterality, with the majority (84%) occurring in Caucasians.
  • Of tumors less than 2 cm, 27.2 percent were treated with radiotherapy.
  • Statistically significant associations were observed with the increased use of radiotherapy for small (< 2 cm) tumors (P = 0.0001).
  • [MeSH-major] Neuroma, Acoustic / epidemiology. Neuroma, Acoustic / therapy


27. Fayad JN, Schwartz MS, Slattery WH, Brackmann DE: Prevention and treatment of cerebrospinal fluid leak after translabyrinthine acoustic tumor removal. Otol Neurotol; 2007 Apr;28(3):387-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prevention and treatment of cerebrospinal fluid leak after translabyrinthine acoustic tumor removal.
  • OBJECTIVE: To determine the incidence rate of cerebrospinal fluid (CSF) leak after translabyrinthine acoustic tumor removal using titanium mesh cranioplasty and to compare with previous series and historical controls.
  • PATIENTS: The series of 389 patients who underwent titanium mesh cranioplasty after translabyrinthine tumor removal between March 2003 and July 2005.
  • The results were compared with those in a group of 1,195 translabyrinthine tumor removal patients from our previously published series and with those in a group of 324 patients from the immediately preceding two-year period.
  • INTERVENTION: Cranioplasty using titanium mesh after acoustic tumor removal.
  • CONCLUSION: In our hands, titanium mesh cranioplasty seems to reduce the rate of CSF leaks after the translabyrinthine removal of acoustic tumors.
  • [MeSH-major] Cerebrospinal Fluid Otorrhea / etiology. Cerebrospinal Fluid Otorrhea / prevention & control. Cochlear Nerve / pathology. Cochlear Nerve / surgery. Cranial Nerve Neoplasms / pathology. Cranial Nerve Neoplasms / surgery. Otologic Surgical Procedures / methods. Postoperative Complications / prevention & control

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  • (PMID = 17414045.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biocompatible Materials; D1JT611TNE / Titanium
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28. McClelland S 3rd, Gerbi BJ, Higgins PD, Orner JB, Hall WA: Safety and efficacy of fractionated stereotactic radiotherapy for acoustic neuromas. J Neurooncol; 2008 Jan;86(2):191-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Safety and efficacy of fractionated stereotactic radiotherapy for acoustic neuromas.
  • BACKGROUND: The treatment of acoustic neuromas (AN) has historically involved surgical excision or stereotactic radiosurgery, with a relatively limited number of reports available describing the use of fractionated stereotactic radiotherapy (FSRT).
  • Median tumor size (maximum diameter) was 2.1 cm (range, 1.1-3.4 cm).
  • RESULTS: Following FSRT, local tumor control was achieved in every patient, with the treatment well-tolerated by all patients.
  • No patient experienced acute complications or facial nerve weakness.
  • Two patients experienced permanent trigeminal nerve morbidity manifesting as facial numbness.
  • CONCLUSION: In our series of 20 patients with AN, all had local tumor control following FSRT, with minimal morbidity.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / methods. Stereotaxic Techniques
  • [MeSH-minor] Adult. Aged. Dose Fractionation. Female. Follow-Up Studies. Hearing Loss / etiology. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Retrospective Studies. Treatment Outcome. Trigeminal Nerve / surgery

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  • (PMID = 17622486.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Netherlands
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29. Yonekawa Y: [Operative neurosurgery: personal view and historical backgrounds (2) acoustic neurinoma]. No Shinkei Geka; 2006 Dec;34(12):1265-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Operative neurosurgery: personal view and historical backgrounds (2) acoustic neurinoma].
  • Microsurgical removal of acoustic neurinoma is still one of the challenging topics in neurosurgery in spite of the development of Gamma-knife or radiosurgery, with which small and moderate sized tumors can be treated.
  • Surgical technique necessitates more expertise in dealing with larger tumors.
  • In this report ongoing microsurgical standard technique for removal of acoustic neurinomas of approx.
  • 3) Intracapsular enucleation after the dural incision and retraction of the biventer lobule with special emphasis on the infrequent anatomical course of the facial and vestibulocochlear nerves on the posterior wall of neurinomas.
  • 4) Localizing the facial nerve and vestibulocochlear nerve at the pontine side, so that decision of preserving or sacrificing the latter in the course of surgery can be made from the viewpoint of hearing preservation and concentrate on facial nerve function.
  • 6) Reduction of remaining tumor-capsule volume by sharp dissection or bipolar cutting, using intraoperative EMG-stimulation which identifies the presence of flattened facial nerve fibers on the capsule.
  • Presence tiny remnant of the tumor capsule attached to the nerve bundles just before the entrance of internal acoustic porus (macroscopical "radical" resection) is considered to be acceptable for better postoperative quality of life.
  • 9) Results of 88 cases during last 10 years are: good function (HB I and II) of the facial nerve 90.5% at the time of two years follow-up, 11.5% hearing preservation, 1 mortality due to aspiration pneumonia.
  • [MeSH-major] Microsurgery. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods. Radiosurgery

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  • (PMID = 17154074.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] English Abstract; Historical Article; Journal Article
  • [Publication-country] Japan
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30. Abram S, Rosenblatt P, Holcomb S: Stereotactic radiation techniques in the treatment of acoustic schwannomas. Otolaryngol Clin North Am; 2007 Jun;40(3):571-88, ix
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  • [Title] Stereotactic radiation techniques in the treatment of acoustic schwannomas.
  • The goals of the treatment of acoustic schwannomas are prohibiting tumor growth and alleviation of symptoms caused by damage to local structures.
  • These symptoms-tinnitus, ataxia, and hearing loss--secondary to eighth nerve dysfunction, as well as symptoms arising from damage to adjacent structures such as the facial nerve, trigeminal nerve, or pons, can be caused by tumor growth or treatment.
  • Determination of optimal therapy must also take into account an understanding of the natural history of the disease, because acoustic schwannomas are slow-growing benign tumors that when left untreated, usually enlarge over time and cause problems.
  • [MeSH-major] Ear Neoplasms / pathology. Ear Neoplasms / radiotherapy. Neuroma, Acoustic / pathology. Neuroma, Acoustic / radiotherapy. Radiosurgery / instrumentation. Stereotaxic Techniques
  • [MeSH-minor] Algorithms. Dose Fractionation. Follow-Up Studies. Humans. Hydrocephalus / epidemiology. Magnetic Resonance Imaging. Neoplasm Invasiveness. Neurofibromatosis 2 / epidemiology. Tinnitus / epidemiology. Vertigo / epidemiology

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  • (PMID = 17544696.001).
  • [ISSN] 0030-6665
  • [Journal-full-title] Otolaryngologic clinics of North America
  • [ISO-abbreviation] Otolaryngol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 31
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31. Likhterov I, Allbright RM, Selesnick SH: LINAC radiosurgery and radiotherapy treatment of acoustic neuromas. 2007. Neurosurg Clin N Am; 2008 Apr;19(2):345-65, vii
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  • [Title] LINAC radiosurgery and radiotherapy treatment of acoustic neuromas. 2007.
  • This article provides an introduction to radiation therapy as it applies to intracranial tumors.
  • It also provides a review of the natural growth progression of acoustic neuromas and accuracy of tumor size determination.
  • Literature on the use of linear accelerator stereotactic radiosurgery and fractionated radiotherapy in acoustic neuroma management is reviewed and summarized.
  • Specifically, the rates of reported tumor control, hearing preservation, facial and trigeminal nerve complications, and hydrocephalus are analyzed.
  • Although the complication rates associated with linear accelerator therapy are relatively low, hearing preservation is poor and acoustic neuroma control is variable.
  • [MeSH-major] Neuroma, Acoustic / history. Radiosurgery / history

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  • (PMID = 18534344.001).
  • [ISSN] 1558-1349
  • [Journal-full-title] Neurosurgery clinics of North America
  • [ISO-abbreviation] Neurosurg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Biography; Classical Article; Historical Article; Journal Article
  • [Publication-country] United States
  • [Personal-name-as-subject] Likhterov I; Allbright RM; Selesnick SH
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32. Iwai Y, Yamanaka K, Yamagata K, Yasui T: Surgery after radiosurgery for acoustic neuromas: surgical strategy and histological findings. Neurosurgery; 2007 Feb;60(2 Suppl 1):ONS75-82; discussion ONS82
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  • [Title] Surgery after radiosurgery for acoustic neuromas: surgical strategy and histological findings.
  • OBJECTIVE: To retrospectively review the authors' experience with surgical resections after failed radiosurgery for acoustic neuromas.
  • METHODS: The study group consisted of six patients with acoustic neuromas.
  • RESULTS: The tumors were subtotally removed (> or = 80%) in four patients and partially removed (< 80%) in the other two patients.
  • Preexisting facial nerve palsy improved in two patients and deteriorated in one patient, and one patient experienced new facial palsy.
  • Histological features were typical of acoustic schwannoma, and some tumors were associated with foamy macrophages, myxoid degeneration, and necrosis attributed to radiation effects.
  • At follow-up, the residual tumor was decreased in five patients and increased in one patient with an expanding intratumoral hematoma.
  • It must be carefully considered because of the natural regression of transient tumor swelling over time.
  • In patients with tumor enlargement several years after radiosurgery, the possibility of chronic intratumoral bleeding resulting from delayed radiation injury must be considered.
  • [MeSH-major] Neoplasm Recurrence, Local / surgery. Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Radiosurgery

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  • (PMID = 17297369.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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33. Ottinger T, Lindberg R, Ekman S: Malignant acoustic schwannoma in a dog. J Vet Diagn Invest; 2009 Jan;21(1):129-32
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  • [Title] Malignant acoustic schwannoma in a dog.
  • A malignant schwannoma of the right acoustic nerve of a dog is described.
  • The neoplasm was found during necropsy of a 12-year-old, spayed, female Labrador Retriever that experienced a sudden onset of severe pain in the neck and upon opening the mouth.
  • The tumor had infiltrative growth, and the spindle-shaped neoplastic cells were arranged in sheets and concentric whorls.
  • [MeSH-major] Dog Diseases / pathology. Neuroma, Acoustic / veterinary
  • [MeSH-minor] Animals. Cochlear Nerve / pathology. Dogs. Female

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  • (PMID = 19139514.001).
  • [ISSN] 1040-6387
  • [Journal-full-title] Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc
  • [ISO-abbreviation] J. Vet. Diagn. Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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34. Abram S, Rosenblatt P, Holcomb S: Stereotactic radiation techniques in the treatment of acoustic schwannomas. 2007. Neurosurg Clin N Am; 2008 Apr;19(2):367-77, vii-viii
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Stereotactic radiation techniques in the treatment of acoustic schwannomas. 2007.
  • The goals of the treatment of acoustic schwannomas are prohibiting tumor growth and alleviation of symptoms caused by damage to local structures.
  • These symptoms-tinnitus, ataxia, and hearing loss-secondary to eighth nerve dysfunction, as well as symptoms arising from damage to adjacent structures such as the facial nerve, trigeminal nerve, or pons, can be caused by tumor growth or treatment.
  • Determination of optimal therapy must also take into account an understanding of the natural history of the disease, because acoustic schwannomas are slow-growing benign tumors that when left untreated, usually enlarge over time and cause problems.
  • [MeSH-major] Neuroma, Acoustic / history. Stereotaxic Techniques / history

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  • (PMID = 18534345.001).
  • [ISSN] 1558-1349
  • [Journal-full-title] Neurosurgery clinics of North America
  • [ISO-abbreviation] Neurosurg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Biography; Classical Article; Historical Article; Journal Article
  • [Publication-country] United States
  • [Personal-name-as-subject] Abram S; Rosenblatt P; Holcomb S
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35. Likhterov I, Allbright RM, Selesnick SH: LINAC radiosurgery and radiotherapy treatment of acoustic neuromas. Otolaryngol Clin North Am; 2007 Jun;40(3):541-70, ix
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] LINAC radiosurgery and radiotherapy treatment of acoustic neuromas.
  • This article provides an introduction to radiation therapy as it applies to intracranial tumors.
  • It also provides a review of the natural growth progression of acoustic neuromas and accuracy of tumor size determination.
  • Literature on the use of linear accelerator stereotactic radiosurgery and fractionated radiotherapy in acoustic neuroma management is reviewed and summarized.
  • Specifically, the rates of reported tumor control, hearing preservation, facial and trigeminal nerve complications, and hydrocephalus are analyzed.
  • Although the complication rates associated with linear accelerator therapy are relatively low, hearing preservation is poor and acoustic neuroma control is variable.
  • [MeSH-major] Ear Neoplasms / radiotherapy. Ear Neoplasms / surgery. Neuroma, Acoustic / radiotherapy. Neuroma, Acoustic / surgery. Radiosurgery / instrumentation

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  • (PMID = 17544695.001).
  • [ISSN] 0030-6665
  • [Journal-full-title] Otolaryngologic clinics of North America
  • [ISO-abbreviation] Otolaryngol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 29
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36. Yu LM, Yang SM, Han DY, Yu LM, Yang WY: [Preliminary study of intraoperative auditory monitoring techniques in acoustic neuroma surgery]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2006 May;41(5):335-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Preliminary study of intraoperative auditory monitoring techniques in acoustic neuroma surgery].
  • OBJECTIVE: To investigate the value of intraoperative auditory monitoring techniques in acoustic neuroma surgery.
  • METHODS: Ten cases with acoustic neuroma were resected with retrosigmoid approach.
  • The hearing was preserved in 2 cases, which had class A hearing post operation with tumor size <2 cm.
  • In another case, the waves of I, III could be evoked after the tumor resection with the disappearance of wave V.
  • The CAP amplitudes decreased significantly in 4 cases and even dropped to zero while dissecting the tumor at the lateral end of the internal auditory canal (IAC) or clamping the internal auditory artery (IAA) during operation.
  • In one case, although the cochlear nerve was cut down, the CAP could still be recorded after the tumor resection.
  • However, the CAP amplitudes was dropped to zero while pressurized and pulled cochlea nerve of brainstem lateral and the wave disappeared post-operation in another cases.
  • One of them showed low amplitude of CAP wave when the tumor partially removed.
  • CONCLUSIONS: In combination with ABR monitoring, ECochG proved to be a useful supplementary tool for hearing preservation in acoustic neurinoma surgery.
  • Drilling of the IAC and tumor removal at the lateral end of the IAC were the most critical steps for achieving hearing preservation.
  • The surgeon's experience are the most significant factors influencing the hearing outcome after removal of acoustic neuroma.
  • [MeSH-major] Cochlear Nerve / physiopathology. Monitoring, Intraoperative / methods. Neuroma, Acoustic / physiopathology

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  • (PMID = 16848284.001).
  • [ISSN] 1673-0860
  • [Journal-full-title] Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
  • [ISO-abbreviation] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] China
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37. Combs SE, Thilmann C, Debus J, Schulz-Ertner D: Long-term outcome of stereotactic radiosurgery (SRS) in patients with acoustic neuromas. Int J Radiat Oncol Biol Phys; 2006 Apr 1;64(5):1341-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term outcome of stereotactic radiosurgery (SRS) in patients with acoustic neuromas.
  • PURPOSE: To evaluate the effectiveness and long-term outcome of stereotactic radiosurgery (SRS) for acoustic neuromas (AN).
  • RESULTS: The overall actuarial 5-year and 10-year tumor control probability in all patients was 91%.
  • Two patients developed tumor progression after SRS at 36 and 48 months.
  • Nineteen patients (73%) were at risk of treatment-related facial nerve toxicity; of these, 1 patient developed a complete facial nerve palsy after SRS (5%).
  • Two patients (8%) developed mild dysesthesia of the trigeminal nerve after SRS.
  • CONCLUSION: Stereotactic radiosurgery results in good local control rates of AN and the risk of cranial nerve toxicities is acceptable.
  • [MeSH-major] Hearing / radiation effects. Neuroma, Acoustic / surgery. Radiosurgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Facial Nerve / radiation effects. Facial Paralysis / etiology. Female. Hearing Loss / etiology. Humans. Male. Middle Aged. Neurofibromatosis 2 / complications. Radiation Injuries / etiology. Trigeminal Neuralgia / etiology

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  • (PMID = 16464537.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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38. Yilmaz I, Erbek S, Erbek S, Ulusoy O, Calişaneller T: [Sudden hearing loss in a patient with a 3-mm acoustic tumor]. Kulak Burun Bogaz Ihtis Derg; 2007;17(2):120-5
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  • [Title] [Sudden hearing loss in a patient with a 3-mm acoustic tumor].
  • It has been reported that acoustic neuroma may be present up to 47.5% of patients with sudden SNHL.
  • Computed tomography showed an increase in the diameter of the left internal acoustic canal, and magnetic resonance imaging (MRI) revealed an intracanalicular mass, 3 mm in size, originating from the left cochlear nerve.
  • [MeSH-major] Neuroma, Acoustic / diagnosis
  • [MeSH-minor] Anti-Inflammatory Agents / administration & dosage. Anti-Inflammatory Agents / therapeutic use. Diagnosis, Differential. Fluocortolone / administration & dosage. Fluocortolone / therapeutic use. Hearing Loss, Sensorineural / etiology. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 17527067.001).
  • [ISSN] 1300-7475
  • [Journal-full-title] Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat
  • [ISO-abbreviation] Kulak Burun Bogaz Ihtis Derg
  • [Language] tur
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Turkey
  • [Chemical-registry-number] 0 / Anti-Inflammatory Agents; 65VXC1MH0J / Fluocortolone
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39. Limb CJ, Long DM, Niparko JK: Acoustic neuromas after failed radiation therapy: challenges of surgical salvage. Laryngoscope; 2005 Jan;115(1):93-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Acoustic neuromas after failed radiation therapy: challenges of surgical salvage.
  • OBJECTIVES: As stereotactic radiation has emerged as a treatment option for acoustic neuromas, cases that require surgical salvage after unsuccessful radiation have emerged.
  • We present a comparison of the technical challenges faced by the surgeons in the treatment of irradiated versus nonirradiated acoustic neuromas.
  • METHODS: We identified nine patients with acoustic neuromas that required surgical resection after radiation therapy.
  • Nine nonirradiated case-control subjects matched for age, sex, tumor size, and surgical approach were identified for purposes of general comparison.
  • Excessive scarring hindered identification of the facial nerve and added uncertainty as to the completeness of tumor removal.
  • Decompression of the internal auditory canal (IAC) dura and resection of neoplasm in the IAC before cerebellopontine angle dissection was required for facial nerve identification.
  • Operative time was significantly longer for irradiated cases, and facial nerve outcomes tended to be poorer, particularly when facial nerve dysfunction prompted the salvage procedure.
  • CONCLUSIONS: Surgical salvage of acoustic neuromas after radiation therapy is feasible, but it presents technical challenges beyond that associated with primary surgical therapy.
  • Poorer outcomes of postoperative cranial nerve status were caused primarily by anatomic changes at the nerve/tumor interface.
  • As surgical experience with the irradiated acoustic neuroma grows, operative observations should be incorporated into the counsel provided to patients with acoustic neuromas as they weigh different management options.
  • [MeSH-major] Neuroma, Acoustic / surgery

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  • (PMID = 15630374.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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40. Yu LM, Yang SM, Han DY, Huang DL, Yang WY: [Management of operative complications in acoustic neuroma surgery]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2006 Jan;41(1):26-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Management of operative complications in acoustic neuroma surgery].
  • OBJECTIVE: To explore the common complications related to acoustic neuromas and to search methods for preventing from them.
  • METHODS: One hundred and five patients with acoustic neuromas underwent 110 operations with the retrosigmoid approach, middle cranial fossa approach and labyrinth approach.
  • Other complications were cerebrospinal fluid fistulas (CSF, 12.7%, 14/110) , intracranial hematoma (5.5%, 6/110), cranial nerve palsies (4.5%, 5/110), meningitis (3.6%, 4/110), tetraparesis (3.6%, 4/110), balance disturbance (1.8%, 2/110), hemiparalysis and anepia (0.9%, 1/110).
  • CSF in this series was another common complication in acoustic neuroma surgery.
  • CONCLUSIONS: The key factors to avoid the complications include mastering the anatomy of different surgical approach, how much of the tumor size, surgical experience and preoperative evaluation of patients' imaging information and other clinical data.
  • [MeSH-major] Neuroma, Acoustic / surgery. Postoperative Complications / prevention & control

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  • (PMID = 16646239.001).
  • [ISSN] 1673-0860
  • [Journal-full-title] Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
  • [ISO-abbreviation] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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41. Vernimmen FJ, Mohamed Z, Slabbert JP, Wilson J: Long-term results of stereotactic proton beam radiotherapy for acoustic neuromas. Radiother Oncol; 2009 Feb;90(2):208-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term results of stereotactic proton beam radiotherapy for acoustic neuromas.
  • BACKGROUND AND PURPOSE: A retrospective study evaluating the role of hypofractionated stereotactic proton beam therapy for acoustic neuromas.
  • Mean minimum tumor dose was 21.4 CGyE/3.
  • Cranial nerve functions were evaluated clinically.
  • RESULTS: With a mean clinical and radiological follow-up of 72 and 60 months respectively, the 5-year results showed a 98% local control, with a hearing preservation of 42%, a facial nerve preservation of 90.5% and a trigeminal nerve preservation of 93%.
  • CONCLUSION: For those patients harboring large acoustic neuromas that are inoperable, hypofractionated stereotactic proton beam offers long-term control with minimal side-effects.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Dose Fractionation. Facial Nerve Diseases / etiology. Female. Hearing. Humans. Male. Middle Aged. Protons. Radiotherapy Dosage. Trigeminal Nerve. Trigeminal Nerve Diseases / etiology. Young Adult

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  • (PMID = 19054586.001).
  • [ISSN] 0167-8140
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Protons
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42. Suzuki M, Yamada C, Inoue R, Kashio A, Saito Y, Nakanishi W: Analysis of vestibular testing in patients with vestibular schwannoma based on the nerve of origin, the localization, and the size of the tumor. Otol Neurotol; 2008 Oct;29(7):1029-33
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  • [Title] Analysis of vestibular testing in patients with vestibular schwannoma based on the nerve of origin, the localization, and the size of the tumor.
  • OBJECTIVES: We aimed to analyze the factors influencing caloric response and vestibular evoked myogenic potential (VEMP) in vestibular schwannoma.
  • SUBJECTS: The subjects comprised 130 patients with unilateral vestibular schwannoma pathologically diagnosed by surgery.
  • METHOD: Caloric response and the amplitude and latency of VEMP were measured and analyzed based on the nerve of origin, localization, and size of the tumor.
  • The tumors were classified into 3 types based on localization: intracanalicular, intermediate, and medial; and into 4 grades based on size: 9 mm or less, 10 to 19 mm, 20 to 29 mm, and 30 mm or greater.
  • RESULTS: : Abnormal rates of caloric response and VEMP in patients with tumors arising from the superior vestibular nerve were not significantly different from those in patients with tumors of the inferior vestibular nerve.
  • In the intermediate and medial type-but not in the intracanalicular type-a significant difference in tumor size was observed between patients with normal caloric response and those with canal paresis as also between patients with normal VEMP and those with abnormal VEMP.
  • In patients with tumors that maximally measured 10 to 19 mm or of the intermediate type, the p- and n-wave latencies of VEMP were significantly prolonged compared with those in the normal opposite ear.
  • CONCLUSION:. 1) The nerve of origin of tumors cannot be predicted based on caloric response and VEMP.
  • 2) In the intermediate and medial types, caloric response and the VEMP amplitude are significantly diminished in association with an increase in tumor size.
  • 3) Prolonged VEMP latencies seem to be not only caused by tumor compression to the brainstem or vestibular spinal tract but also by tumor compression isolated to the inferior vestibular nerve.
  • [MeSH-major] Evoked Potentials, Auditory / physiology. Neuroma, Acoustic / diagnosis. Neuroma, Acoustic / surgery. Vestibular Nerve / pathology. Vestibule, Labyrinth / pathology
  • [MeSH-minor] Calorimetry. Humans. Magnetic Resonance Imaging. Reaction Time. Retrospective Studies. Vestibular Function Tests

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  • (PMID = 18698272.001).
  • [ISSN] 1537-4505
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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43. Sinha S, Sharma BS: Cystic acoustic neuromas: surgical outcome in a series of 58 patients. J Clin Neurosci; 2008 May;15(5):511-5
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  • [Title] Cystic acoustic neuromas: surgical outcome in a series of 58 patients.
  • We aimed to analyze the clinical characteristics and surgical outcomes of surgically treated cystic acoustic neuromas, and to determine the prognostic significance of the presence of cystic components, by comparing surgical outcomes for solid and cystic tumors.
  • A total of 58 patients (20.4%) with newly diagnosed cystic tumor were studied.
  • The surgical outcome was analyzed in terms of extent of tumor removal, facial nerve preservation, morbidity and mortality; and was compared with that in patients with solid tumors.
  • Facial nerve preservation rates were much better for solid tumors (82.7%) than for cystic tumors (67.9%).
  • The extent of tumor removal was complete in 75.9% of patients with cystic tumors as compared with 90.2% for solid acoustic neuromas.
  • Cystic tumors differ from solid acoustic neuromas by having a rapid growth pattern, short clinical history and more frequent facial nerve involvement.
  • [MeSH-major] Cranial Nerve Neoplasms / surgery. Cysts / surgery. Neuroma, Acoustic / surgery. Neurosurgery / methods

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  • (PMID = 18329881.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article
  • [Publication-country] Scotland
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44. Meyer TA, Canty PA, Wilkinson EP, Hansen MR, Rubinstein JT, Gantz BJ: Small acoustic neuromas: surgical outcomes versus observation or radiation. Otol Neurotol; 2006 Apr;27(3):380-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Small acoustic neuromas: surgical outcomes versus observation or radiation.
  • OBJECTIVE: Evaluate factors affecting outcomes of small acoustic neuroma (AN) removal via a middle cranial fossa (MCF) approach, and compare results to published data on observation and radiation therapy.
  • METHODS: 162 consecutive patients (ages 19-70) with unilateral AN (0.2-2.5 cm in largest dimension) removed through a MCF approach were reviewed focusing on preservation of hearing, facial nerve function and complications.
  • RESULTS: Both tumor size and pre-operative WRS were related to post-operative WRS (p<0.01).
  • When the patients were stratified by tumor size, the patients with small tumors (2-10 mm) faired better than the overall group.
  • WRS for eight others improved to >70% after surgery.
  • When the tumor was 1.1-1.4 cm (N=34), the chance of preserving some hearing decreased to 42% (14/33).
  • When the tumor reached 1.5-2.5 cm (N=35), the hearing preservation rate was 43%.
  • If the WRS was also >70% (N=24), only eight (33%) maintained WRS of 70%, and one other improved to >70%.
  • The addition of intra-operative whole eighth nerve near field monitoring improved results during small tumor (<or=1.0 cm) removal preserving some hearing in 80% (32/40) and preserving >70% WRS in 76% (22/29) of those with >70% pre-operative WRS.
  • Good facial nerve function (HB I-II) was achieved in 97% (86% HB I).
  • When tumor size was <or=1.0 cm (N=93), however, good facial nerve function was obtained in 100% (94% HB I).
  • CONCLUSION: Our results suggest that removal of unilateral AN through an MCF approach when the tumor is small and hearing is good provides the best opportunity for hearing preservation and normal facial nerve function.
  • Observation historically results in tumor growth in young and middle-age patients with subsequent hearing loss.
  • Radiation may prevent most tumors from growing, and more data are needed to determine long-term tumor control and hearing preservation rates.
  • [MeSH-major] Auditory Threshold. Facial Nerve / physiology. Hearing Loss / prevention & control. Neuroma, Acoustic / radiotherapy. Neuroma, Acoustic / surgery

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  • (PMID = 16639278.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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45. Park HY, Kim SH, Son EJ, Lee HK, Lee WS: Intracanalicular facial nerve schwannoma. Otol Neurotol; 2007 Apr;28(3):376-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intracanalicular facial nerve schwannoma.
  • OBJECTIVE: To investigate the capability of preoperative evaluations in predicting the precise anatomic origin of intracanalicular tumors.
  • PATIENTS: A total of 11 patients (8 men and 3 women, 26-70 years old) with intracanalicular tumors who were treated surgically were included.
  • MAIN OUTCOME MEASURE: Preoperative symptoms, pure-tone average, auditory brainstem response, caloric test, electroneuronography, and magnetic resonance imaging were compared between patients with facial nerve schwannomas and patients with vestibular schwannomas.
  • RESULTS: Postoperatively, facial nerve schwannomas were diagnosed pathologically in 2 (18%) of 11 patients.
  • There were not any clues suggesting facial nerve schwannoma in preoperative evaluations.
  • CONCLUSION: A facial nerve schwannoma may be misdiagnosed as a vestibular schwannoma, especially when the tumor is confined to the internal auditory canal.
  • There are no useful preoperative evaluation tools in predicting the precise nerve origin of intracanalicular tumors.
  • [MeSH-major] Cranial Nerve Neoplasms / pathology. Facial Nerve / pathology. Neurilemmoma / pathology
  • [MeSH-minor] Adult. Aged. Audiometry, Pure-Tone. Diagnosis, Differential. Ear, Inner. Evoked Potentials, Auditory, Brain Stem / physiology. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neuroma, Acoustic / pathology. Otologic Surgical Procedures. Retrospective Studies

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  • (PMID = 17414044.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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46. Brozek-Madry E, Niemczyk K, Morawski K: [Intralabyrinthine schwannoma of the vestibulocochlear nerve]. Otolaryngol Pol; 2009 Sep-Oct;63(5):437-41
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  • [Title] [Intralabyrinthine schwannoma of the vestibulocochlear nerve].
  • AIM: Presenting and discussing the patient with intravestibular schwannoma of the vestibulocochlear nerve, the course of disease, audiologic and radiologic examination and treatment possibilities.
  • RESULTS: A 34-year-old male was diagnosed with a tumor localized in the left vestibule and semicircular canals without accompanying vertigo at any time of the disease but with tinnitus and total deafness of the left ear.
  • Preoperative diagnosis was established on the basis of MRI with contrast.
  • Localization of the tumor laterally to the fundus of internal auditory canal was essential for the diagnosis.
  • Their occurrence implies that schwannomas can originate at any segment of vestibulocochlear nerve.
  • Present trials of these tumors classification were presented.
  • Treatment depends on the intensity of symptoms and tumor expansion, while approach is dependant on its localization.
  • CONCLUSION: Elaborate radiologic examination including MRI with contrast is essential in case of atypical course of disease with hearing loss, tinnitus and vertigo, or with early diagnosis of Meniere disease.
  • [MeSH-major] Cranial Nerve Neoplasms / diagnosis. Cranial Nerve Neoplasms / surgery. Neuroma, Acoustic / diagnosis. Neuroma, Acoustic / surgery. Vestibulocochlear Nerve Diseases / diagnosis. Vestibulocochlear Nerve Diseases / surgery

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  • (PMID = 20169910.001).
  • [ISSN] 0030-6657
  • [Journal-full-title] Otolaryngologia polska = The Polish otolaryngology
  • [ISO-abbreviation] Otolaryngol Pol
  • [Language] pol
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Poland
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47. Schlieter M, Zoubaa S, Kress B, Unterberg A, Jacobi C, Hähnel S: Hemorrhagic acoustic schwannoma: radiological and histopathological findings. J Neuroradiol; 2005 Jun;32(3):210-2
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  • [Title] Hemorrhagic acoustic schwannoma: radiological and histopathological findings.
  • A 49-year-old man on anticoagulation treatment with phenprocoumon presented with acute right sided 7th and 8th cranial nerve palsy, acute hearing loss, headache, vertigo, and vomiting.
  • CT and MRI revealed a cerebellopontine angle tumor 15mm in diameter and acute intratumoral hematoma.
  • [MeSH-major] Cerebral Hemorrhage / pathology. Cerebral Hemorrhage / radiography. Neuroma, Acoustic / pathology. Neuroma, Acoustic / radiography
  • [MeSH-minor] Facial Nerve Diseases / etiology. Humans. Male. Middle Aged. Vestibulocochlear Nerve Diseases / etiology

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  • (PMID = 16134303.001).
  • [ISSN] 0150-9861
  • [Journal-full-title] Journal of neuroradiology. Journal de neuroradiologie
  • [ISO-abbreviation] J Neuroradiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] France
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48. Chihara Y, Ito K, Sugasawa K, Shin M: Neurological complications after acoustic neurinoma radiosurgery: revised risk factors based on long-term follow-up. Acta Otolaryngol Suppl; 2007 Dec;(559):65-70
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Neurological complications after acoustic neurinoma radiosurgery: revised risk factors based on long-term follow-up.
  • CONCLUSIONS: The precise risk factors for neurological complications after acoustic neurinoma radiosurgery were identified on long-term follow-up.
  • Type 2 neurofibromatosis was found to be a risk factor for hearing loss and peripheral tumor dose was a risk factor for seventh and fifth cranial nerve injuries.
  • At the present time, controversy exists regarding history of prior surgical resection and tumor size as risk factors for cranial nerve complications.
  • PATIENTS AND METHODS: Between June 1990 and September 1998, 138 patients with acoustic neurinomas had SRS at Tokyo University Hospital.
  • The average tumor diameter ranged from 6.7 to 25.4 mm (mean 13.9 mm).
  • The maximum tumor doses ranged from 20 to 40 Gy (mean 29.8 Gy), and the peripheral doses ranged from 12 to 25 Gy (mean 15.4 Gy).
  • The neurological complications studied included hearing loss, facial palsy, and trigeminal nerve dysfunction.
  • The variables analyzed were age, gender, prior operation, neurofibromatosis type 2 (NF2), tumor diameter, maximum tumor dose, peripheral tumor irradiation dose, and the number of isocenters.
  • RESULTS: NF2 was significantly correlated with both total hearing loss and pure tone threshold (PTA) elevation; a history of prior surgical resection, tumor size, and the peripheral tumor dose were significantly correlated with facial palsy; and the peripheral tumor dose was significantly correlated with trigeminal neuropathy.
  • [MeSH-major] Neuroma, Acoustic / surgery. Postoperative Complications
  • [MeSH-minor] Adolescent. Adult. Aged. Facial Nerve Injuries / epidemiology. Facial Nerve Injuries / etiology. Female. Follow-Up Studies. Hearing Disorders / epidemiology. Hearing Disorders / etiology. Humans. Male. Middle Aged. Neurofibromatosis 2 / epidemiology. Neurofibromatosis 2 / etiology. Prevalence. Radiosurgery / instrumentation. Risk Factors. Trigeminal Nerve Diseases / epidemiology. Trigeminal Nerve Diseases / etiology

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  • (PMID = 18340560.001).
  • [ISSN] 0365-5237
  • [Journal-full-title] Acta oto-laryngologica. Supplementum
  • [ISO-abbreviation] Acta Otolaryngol Suppl
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Norway
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49. Yang SM, Yu LM, Yu LM, Han DY: [Technique of hearing preservation during acoustic neuroma surgery]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2008 Aug;43(8):564-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Technique of hearing preservation during acoustic neuroma surgery].
  • OBJECTIVE: To explore the possibility of hearing protection in acoustic neurinoma (AN) resection and to evaluate the effect of dynamic auditory monitoring and the effect of oto-endoscope for hearing protection.
  • Maximal diameters of the tumor varied between 12 and 33 millimeters with an average of 19.9 millimeters.
  • All cases were operated on by retrosigmoid approach with routine facial nerve monitoring.
  • RESULTS: In all 18 cases, tumors were resected completely in 16 cases, but sub-totally removed in 2 cases which were II neurofibromatosis.
  • In all 18 cases, there were 5 cases with tumor diameter more than 20 millimeters, in which only 2 cases of them preserved hearing function (2/5).
  • However, 9 cases preserved their hearing function in the other 13 cases whose tumors diameter less than 20 millimeters (69.2%, 9/13).
  • During operative monitoring, when drilling posterior lip of internal auditory canal (IAC), dragging and electric coagulating nearby IAC, especially clamping labyrinthine artery, removing tumor in IAC or electric coagulating arachnoid blood vessel on the top of tumor tissue, the ABR waves were affected greatly.
  • [MeSH-major] Hearing Loss / prevention & control. Neuroma, Acoustic / surgery. Otologic Surgical Procedures

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  • (PMID = 18959258.001).
  • [ISSN] 1673-0860
  • [Journal-full-title] Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
  • [ISO-abbreviation] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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50. Han DY, Yu LM, Yu LM, Ji F, Young WY, Yang SM: Acoustic neuroma surgery for preservation of hearing: technique and experience in the Chinese PLA General Hospital. Acta Otolaryngol; 2010 May;130(5):583-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Acoustic neuroma surgery for preservation of hearing: technique and experience in the Chinese PLA General Hospital.
  • CONCLUSIONS: Good hearing preservation can be achieved during acoustic neuroma surgery assisted by real-time dynamic auditory monitoring and ear endoscopic techniques.
  • OBJECTIVE: To explore techniques to preserve hearing during acoustic neuroma resection.
  • From July 2003 to July 2007, intraoperative auditory monitoring using auditory brainstem response (ABR) and electrocochleography (EcochG) was conducted in 18 of 138 patients undergoing surgery for acoustic neuroma who had preoperative hearing.
  • RESULTS: Hearing was preserved in 11 of the 18 patients (61.1%): 2 of 5 patients whose tumors were larger than 20 mm (40%), and 9 of 13 patients with smaller tumors (69.2%).
  • Intraoperative monitoring revealed that the waveform was influenced when the posterior labium of the internal acoustic meatus was ground and drilled, or when traction or electrocoagulation was performed near the opening of the internal acoustic meatus, especially when the internal auditory artery was clamped, the tumor in the internal acoustic meatus was treated, and the arachnoid vessels in the inner-most layer of the tumor surface were clamped or electrocoagulated.
  • [MeSH-major] Hearing Loss / prevention & control. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / adverse effects
  • [MeSH-minor] Adolescent. Adult. Facial Nerve Diseases / etiology. Female. Hearing Tests. Humans. Male. Middle Aged. Retrospective Studies. Young Adult

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  • (PMID = 20406132.001).
  • [ISSN] 1651-2251
  • [Journal-full-title] Acta oto-laryngologica
  • [ISO-abbreviation] Acta Otolaryngol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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51. Baumann I, Polligkeit J, Blumenstock G, Mauz PS, Zalaman IM, Maassen MM: Quality of life after unilateral acoustic neuroma surgery via middle cranial fossa approach. Acta Otolaryngol; 2005 Jun;125(6):585-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Quality of life after unilateral acoustic neuroma surgery via middle cranial fossa approach.
  • CONCLUSIONS: Patients with acoustic neuroma experienced reduced quality of life (QOL) after surgery.
  • In the future, QOL should be a basic factor in the outcome evaluation of different therapeutic regimens in the treatment of acoustic neuroma.
  • OBJECTIVE: To measure the QOL of patients who underwent unilateral acoustic neuroma surgery via the middle cranial fossa approach.
  • Facial nerve function was described using the House-Brackmann grading system.
  • Gender, age, tumor size or location and clinical symptoms such as hearing loss and restricted facial nerve function did not have an effect on QOL.
  • [MeSH-major] Cranial Fossa, Middle / surgery. Neuroma, Acoustic / surgery. Quality of Life
  • [MeSH-minor] Adult. Age Factors. Aged. Attitude to Health. Audiometry, Pure-Tone. Auditory Threshold / physiology. Bone Conduction / physiology. Facial Nerve / physiopathology. Facial Paralysis / physiopathology. Female. Follow-Up Studies. Hearing Disorders / physiopathology. Humans. Male. Middle Aged. Sex Factors

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  • (PMID = 16076706.001).
  • [ISSN] 0001-6489
  • [Journal-full-title] Acta oto-laryngologica
  • [ISO-abbreviation] Acta Otolaryngol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Norway
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52. Gouveris H, Akkafa S, Lippold R, Mann W: Influence of nerve of origin and tumor size of vestibular schwannoma on dynamic posturography findings. Acta Otolaryngol; 2006 Dec;126(12):1281-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Influence of nerve of origin and tumor size of vestibular schwannoma on dynamic posturography findings.
  • CONCLUSION: Condition 5-score (C5S) and vestibular ratio (VER) correlate, but condition-6-score (C6S) and mean overall balance score (MOBS) do not, with the size of an inferior vestibular nerve (IVN) vestibular schwannoma (VS).
  • OBJECTIVES: To test whether the size of a superior vestibular nerve (SVN) or IVN VS, as measured on MRI scans, correlates with computerized dynamic platform posturography (CDPP) findings and whether CDPP findings could preoperatively predict the nerve of origin of the vs. PATIENTS AND METHODS: This was a retrospective study.
  • Spearman's rank correlation coefficients were calculated between the tumor's larger dimension and each of the four parameters for SVN and IVN vs. The nerve of VS origin was identified intraoperatively.
  • Neither C6S nor MOBS showed any significant correlation with the tumor's larger dimension.
  • [MeSH-major] Neuroma, Acoustic / pathology. Postural Balance. Vestibular Nerve / pathology

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  • (PMID = 17101589.001).
  • [ISSN] 0001-6489
  • [Journal-full-title] Acta oto-laryngologica
  • [ISO-abbreviation] Acta Otolaryngol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Norway
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53. Kano H, Kondziolka D, Khan A, Flickinger JC, Lunsford LD: Predictors of hearing preservation after stereotactic radiosurgery for acoustic neuroma. J Neurosurg; 2009 Oct;111(4):863-73
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Predictors of hearing preservation after stereotactic radiosurgery for acoustic neuroma.
  • OBJECT: Many patients with acoustic neuromas (ANs) have hearing function at diagnosis and desire to maintain it.
  • To date, radiosurgical techniques have been focused on conformal irradiation of the tumor mass, with less attention to inner ear structures for which there was scant radiobiological information.
  • The authors of this study evaluated tumor control and hearing preservation as they relate to tumor volume, imaging characteristics, and nerve and cochlear radiation dose following stereotactic radiosurgery (SRS) using the Gamma Knife.
  • The median tumor volume was 0.75 cm(3) (range 0.07-7.7 cm(3)), and the median radiation dose to the tumor margin was 12.5 Gy (range 12-13 Gy).
  • At diagnosis, a greater distance from the lateral tumor to the end of the internal auditory canal correlated with better hearing function.
  • Significant prognostic factors for serviceable hearing preservation were (all pre-SRS) GR Class I hearing, an SDS >or= 80%, a PTA < 20 dB, a patient age < 60 years, an intracanalicular tumor location, and a tumor volume < 0.75 cm(3).
  • Tumor volume and anatomy relate to the hearing level before radiosurgery and influence technique.
  • [MeSH-major] Hearing Loss / prevention & control. Neuroma, Acoustic / surgery. Radiosurgery / methods

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  • (PMID = 19284227.001).
  • [ISSN] 1933-0693
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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54. Fiscina F, Gouveris H, Mann W: Influence of nerve branch of origin and extracanalicular extension of the tumor on hearing after middle fossa removal of vestibular schwannoma. Acta Otolaryngol; 2007 Oct;127(10):1058-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Influence of nerve branch of origin and extracanalicular extension of the tumor on hearing after middle fossa removal of vestibular schwannoma.
  • CONCLUSION: Neither nerve branch of origin nor extracanalicular (up to 1 cm) extension of a vestibular schwannoma (VS) influence the postoperative hearing outcome in patients operated via a middle cranial fossa (MCF) approach.
  • OBJECTIVE: To test whether the nerve branch of tumor origin and an extracanalicular, up to 1 cm, tumor extension influences hearing outcome after MCF VS surgery.
  • Twenty patients had a superior vestibular nerve (SVN) tumor and 27 patients had an inferior vestibular nerve (IVN) tumor.
  • In three patients the nerve branch of origin of the VS could not be unequivocally determined.
  • Thirty-four patients had a purely intracanalicular (IC) tumor and 16 patients had an extracanalicular extension in the cerebello-pontine angle.
  • RESULTS: Neither vestibular nerve branch of origin nor extracanalicular tumor extension (up to 1 cm) caused any significant difference in the degree of postoperative hearing change at any of the tested PTA frequencies.
  • [MeSH-major] Cranial Fossa, Middle / surgery. Hearing / physiology. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / methods. Vestibular Nerve / pathology. Vestibule, Labyrinth / innervation

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  • (PMID = 17851965.001).
  • [ISSN] 0001-6489
  • [Journal-full-title] Acta oto-laryngologica
  • [ISO-abbreviation] Acta Otolaryngol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Norway
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55. Zhang Z, Wu H, Huang Q, Jia H, Wang Z: [Study of postoperative facial nerve function influenced by sterical position between facial nerve and vestibular schwannoma]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2009 Apr;23(7):292-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Study of postoperative facial nerve function influenced by sterical position between facial nerve and vestibular schwannoma].
  • OBJECTIVE: To study the postoperative facial nerve function influenced by sterical position between facial nerve (FN) and vestibular schwannoma (VS).
  • METHOD: A retrospective review was performed of 101 patients with unilateral VS, who underwent tumor total removal via enlarged translabyrinthine approach between 2003 and 2006.
  • Data concerning tumor stage based on tumor size, intra-operative sterical position between FN and VS which was classed on 4 types (type I: FN anterior to VS; type 2: anterior and superior to VS; type 3: superior to VS and type 4: posterior to VS), postoperative facial nerve function according to the House and Brackmann classification at days 7, 30, 90 and 180.
  • RESULT: The facial nerve was preserved anatomically in 98%.
  • Good facial function at days 180 was present in 73% and decreased along with the augmentation of tumor size.
  • The prognostic factor of latter includes not only tumor size, but also sterical position between FN and vs.
  • [MeSH-major] Facial Nerve / anatomy & histology. Neurilemmoma. Neuroma, Acoustic / surgery

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  • (PMID = 19670604.001).
  • [ISSN] 1001-1781
  • [Journal-full-title] Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery
  • [ISO-abbreviation] Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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56. Yong RL, Westerberg BD, Dong C, Akagami R: Length of tumor-cochlear nerve contact and hearing outcome after surgery for vestibular schwannoma. J Neurosurg; 2008 Jan;108(1):105-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Length of tumor-cochlear nerve contact and hearing outcome after surgery for vestibular schwannoma.
  • OBJECTIVES: Tumor size is likely to be a major determinant of hearing preservation after surgery for vestibular schwannoma.
  • Findings in some large case series have not supported this concept, possibly due to variation in the technique used for tumor measurement.
  • The authors sought to determine if the length of tumor-cochlear nerve contact was predictive of hearing outcome in adults undergoing resection of a vestibular schwannoma.
  • METHODS: Patients who underwent a hearing-preserving approach for resection of a vestibular schwannoma at one institution by a neurosurgeon/neurotologist team between 2001 and 2005 were screened.
  • Magnetic resonance images were reviewed and used to calculate the length of tumor-cochlear nerve contact.
  • Tumors were also measured according to AAO-HNS guidelines.
  • Univariate analysis revealed that extracanalicular length of tumor-cochlear nerve contact (p = 0.0365), preoperative hearing class (p = 0.028), I-V interpeak latency of the brainstem auditory evoked potential (p = 0.021), and the interaural I-V interpeak latency difference (p = 0.018) were predictive of hearing outcome.
  • CONCLUSIONS: Vestibular schwannomas with greater lengths of tumor-cochlear nerve contact increase a patient's risk for hearing loss after surgery with attempted hearing preservation.
  • Data from the experience of a single surgical team can be used to estimate the probability of good hearing outcome for any given patient with serviceable hearing and a vestibular schwannoma.
  • [MeSH-major] Cochlear Nerve / pathology. Cochlear Nerve / surgery. Hearing Loss / etiology. Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery

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  • (PMID = 18173318.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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57. Kim AH, Edwards BM, Telian SA, Kileny PR, Arts HA: Transient evoked otoacoustic emissions pattern as a prognostic indicator for hearing preservation in acoustic neuroma surgery. Otol Neurotol; 2006 Apr;27(3):372-9
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  • [Title] Transient evoked otoacoustic emissions pattern as a prognostic indicator for hearing preservation in acoustic neuroma surgery.
  • OBJECTIVE: To determine whether pre-operative transient otoacoustic emission (TEOAE) patterns are predictive of successful hearing preservation in acoustic neuroma surgery.
  • PATIENTS: A convenience sample was identified in whom pre-operative TEOAE data were available in patients undergoing acoustic neuroma surgery from 1993-2004.
  • INTERVENTIONS: Subjects underwent attempted hearing preservation surgery via middle cranial fossa or retrosigmoid approaches.
  • Other variables of prognostic significance to hearing preservation in our series included smaller tumor size, tumor location within the IAC, better pre-operative hearing, and shorter latencies on ABR.
  • CONCLUSION: A robust pre-operative TEOAE frequency band pattern may be used as a favorable prognostic indicator for potential hearing preservation in acoustic neuroma surgery.
  • The prognostic value may be enhanced when combined with other prognostic factors such as tumor size, tumor location, pre-operative ABR and audiometric results.
  • [MeSH-major] Auditory Threshold. Hearing Loss / prevention & control. Neuroma, Acoustic / surgery. Otoacoustic Emissions, Spontaneous / physiology
  • [MeSH-minor] Adolescent. Adult. Aged. Facial Nerve Diseases / etiology. Female. Humans. Logistic Models. Male. Middle Aged. Predictive Value of Tests. Preoperative Care. Prognosis. Retrospective Studies. Treatment Outcome

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  • (PMID = 16639277.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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58. Jacob A, Robinson LL Jr, Bortman JS, Yu L, Dodson EE, Welling DB: Nerve of origin, tumor size, hearing preservation, and facial nerve outcomes in 359 vestibular schwannoma resections at a tertiary care academic center. Laryngoscope; 2007 Dec;117(12):2087-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Nerve of origin, tumor size, hearing preservation, and facial nerve outcomes in 359 vestibular schwannoma resections at a tertiary care academic center.
  • OBJECTIVE: To determine nerve of origin, tumor size, hearing preservation rates, and facial nerve outcomes in a retrospective cohort study of patients undergoing translabyrinthine (TL), middle cranial fossa (MCF), and retrosigmoid/suboccipital (SO) approaches to vestibular schwannomas (VS).
  • The inferior vestibular nerve (IVN) was the nerve of origin in 84 of 359 cases (23.3%), while the superior vestibular nerve (SVN) was the nerve of origin in 36 patients (10%).
  • In 239 of 359 cases (66.6%), the nerve of origin was not identified.
  • Forty patients undergoing hearing preservation surgery had hearing results and nerve of origin data available for review.
  • Functional hearing (<50dB PTA and >50% speech discrimination) was preserved in 10 of 15 patients (75%) with SVN tumors, while only 7 of 25 patients (28%) with IVN tumors retained functional hearing.
  • Facial nerve outcomes and nerve of origin were recorded simultaneously in 109 patients.
  • Seventy-one of 74 patients (95%) patients with IVN tumors achieved a House-Brackmann (HB) grade I-III, while 35 of 35 patients (100%) with SVN tumors retained HB I-III facial function.
  • Looking at tumor size versus hearing preservation, functional hearing was preserved in 22 of 49 patients (45%) with <1-cm tumors, and 4 of 20 patients (20%) with 1- to 1.5-cm tumors.
  • For all cases with documented facial nerve function, HB I-III were achieved in 96% of SO, 94% of MCF, and 88% of TL procedures.
  • CONCLUSIONS: Our retrospective data indicated that IVN tumors were twice as common as SVN tumors.
  • The nerve of origin did not affect facial nerve outcomes but did impact hearing preservation rates.
  • Patients with tumors <1 cm in size had the best chance for hearing preservation.
  • Overall facial nerve preservation was excellent with >90% achieving HB 1 to 3 function at final follow-up.
  • [MeSH-major] Facial Nerve / physiopathology. Facial Paralysis / prevention & control. Hearing / physiology. Magnetic Resonance Imaging / methods. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / methods. Vestibulocochlear Nerve / physiopathology
  • [MeSH-minor] Academic Medical Centers. Adolescent. Adult. Aged. Aged, 80 and over. Audiometry, Pure-Tone. Auditory Threshold / physiology. Child. Female. Follow-Up Studies. Hearing Loss, Sensorineural / diagnosis. Hearing Loss, Sensorineural / etiology. Hearing Loss, Sensorineural / prevention & control. Humans. Male. Middle Aged. Postoperative Complications / prevention & control. Prognosis. Retrospective Studies. Treatment Outcome

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  • (PMID = 17921903.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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59. Borba LA, Araújo JC, de Oliveira JG, Filho MG, Moro MS, Tirapelli LF, Colli BO: Surgical management of glomus jugulare tumors: a proposal for approach selection based on tumor relationships with the facial nerve. J Neurosurg; 2010 Jan;112(1):88-98
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  • [Title] Surgical management of glomus jugulare tumors: a proposal for approach selection based on tumor relationships with the facial nerve.
  • OBJECT: The goal of this paper is to analyze the extension and relationships of glomus jugulare tumor with the temporal bone and the results of its surgical treatment aiming at preservation of the facial nerve.
  • Based on the tumor extension and its relationships with the facial nerve, new criteria to be used in the selection of different surgical approaches are proposed.
  • METHODS: Between December 1997 and December 2007, 34 patients (22 female and 12 male) with glomus jugulare tumors were treated.
  • Clinical findings included hearing loss in 88%, swallowing disturbance in 50%, and facial nerve palsy in 41%.
  • The tumor was supplied by the external carotid artery in all cases, the internal carotid artery in 44%, and the vertebral artery in 32%.
  • The infralabyrinthine retrofacial approach (Type A) was used in 32.5%; infralabyrinthine pre- and retrofacial approach without occlusion of the external acoustic meatus (Type B) in 20.5%; infralabyrinthine pre- and retrofacial approach with occlusion of the external acoustic meatus (Type C) in 41%; and the infralabyrinthine approach with transposition of the facial nerve and removal of the middle ear structures (Type D) in 6% of the patients.
  • Among 20 patients without preoperative facial nerve dysfunction, the nerve was kept in anatomical position in 19 (95%), and facial nerve function was normal during the immediate postoperative period in 17 (85%).
  • Six patients (17.6%) had a new lower cranial nerve deficit, but recovery of swallowing function was adequate in all cases.
  • CONCLUSIONS: Radical removal of glomus jugulare tumor can be achieved without anterior transposition of the facial nerve.
  • The extension of dissection, however, should be tailored to each case based on tumor blood supply, preoperative symptoms, and tumor extension.
  • The operative field provided by the retrofacial infralabyrinthine approach, or the pre- and retrofacial approaches, with or without closure of the external acoustic meatus, allows a wide exposure of the jugular foramen area.
  • [MeSH-major] Brain Neoplasms / surgery. Facial Nerve. Glomus Jugulare Tumor / surgery. Neurosurgical Procedures / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Cerebral Angiography. Embolization, Therapeutic / methods. Face / surgery. Facial Nerve Diseases / etiology. Facial Nerve Diseases / physiopathology. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Treatment Outcome. Young Adult

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  • (PMID = 19425885.001).
  • [ISSN] 1933-0693
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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60. Poetker DM, Jursinic PA, Runge-Samuelson CL, Wackym PA: Distortion of magnetic resonance images used in gamma knife radiosurgery treatment planning: implications for acoustic neuroma outcomes. Otol Neurotol; 2005 Nov;26(6):1220-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Distortion of magnetic resonance images used in gamma knife radiosurgery treatment planning: implications for acoustic neuroma outcomes.
  • OBJECTIVE: To quantify the image distortion of our series of acoustic neuromas treated with gamma knife radiosurgery.
  • PATIENTS: Patients undergoing gamma knife radiosurgery for the treatment of acoustic neuromas.
  • Known clinical measurements of audiometric, vestibular, facial, and trigeminal nerve functions were then compared with current measurements of tumor size.
  • Tumor volumes of the treatment plan that fell outside of the internal auditory canal ranged from 0 to 414 mm, with a mean of 90.5 mm.
  • The mean percentage that fell outside of the internal auditory canal was 16.7% of total tumor volume (range, 2.4-77.6%).
  • We could not draw any consistent correlations between degree of image shift and continued tumor growth or objective examination values.
  • Although the image shift does not seem to affect the growth of the acoustic neuromas or auditory or facial nerve function, longer term follow-up is required to fully appreciate the true impact of this image shift.
  • [MeSH-major] Artifacts. Image Processing, Computer-Assisted / standards. Magnetic Resonance Imaging / standards. Neuroma, Acoustic / surgery. Radiosurgery / standards. Radiotherapy Planning, Computer-Assisted / standards. Surgery, Computer-Assisted / standards

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  • (PMID = 16272946.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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61. Balasubramaniam A, Shannon P, Hodaie M, Laperriere N, Michaels H, Guha A: Glioblastoma multiforme after stereotactic radiotherapy for acoustic neuroma: case report and review of the literature. Neuro Oncol; 2007 Oct;9(4):447-53
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  • [Title] Glioblastoma multiforme after stereotactic radiotherapy for acoustic neuroma: case report and review of the literature.
  • Although the short-term risks are minimal, the long-term risks of radiation-induced de novo secondary neoplasms or malignant progression of the primary benign tumor need to be considered.
  • There are currently 19 reported cases of tumors linked with stereotactic radiotherapy/radiosurgery, to which we add our second institutional experience of a patient who succumbed to a glioblastoma multiforme (GBM) after stereotactic radiotherapy for an acoustic neuroma (AN).
  • Review of these 20 cases revealed 10 de novo secondary tumors, of which eight were malignant, with six being malignant gliomas.
  • Accelerated growth of the primary benign AN, some 2 to 6 years after focused radiotherapy, was found in six of eight NF2 patients, with pathological verification of a malignant nerve sheath tumor documented in most.
  • [MeSH-major] Brain Neoplasms / etiology. Glioblastoma / etiology. Neoplasms, Radiation-Induced / etiology. Neoplasms, Second Primary / etiology. Neuroma, Acoustic / surgery. Radiosurgery / adverse effects


62. Parhizkar N, Hiltzik DH, Selesnick SH: Facial nerve rerouting in skull base surgery. Otolaryngol Clin North Am; 2005 Aug;38(4):685-710, ix
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Facial nerve rerouting in skull base surgery.
  • Facial nerve rerouting techniques were developed to facilitate re-section of extensive tumors occupying the skull base.
  • Facial nerve rerouting has its own limitations and risks, requiring microsurgical expertise, additional surgical time, and often some degree of facial nerve paresis.
  • This article presents different degrees of anterior and posterior facial nerve rerouting, techniques of facial nerve rerouting, and a comprehensive review of outcomes.
  • It then reviews anatomic and functional preservation of the facial nerve in acoustic neuroma resection, technical aspects of facial nerve dissection, intracranial facial nerve repair options, and outcomes for successful acoustic neuroma surgery.
  • [MeSH-major] Facial Nerve / surgery. Skull Base Neoplasms / surgery
  • [MeSH-minor] Cranial Fossa, Middle / surgery. Dissection. Glomus Jugulare Tumor / surgery. Glomus Tumor / surgery. Humans. Meningeal Neoplasms / surgery. Meningioma / surgery. Neuroma, Acoustic / surgery

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  • (PMID = 16005726.001).
  • [ISSN] 0030-6665
  • [Journal-full-title] Otolaryngologic clinics of North America
  • [ISO-abbreviation] Otolaryngol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 79
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63. Swensson RC, Swensson RP, Pizzini FE, Boldorini PR, Jorge Júnior JJ: An uncommon presentation of an VIII nerve tumor. Braz J Otorhinolaryngol; 2008 Jul-Aug;74(4):628-31
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  • [Title] An uncommon presentation of an VIII nerve tumor.
  • Vestibular Shwannomas are responsible for 80-90% of the cerebelar-pontine angle tumors and their incidence is of 0.8 to 20.5% of all tumors.
  • He also had mouth twisting but no other involvement of other cranial nerves.
  • [MeSH-major] Cranial Nerve Neoplasms / diagnosis. Neuroma, Acoustic / diagnosis. Vestibulocochlear Nerve. Vestibulocochlear Nerve Diseases / diagnosis

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  • (PMID = 18852994.001).
  • [ISSN] 1808-8694
  • [Journal-full-title] Brazilian journal of otorhinolaryngology
  • [ISO-abbreviation] Braz J Otorhinolaryngol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Brazil
  • [Number-of-references] 15
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64. Kurowska-Mroczek E, Zabek M, Osuch B, Stelmachów J: Therapeutic management of acoustic neurinoma during twin pregnancy: a case report. J Reprod Med; 2009 Jun;54(6):393-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Therapeutic management of acoustic neurinoma during twin pregnancy: a case report.
  • BACKGROUND: Acoustic neuromas belong to relatively rare illnesses in pregnant women.
  • Magnetic resonance imaging showed a vestibular acoustic neuroma of cranial nerve VII on the right side.
  • On the 14th postoperative day a team of neurosurgeons performed a right suboccipital craniectomy and completely removed the tumor.
  • CONCLUSION: The treatment of acoustic neuroma depends on the general health of a patient and the length of pregnancy.
  • [MeSH-major] Neuroma, Acoustic / diagnosis. Neuroma, Acoustic / surgery. Pregnancy Complications, Neoplastic / diagnosis. Pregnancy Complications, Neoplastic / surgery. Pregnancy, Multiple

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  • (PMID = 19639930.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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65. Combs SE, Volk S, Schulz-Ertner D, Huber PE, Thilmann C, Debus J: Management of acoustic neuromas with fractionated stereotactic radiotherapy (FSRT): long-term results in 106 patients treated in a single institution. Int J Radiat Oncol Biol Phys; 2005 Sep 1;63(1):75-81
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of acoustic neuromas with fractionated stereotactic radiotherapy (FSRT): long-term results in 106 patients treated in a single institution.
  • PURPOSE: To assess the long-term outcome and toxicity of fractionated stereotactic radiotherapy for acoustic neuromas in 106 patients treated in a single institution.
  • PATIENTS AND METHODS: Between October 1989 and January 2004, fractionated stereotactic radiotherapy (FSRT) was performed in 106 patients with acoustic neuroma (AN).
  • The median irradiated tumor volume was 3.9 mL (range, 2.7-30.7 mL).
  • Actuarial local tumor control rates at 3- and 5- years after FSRT were 94.3% and 93%, respectively.
  • Actuarial hearing preservation without the diagnosis of NF-2 was 98%.
  • Cranial nerve toxicity other than hearing impairment was rare.
  • The rate of radiation induced toxicity to the trigeminal and facial nerve was 3.4% and 2.3%, respectively.
  • CONCLUSION: Fractionated stereotactic radiotherapy is safe and efficacious for the treatment of AN, with mild toxicity with regard to hearing loss and cranial nerve function.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Dose Fractionation. Female. Follow-Up Studies. Hearing. Humans. Male. Middle Aged. Neurofibromatosis 2 / complications. Treatment Outcome. Trigeminal Nerve Diseases / etiology

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  • (PMID = 16111574.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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66. Strauss C, Prell J, Rampp S, Romstöck J: Split facial nerve course in vestibular schwannomas. J Neurosurg; 2006 Nov;105(5):698-705
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Split facial nerve course in vestibular schwannomas.
  • OBJECT: The facial nerve in vestibular schwannomas (VSs) is located on the ventral tumor surface in more than 90% of cases; other courses are rare.
  • A split facial nerve course with two distinct bundles has thus far been described exclusively for medial extrameatal tumors.
  • METHODS: Between 1996 and 2005, 16 consecutive cases of 241 surgically treated VSs were observed to have distinct splitting of the facial nerve.
  • The mean tumor size measured 27 mm.
  • In one third of the cases, intrameatal tumor extension with obliteration of the fundus was documented.
  • In all 16 patients, distinct splitting of the facial nerve was demonstrated.
  • The major portion of the facial nerve followed a typical course on the ventral tumor surface.
  • The smaller nerve portion in all cases ran parallel to the brainstem up to the level of the trigeminal root exit zone and crossed on the cranial tumor pole to the internal auditory canal.
  • The two nerve portions rejoined at the level of the porus acusticus.
  • The smaller portion carried fibers exclusively to the orbicularis oris muscle, whereas the major portion supplied all three branches of the facial nerve.
  • CONCLUSIONS: In VSs, an aberrant course with distinct splitting of the facial nerve adds considerably to the surgical challenge.
  • Long-term facial nerve results are excellent with extensive neurophysiological monitoring, which allows the differentiation and identification of aberrant facial nerve fibers and avoids additional risks to facial nerve preservation.
  • [MeSH-major] Facial Nerve / pathology. Facial Nerve / physiopathology. Neuroma, Acoustic / pathology. Neuroma, Acoustic / physiopathology
  • [MeSH-minor] Adult. Aged. Cochlear Nerve / physiopathology. Cohort Studies. Electromyography. Facial Muscles / physiopathology. Female. Humans. Male. Middle Aged. Monitoring, Intraoperative. Treatment Outcome

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  • (PMID = 17121130.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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67. Wang ZM, Xu WQ: [Analysis of prognostic factors in microsurgery of intratemporal facial nerve schwannoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2007 Jan;42(1):30-2
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Analysis of prognostic factors in microsurgery of intratemporal facial nerve schwannoma].
  • OBJECTIVE: To discuss prognostic factors in microsurgery of intratemporal facial nerve schwannoma.
  • METHODS: Clinical and follow-up materials from 13 cases of facial nerve schwannoma were analyzed retrospectively.
  • Eleven cases among them received facial nerve reconstruction.
  • The House-Brackmann grades of the cases received facial nerve reconstruction were II through V.
  • Spearman rank-order correlation showed the postoperative facial nerve function was correlated with the preoperative duration of facial nerve paralysis (r = 0.925, P = 0.000) and the preoperative facial nerve function(r = 0.712, P = 0.021).
  • Mann-Whitney U test showed that the tumor position had no effect on the postoperative facial nerve function (P = 0.889).
  • CONCLUSIONS: Among most of the patients who received microsurgery of facial nerve schwannoma, facial nerve functions could be restored to great extent.
  • The longer the preoperative duration of facial nerve paralysis or the worse the preoperative facial nerve function, the worse the postoperative facial nerve function in cases who received facial nerve resection and reconstruction.
  • Facial nerve reconstruction was helpful for the patient with facial nerve schwannoma whose facial muscles were denervated but have fibrillation potentials, as well as for the patient whose facial nerve schwannoma intruded internal acoustic canal.
  • [MeSH-major] Facial Neoplasms / diagnosis. Facial Nerve / pathology. Microsurgery. Neurilemmoma / diagnosis
  • [MeSH-minor] Adult. Aged. Facial Paralysis / diagnosis. Facial Paralysis / etiology. Female. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Treatment Outcome

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  • (PMID = 17432353.001).
  • [ISSN] 1673-0860
  • [Journal-full-title] Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
  • [ISO-abbreviation] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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68. Corona AP, Oliveira JC, Souza FP, Santana LV, Rêgo MA: Risk factors associated with vestibulocochlear nerve schwannoma: systematic review. Braz J Otorhinolaryngol; 2009 Jul-Aug;75(4):593-615
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  • [Title] Risk factors associated with vestibulocochlear nerve schwannoma: systematic review.
  • The vestibulocochlear nerve schwannoma (VS) is a benign tumor that stems from the edge of the Schwann s sheath.
  • It is considered the most frequent intracranial benign tumor, of low lethality rate and unknown etiology.
  • METHODS: electronic search of studies using the following key words: 'risk', 'schwannoma', 'vestibular', 'neuroma' and 'acoustic'.
  • [MeSH-major] Environmental Exposure / adverse effects. Neuroma, Acoustic / etiology

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  • (PMID = 19784431.001).
  • [ISSN] 1808-8686
  • [Journal-full-title] Brazilian journal of otorhinolaryngology
  • [ISO-abbreviation] Braz J Otorhinolaryngol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Brazil
  • [Number-of-references] 49
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69. Sughrue ME, Kaur R, Kane AJ, Rutkowski MJ, Kaur G, Yang I, Pitts LH, Parsa AT: The value of intraoperative facial nerve electromyography in predicting facial nerve function after vestibular schwannoma surgery. J Clin Neurosci; 2010 Jul;17(7):849-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The value of intraoperative facial nerve electromyography in predicting facial nerve function after vestibular schwannoma surgery.
  • The prognostic significance of intraoperative facial nerve electromyography (EMG) changes is not well-established in vestibular schwannoma (VS) surgery.
  • We studied facial nerve EMG with a threshold >0.05mA and performed subgroup analyses based on tumor size, resection approach, and extent of resection, for prediction of long-term facial nerve outcome.
  • The positive predictive value and negative predictive values (NPV) of facial nerve EMG for detection of permanent facial palsy are 68% and 63%, respectively.
  • The NPV decreased with increasing tumor size (72% versus [vs.] 64% vs. 53%) due to the increasing prevalence of post-operative facial nerve palsy in these patients.
  • In conclusion, while facial nerve EMG is a critical adjunct for locating the facial nerve intraoperatively, its predictive value for facial nerve function remains to be determined.
  • [MeSH-major] Facial Nerve / physiology. Monitoring, Intraoperative / methods. Neuroma, Acoustic / physiopathology. Neuroma, Acoustic / surgery. Postoperative Complications / physiopathology

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  • (PMID = 20471836.001).
  • [ISSN] 1532-2653
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Scotland
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70. Zhang R, Liu JP, Dai C: [Misdiagnosis of facial never tumor]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2007 Nov;42(11):817-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Misdiagnosis of facial never tumor].
  • OBJECTIVE: To analyze the misdiagnosis of facial nerve tumor and better understand facial nerve tumor.
  • METHODS: Twenty-eight patients with facial nerve tumor were undergone surgical treatment during January 1993 to September 2006.
  • Facial nerve function was evaluated with House-Brackmann grading system.
  • Two cases were misdiagnosed as parotid tumor preoperatively.
  • They were identified as facial never tumor because the masses originated from facial nerve during the surgery and confirmed by pathological examination.
  • Four cases with unilateral facial nerve paralysis lasting from one year to eight years had been misdiagnosed as Bell palsy.
  • Two cases with recurrent facial nerve palsy were misdiagnosed as Bell palsy.
  • Finally MRI and CT demonstrated a mass at the genicular segment of facial nerve.
  • One case with hearing loss and mass in external acoustic meatus was misdiagnoses as external acoustic meatus neoplasm.
  • One case with ear discharge, tympanic membrane perforation, soft tissue mass at epitympanum was misdiagnosed as chronic suppurative otitis media, lump was found close to the horizontal segment of facial nerve intraoperatively, and then it was confirmed as facial schwannomas by pathology.
  • After admission, MRI study revealed the mass was involved in the facial nerve and parotid gland, and facial nerve tumor was suspected.
  • All the 11 cases were undergone surgery, and the diagnosis was confirmed pathologically.
  • CONCLUSIONS: Facial nerve tumor was rare and unfamiliar with most of Otologists.
  • The present study showed that the three symptoms or signs should be alert: patient presents with facial paralysis does not partially recovered within six months or patient presents with recurrent facial paralysis, CT scan and MRI should be ordered for these patients to rule out space-occupation along facial nerve.
  • Soft tissue mass associates with the horizontal or vertical segment of facial nerve should be distinguished with Cholesteatoma and otitis media while patient complains of facial paralysis.
  • Parotid neoplasm close to facial nerve should be considered it originates from facial nerve.
  • [MeSH-major] Cranial Nerve Neoplasms / diagnosis. Diagnostic Errors. Facial Nerve Diseases / diagnosis. Neurilemmoma / diagnosis

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  • (PMID = 18300442.001).
  • [ISSN] 1673-0860
  • [Journal-full-title] Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
  • [ISO-abbreviation] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
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71. Marouf R, Noudel R, Roche PH: Facial nerve outcome after microsurgical resection of vestibular schwannoma. Prog Neurol Surg; 2008;21:103-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Facial nerve outcome after microsurgical resection of vestibular schwannoma.
  • The risk of facial nerve palsy after microsurgical removal of vestibular schwannoma cannot be totally eradicated.
  • Taken together, the data from our personal experience and analysis of the literature indicate that the major predictor of postoperative facial deficit is tumor size.
  • When confronted with large tumors, we personally changed our surgical goals and considered that facial nerve conservation and tumor control are interconnected priorities instead of radical removal.
  • [MeSH-major] Facial Nerve Injuries / epidemiology. Facial Nerve Injuries / prevention & control. Facial Paralysis / epidemiology. Facial Paralysis / prevention & control. Microsurgery / adverse effects. Neuroma, Acoustic / surgery

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  • (PMID = 18810207.001).
  • [ISSN] 0079-6492
  • [Journal-full-title] Progress in neurological surgery
  • [ISO-abbreviation] Prog Neurol Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 23
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72. Ju DT, Lin JW, Lin MS, Lee LM, Tseng HM, Wei CP, Yen CH, Hung CC, Hung KS, Lin CM, Lin TJ, Chiu WT, Tsai JT: Hypofractionated CyberKnife stereotactic radiosurgery for acoustic neuromas with and without association to neurofibromatosis Type 2. Acta Neurochir Suppl; 2008;101:169-73
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  • [Title] Hypofractionated CyberKnife stereotactic radiosurgery for acoustic neuromas with and without association to neurofibromatosis Type 2.
  • CyberKnife stereotactic radiosurgery (CKSRS) has been proved effective in treating intra-cranial lesions.
  • To treat acoustic neuroma (AN) patients with or without neurofibromatosis Type 2 (NF2) associations, the functional preservation of hearing, trigeminal nerve, and facial nerve are important.
  • Cranial nerve function, audiograms, and magnetic resonance images (MRI) were monitored.
  • Tumors with volumes ranging from 0.13 to 24.8 cm3 (mean 5.4 cm3) were irradiated with the marginal dose 1800-2000 cGy/3 fractions.
  • Tumors were treated with an 80 to 89% isodose line (mean 83%) and mean 97.9% tumor coverage.
  • Tumor regression was seen in 9 patients (43%) and stable in 12 patients (57%).
  • 100% tumor control rate was achieved.
  • Hypofractionated CKSRS was not only effective in tumor control but also excellent in hearing preservation for non-NF2 AN.
  • But for NF2 patients, although the tumor control was remarkable, hearing preservation was modest as in non-NF2 patients.
  • [MeSH-major] Neurofibromatosis 2 / surgery. Neuroma, Acoustic / surgery. Radiosurgery / methods


73. Neff BA, Ting J, Dickinson SL, Welling DB: Facial nerve monitoring parameters as a predictor of postoperative facial nerve outcomes after vestibular schwannoma resection. Otol Neurotol; 2005 Jul;26(4):728-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Facial nerve monitoring parameters as a predictor of postoperative facial nerve outcomes after vestibular schwannoma resection.
  • OBJECTIVE: To evaluate whether the intraoperative stimulus threshold and response amplitude measurements from facial electromyography can predict facial nerve function at 1 year after vestibular schwannoma resection.
  • PATIENTS: Seventy-four consecutive vestibular schwannoma patients.
  • INTERVENTION: The minimal stimulus intensity (in milliamperes) and electromyographic response amplitude (in microvolts) were recorded during stimulation applied to the proximal facial nerve after vestibular schwannoma removal.
  • MAIN OUTCOME MEASURE: Facial nerve outcomes at 1 year were evaluated using the House-Brackmann scale.
  • Analysis was then performed to evaluate whether these electrophysiologic recordings and tumor size could predict facial nerve functional outcomes.
  • RESULTS: Of the 74 patients, 66 of 74 (89%) had House-Brackmann Grade I or II facial nerve function and 8 of 74 (11%) had House-Brackmann Grade III-VI function at 1 year after surgery.
  • In addition, although tumor size was found to independently predict facial nerve outcomes at 1 year, it did not improve the ability to predict facial nerve function over a model using stimulus intensity and amplitude alone.
  • CONCLUSION: Individually, minimal stimulus intensity or response amplitude was less successful in predicting long-term postoperative facial nerve function.
  • However, if both parameters are considered together, the study demonstrates that they are good prognostic indicators for facial nerve function at 1 year after surgery.
  • [MeSH-major] Facial Nerve / physiopathology. Neuroma, Acoustic / physiopathology. Neuroma, Acoustic / surgery

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  • (PMID = 16015176.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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74. Maire JP, Huchet A, Milbeo Y, Darrouzet V, Causse N, Célérier D, Liguoro D, Bébéar JP: Twenty years' experience in the treatment of acoustic neuromas with fractionated radiotherapy: a review of 45 cases. Int J Radiat Oncol Biol Phys; 2006 Sep 1;66(1):170-8
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  • [Title] Twenty years' experience in the treatment of acoustic neuromas with fractionated radiotherapy: a review of 45 cases.
  • PURPOSE: To evaluate very long-term results of fractionated radiotherapy (FRT) of acoustic neuromas (AN).
  • The median tumor diameter was 31 mm (range, 11-55 mm).
  • Tumor shrinkage was observed in 27 (59%) and stable disease in 16 (35%).
  • Tumor progression occurred in three patients, 12 to 15 months after FRT.
  • Two additional tumors recurred after shrinkage 20 and 216 months after treatment and were operated on.
  • Actuarial local tumor control rates at 5 and 15 years were 86%.
  • For the patient who had a tumor recurrence at 216 months, histologic examination documented transformation to a low-grade malignant peripheral nerve sheath tumor.
  • [MeSH-major] Neuroma, Acoustic / radiotherapy

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  • (PMID = 16904521.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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75. Bernat I, Grayeli AB, Esquia G, Zhang Z, Kalamarides M, Sterkers O: Intraoperative electromyography and surgical observations as predictive factors of facial nerve outcome in vestibular schwannoma surgery. Otol Neurotol; 2010 Feb;31(2):306-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraoperative electromyography and surgical observations as predictive factors of facial nerve outcome in vestibular schwannoma surgery.
  • OBJECTIVE: To evaluate the predictive value of electromyographic recordings for the immediate facial nerve outcome after solitary vestibular schwannoma (VS) removal.
  • Intraoperative direct facial nerve stimulation at the brainstem (proximal pre site) before resection and at the brainstem (proximal post and distal sites, respectively) and internal acoustic meatus after resection were performed.
  • Poor facial nerve outcomes were observed for large tumor with a facial nerve superior to the tumor with a strong adhesion to the nerve.
  • With a stimulation threshold at proximal site after proximal site tumor resection at less than or equal to 0.04 mA, a good facial function was observed in 77% at Day 8.
  • CONCLUSION: Using CM recording stimulation and supramaximal stimulation of the facial nerve in combination with thresholds seem to increase the predictive value of the monitoring for the immediate facial nerve function for VS surgery.
  • [MeSH-major] Ear Neoplasms / surgery. Facial Nerve Injuries / epidemiology. Facial Nerve Injuries / etiology. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / adverse effects. Postoperative Complications / epidemiology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brain Stem / physiology. Electric Stimulation. Electromyography. Facial Nerve / physiology. Female. Humans. Male. Middle Aged. Monitoring, Intraoperative. Neural Conduction / physiology. Predictive Value of Tests. Young Adult

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  • (PMID = 19816232.001).
  • [ISSN] 1537-4505
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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76. Chen L, Chen LH, Ling F, Liu YS, Samii M, Samii A: Removal of vestibular schwannoma and facial nerve preservation using small suboccipital retrosigmoid craniotomy. Chin Med J (Engl); 2010 Feb 5;123(3):274-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Removal of vestibular schwannoma and facial nerve preservation using small suboccipital retrosigmoid craniotomy.
  • BACKGROUND: Vestibular schwannoma, the commonest form of intracranial schwannoma, arises from the Schwann cells investing the vestibular nerve.
  • At present, the surgery for vestibular schwannoma remains one of the most complicated operations demanding for surgical skills in neurosurgery.
  • And the trend of minimal invasion should also be the major influence on the management of patients with vestibular schwannomas.
  • We summarized the microsurgical removal experience in a recent series of vestibular schwannomas and presented the operative technique and cranial nerve preservation in order to improve the rates of total tumor removal and facial nerve preservation.
  • METHODS: A retrospective analysis was performed in 145 patients over a 7-year period who suffered from vestibular schwannomas that had been microsurgically removed by suboccipital retrosigmoid transmeatus approach with small craniotomy.
  • CT thinner scans revealed the tumor size in the internal auditory meatus and the relationship of the posterior wall of the internal acoustic meatus to the bone labyrinths preoperatively.
  • The posterior wall of the internal acoustic meatus was designedly drilled off.
  • RESULTS: Total tumor resection was achieved in 140 cases (96.6%) and subtotal resection in 5 cases.
  • The anatomical integrity of the facial nerve was preserved in 91.0% (132/145) of the cases.
  • Intracranial end-to-end anastomosis of the facial nerve was performed in 7 cases.
  • Functional preservation of the facial nerve was achieved in 115 patients (Grade I and Grade II, 79.3%).
  • Preservation of nerves and vessels were as important as tumor removal during the operation.
  • CT thinner scan could show the relationship between the posterior wall of the internal acoustic meatus and bone labyrinths, that is helpful for a safe drilling of the posterior wall of the internal acoustic meatus.
  • CONCLUSIONS: The goal of every surgery should be the preservation of function of all cranial nerves.
  • Knowing the microanatomy of the cerebellopontine angle and internal auditory meatus, intraoperating neurophysiological monitoring of the facial nerve function, and the microsurgical techniques of the surgeons are all important factors for improving total tumor removal and preserving facial nerve function.
  • [MeSH-major] Craniotomy / methods. Facial Nerve / surgery. Neuroma, Acoustic / surgery

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  • (PMID = 20193244.001).
  • [ISSN] 0366-6999
  • [Journal-full-title] Chinese medical journal
  • [ISO-abbreviation] Chin. Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
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77. Bouchene M, Pavillon S, Zaouche S, Boulud B, Dubreuil C: [Predictive factors of facial palsy of the acoustic neurinoma after retrosigmoid surgery: 230 cases]. Ann Otolaryngol Chir Cervicofac; 2006 Dec;123(6):319-24
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  • [Title] [Predictive factors of facial palsy of the acoustic neurinoma after retrosigmoid surgery: 230 cases].
  • [Transliterated title] Facteurs prédictifs de la survenue des paralysies faciales du neurinome de l'acoustique opéré par voie rétro-sigmoïde. A propos de 230 cas.
  • OBJECTIVES: To determine predictive factors influencing postoperative facial palsy during retro sigmoid approach in vestibular schwannoma surgery.
  • MATERIAL AND METHODS: Retrospective study over 230 patients with vestibular schwannoma, mostly stade I and II, operated by retro sigmoid approach, by the same oto neuro chirurgical team between 1993 and 2004.
  • Pre and post operative parameters taken into consideration: quantitative: age and sex, audiometric parameters, duration of clinical symptoms; qualitative: tumor anatomic factors and facial nerve function according to House Brackmann classification.
  • RESULTS: 8 days after surgery, 92% of patients have a normal or subnormal facial nerve function, 5% a facial paresis and 3% a paralysis.
  • Latency of vertigo with facial nerve paralysis is 4.33 vs. 1.97 year in absence of paralysis.
  • Hearing conservation is 85% without facial nerve paralysis vs. 58% with facial nerve paralysis; Wave III latency (PEAP) with facial nerve paralysis is 4.54 vs. 4.28 ms if not.
  • CONCLUSION: Significant predictive factors of facial nerve palsy outcome are: age, post surgery hearing conservation, wave III latency, difficulty in tumor dissection, vertigo latency.
  • [MeSH-major] Facial Paralysis / etiology. Neuroma, Acoustic / surgery. Postoperative Complications
  • [MeSH-minor] Adolescent. Adult. Age Factors. Aged. Child. Evoked Potentials. Facial Nerve / physiology. Female. Follow-Up Studies. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Sex Factors. Time Factors. Vertigo / etiology

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  • (PMID = 17202990.001).
  • [ISSN] 0003-438X
  • [Journal-full-title] Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris
  • [ISO-abbreviation] Ann Otolaryngol Chir Cervicofac
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
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78. Harsha WJ, Backous DD: Counseling patients on surgical options for treating acoustic neuroma. Otolaryngol Clin North Am; 2005 Aug;38(4):643-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Counseling patients on surgical options for treating acoustic neuroma.
  • The selection of surgical approach for the removal of AN is a complex one, depending on factors related to specific tumor anatomy, patient characteristics, and the familiarity and skill level of the skull base team.Overall, the literature supports that surgical outcomes are acceptable in regard to tumor removal, patient safety, and complication rates.
  • The inconsistent reporting methods in the current literature make it difficult to assess logically the rates for hearing preservation, facial nerve outcome, and complications as controlled for tumor size and other preoperative patient characteristics.
  • The best conclusions would be from prospective surgical trials controlling for patient factors, size of the tumor, and experience of the skull base team.
  • [MeSH-major] Neuroma, Acoustic / surgery. Otorhinolaryngologic Surgical Procedures
  • [MeSH-minor] Cerebrospinal Fluid Otorrhea / etiology. Cerebrospinal Fluid Rhinorrhea. Counseling. Facial Nerve. Humans. Postoperative Complications. Treatment Outcome

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  • (PMID = 16005723.001).
  • [ISSN] 0030-6665
  • [Journal-full-title] Otolaryngologic clinics of North America
  • [ISO-abbreviation] Otolaryngol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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79. Penido Nde O, Tangerina RP, Kosugi EM, Abreu CE, Vasco MB: Vestibular Schwannoma: spontaneous tumor involution. Braz J Otorhinolaryngol; 2007 Nov-Dec;73(6):867-71
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  • [Title] Vestibular Schwannoma: spontaneous tumor involution.
  • The natural history of Vestibular Schwannomas (VS) is yet not totally known, but most of them have the tendency to slow growth, sometimes without any kind of symptoms during the individuals entire time.
  • Considering tumors that grow, about 70% have grown less than 2mm an year.
  • Advanced radiological diagnosis, especially magnetic resonance imaging with gadolinium helps us diagnose small and less symptomatic tumors.
  • Treatment of choice still is complete tumor resection.
  • Surgical approaches have improved considerably and have helped preserve facial nerve function and hearing.
  • Considering VSs natural history, there is a possibility for conservative treatment for these tumors, because their growth in the first year after diagnosis predicts tumor growth behavior in the next years.
  • Surgery should be done in cases of tumor growth, patients desire or symptoms worsening.
  • Moreover, in terms of postoperative sequelae, there is no difference between patients who underwent surgery immediately after diagnosis and those who underwent initial conservative treatment for these tumors.
  • [MeSH-major] Neoplasm Regression, Spontaneous / pathology. Neuroma, Acoustic / pathology

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  • (PMID = 18278239.001).
  • [ISSN] 1808-8694
  • [Journal-full-title] Brazilian journal of otorhinolaryngology
  • [ISO-abbreviation] Braz J Otorhinolaryngol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Brazil
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80. Tsutsumi T, Nakajima N, Hirose T, Watanabe K: Total-length invasion of the facial nerve by parotid carcinoma ex pleomorphic adenoma. Auris Nasus Larynx; 2009 Oct;36(5):618-22
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  • [Title] Total-length invasion of the facial nerve by parotid carcinoma ex pleomorphic adenoma.
  • A case of parotid carcinoma extending along the facial nerve up to the internal auditory canal is presented.
  • Total parotid resection with neck dissection was performed, as well as resection of the ear canal, eardrum, ossicles, and transmastoid and translabyrinthine facial nerve, and obliteration using the fascia lata and fatty tissue.
  • The facial nerve showed continuous swelling along its length with lump formation at the site of the geniculate ganglion and the internal acoustic canal.
  • Within the facial nerve, the epineurium, perineurium and endoneurium were affected throughout its length.
  • Preoperative MRI with a contrast medium revealed the site of lump formation on the facial nerve, though it did not reveal the consecutive spread of the tumor along the nerve trunk.
  • CT of the temporal bone is strongly recommended for detection of swelling of the temporal bone segment of the nerve trunk, which could provide confirming evidence of invasion by a parotid carcinoma.
  • [MeSH-major] Adenocarcinoma / diagnosis. Adenoma, Pleomorphic / diagnosis. Facial Nerve / pathology. Parotid Gland. Salivary Gland Neoplasms / diagnosis
  • [MeSH-minor] Facial Bones / radiography. Facial Paralysis / etiology. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Invasiveness. Radiotherapy, Adjuvant. Tomography, X-Ray Computed

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  • (PMID = 19261405.001).
  • [ISSN] 1879-1476
  • [Journal-full-title] Auris, nasus, larynx
  • [ISO-abbreviation] Auris Nasus Larynx
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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81. Ushio M, Iwasaki S, Chihara Y, Kawahara N, Morita A, Saito N, Murofushi T: Is the nerve origin of the vestibular schwannoma correlated with vestibular evoked myogenic potential, caloric test, and auditory brainstem response? Acta Otolaryngol; 2009 Oct;129(10):1095-100
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is the nerve origin of the vestibular schwannoma correlated with vestibular evoked myogenic potential, caloric test, and auditory brainstem response?
  • CONCLUSIONS: The results of the caloric test, vestibular evoked myogenic potential (VEMP), and auditory brainstem response (ABR) in patients with vestibular schwannoma (VS) did not show clear correlation with the nerve origin of the tumor but with tumor size.
  • When we focused on patients with VS within the internal acoustic canal (IAC), neither the nerve origin of the tumor nor the tumor size showed clear correlation with the results of these tests.
  • OBJECTIVES: This study examined the correlation of the nerve origin of VS, superior or inferior vestibular nerve, with the results of function tests.
  • Tumor size was measured with preoperative MRI.
  • RESULTS: The nerve origin of the tumor was identified in 63 of the 109 patients.
  • Mean tumor size in patients showing abnormal responses was larger than that in patients showing normal responses on each test.
  • [MeSH-major] Neuroma, Acoustic / etiology
  • [MeSH-minor] Adult. Aged. Caloric Tests. Evoked Potentials, Auditory, Brain Stem. Humans. Middle Aged. Vestibular Evoked Myogenic Potentials. Vestibular Nerve / pathology. Vestibular Nerve / physiopathology. Young Adult

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  • (PMID = 19034733.001).
  • [ISSN] 1651-2251
  • [Journal-full-title] Acta oto-laryngologica
  • [ISO-abbreviation] Acta Otolaryngol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
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82. Akamatsu Y, Murakami K, Watanabe M, Jokura H, Tominaga T: Malignant peripheral nerve sheath tumor arising from benign vestibular schwannoma treated by gamma knife radiosurgery after two previous surgeries: a case report with surgical and pathological observations. World Neurosurg; 2010 Jun;73(6):751-4
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  • [Title] Malignant peripheral nerve sheath tumor arising from benign vestibular schwannoma treated by gamma knife radiosurgery after two previous surgeries: a case report with surgical and pathological observations.
  • BACKGROUND: Gamma knife radiosurgery (GKRS) is an effective treatment for vestibular schwannomas with lower morbidity and mortality.
  • METHODS: We describe a case presenting with malignant peripheral nerve sheath tumor (MPNST) at 8 years after GKRS after incomplete resections.
  • RESULTS: The tumor appeared to be a typical benign schwannoma at the surgery preceding GKRS, and rapidly enlarged after long-term control, causing progressive neurological deterioration.
  • Operative findings showed that the tumor was composed of two different components, and histopathology distinctively demonstrated MPNST and benign schwannoma.
  • [MeSH-major] Mixed Tumor, Malignant / etiology. Mixed Tumor, Malignant / pathology. Neoplasms, Radiation-Induced / pathology. Nerve Sheath Neoplasms / etiology. Nerve Sheath Neoplasms / pathology. Neuroma, Acoustic / surgery. Radiosurgery / adverse effects
  • [MeSH-minor] Aged. Cell Transformation, Neoplastic / pathology. Cell Transformation, Neoplastic / radiation effects. Female. Humans. Neurosurgical Procedures / methods. Radiation Injuries / diagnosis. Radiation Injuries / pathology. Reoperation / methods. Treatment Failure. Treatment Outcome. Vestibular Nerve / pathology. Vestibular Nerve / radiation effects. Vestibular Nerve / surgery


83. Liu JK, Sayama CM, Shelton C, MacDonald JD: Transient facial nerve palsy after topical papaverine application during vestibular schwannoma surgery. Case report. J Neurosurg; 2007 Nov;107(5):1039-42
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  • [Title] Transient facial nerve palsy after topical papaverine application during vestibular schwannoma surgery. Case report.
  • Some evidence in the literature supports the topical application of papaverine to the cochlear nerve to prevent internal auditory artery vasospasm and cochlear ischemia as a method of enhancing the ability to preserve hearing during acoustic neuroma surgery.
  • The authors report a case of transient facial nerve palsy that occurred after papaverine was topically applied during a hearing preservation acoustic neuroma removal.
  • Magnetic resonance imaging demonstrated a 1.5-cm acoustic neuroma in the right cerebellopontine angle (CPA).
  • A retrosigmoid approach was performed to achieve gross-total resection of the tumor.
  • During tumor removal, a solution of 3% papaverine soaked in a Gelfoam pledget was placed over the cochlear nerve.
  • Shortly thereafter, the quality of the facial nerve stimulation deteriorated markedly.
  • Electrical stimulation of the facial nerve did not elicit a response at the level of the brainstem but was observed to elicit a robust response more peripherally.
  • At the 1-month follow-up examination, the patient exhibited normal facial nerve function and stable hearing.
  • Intracisternal papaverine may cause a transient facial nerve palsy by producing a temporary conduction block of the facial nerve.
  • [MeSH-major] Facial Paralysis / chemically induced. Neuroma, Acoustic / surgery. Papaverine / adverse effects. Vasodilator Agents / adverse effects

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  • (PMID = 17977279.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Vasodilator Agents; DAA13NKG2Q / Papaverine
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84. Taoka T, Hirabayashi H, Nakagawa H, Sakamoto M, Myochin K, Hirohashi S, Iwasaki S, Sakaki T, Kichikawa K: Displacement of the facial nerve course by vestibular schwannoma: preoperative visualization using diffusion tensor tractography. J Magn Reson Imaging; 2006 Nov;24(5):1005-10
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  • [Title] Displacement of the facial nerve course by vestibular schwannoma: preoperative visualization using diffusion tensor tractography.
  • PURPOSE: To preoperatively visualize the course of the facial nerve, which is displaced by vestibular schwannoma, using diffusion tensor (DT) tractography, and to evaluate the agreement with surgical findings.
  • MATERIALS AND METHODS: The subjects were eight patients with vestibular schwannoma who had undergone removal surgery.
  • DT MR images were obtained and tracts that were considered to represent the facial nerve were constructed.
  • RESULTS: We obtained a tract that connected the internal auditory meatus and brainstem, and was considered to represent the facial nerve in seven of eight cases.
  • One exception was a case in which the tumor was too large to enable intraoperative observation of the facial nerve; however, the facial nerve appeared to be displaced anteriorly at intracapsular resection, in agreement with tractography.
  • We consider DT tractography to be a useful tool for preoperatively predicting facial nerve displacement in vestibular schwannoma.
  • [MeSH-major] Diffusion Magnetic Resonance Imaging / methods. Facial Nerve / pathology. Nerve Fibers, Myelinated / pathology. Neurilemmoma / pathology. Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Surgery, Computer-Assisted / methods
  • [MeSH-minor] Adult. Aged. Facial Nerve Injuries / pathology. Facial Nerve Injuries / prevention & control. Female. Humans. Male. Middle Aged. Treatment Outcome

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  • [Copyright] Copyright (c) 2006 Wiley-Liss, Inc.
  • (PMID = 17031835.001).
  • [ISSN] 1053-1807
  • [Journal-full-title] Journal of magnetic resonance imaging : JMRI
  • [ISO-abbreviation] J Magn Reson Imaging
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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85. Piccirillo E, Wiet MR, Flanagan S, Dispenza F, Giannuzzi A, Mancini F, Sanna M: Cystic vestibular schwannoma: classification, management, and facial nerve outcomes. Otol Neurotol; 2009 Sep;30(6):826-34
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  • [Title] Cystic vestibular schwannoma: classification, management, and facial nerve outcomes.
  • OBJECTIVE: Review of postoperative morbidity and facial nerve outcomes of cystic vestibular schwannoma (CVS) patients compared with solid vestibular schwannoma (SVS) patients and a proposal for a new CVS classification system.
  • MAIN OUTCOME MEASURE: Preoperative and postoperative (at least 1 yr) House-Brackmann facial nerve (HBFN) grade evaluation.
  • Comparison of tumor size and 1-year HBFN grades showed significant, moderate to strong, Pearson correlation (0.38).
  • Comparison of long-term facial nerve outcomes with a sample of 57 matched SVS patients showed no significant difference (p = 0.74).
  • When the tumor was adherent to the facial nerve and a dissection plane could not be developed between the cyst wall and the nerve, only subtotal resection could offer the CVS patients a normal facial nerve outcome.
  • Central and thick-walled tumors can be removed in almost all cases.
  • However, when peripheral thin-walled, adherent, cystic tumors are confronted and the cysts are medially or anteriorly located, we recommend subtotal resection, leaving portions of the cyst walls on neurovascular structures and on the facial nerve.
  • This surgical strategy allows us to improve facial nerve outcomes and to reduce complications.
  • [MeSH-major] Cranial Nerve Neoplasms / classification. Cranial Nerve Neoplasms / surgery. Facial Nerve Diseases / epidemiology. Facial Nerve Diseases / etiology. Neuroma, Acoustic / classification. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / methods. Postoperative Complications / epidemiology

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  • (PMID = 19704364.001).
  • [ISSN] 1537-4505
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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86. Kiyomizu K, Matsuda K, Nakayama M, Tono T, Matsuura K, Kawano H, Toyama K, Komune S: Preservation of the auditory nerve function after translabyrinthine removal of vestibular schwannoma. Auris Nasus Larynx; 2006 Mar;33(1):7-11
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  • [Title] Preservation of the auditory nerve function after translabyrinthine removal of vestibular schwannoma.
  • OBJECTIVE: To evaluate the function of the postoperative auditory nerve preserved after translabyrinthine (TL) vestibular schwannoma (VS) removal.
  • METHODS: Fifteen patients, who underwent unilateral VS resection via a TL approach, were preserved auditory nerve anatomically.
  • RESULTS: Four cases (27%) out of fifteen patients were retained the functional integrity of the auditory nerve after surgery.
  • The maximum tumor size in the group with a positive response to EST or EABR was significantly smaller than that in the group with a negative response to EST.
  • It seems to be difficult to preserve auditory nerve function in cases where a tumor extends to the fundus of internal auditory canal.
  • CONCLUSION: These results suggest that size of tumor and/or extension of tumor to the fundus might be important factors in preserving the auditory nerve function even if using a TL approach.
  • [MeSH-major] Cochlear Nerve / injuries. Ear, Inner / surgery. Neuroma, Acoustic / surgery. Otorhinolaryngologic Surgical Procedures / methods


87. Isaacson B, Telian SA, El-Kashlan HK: Facial nerve outcomes in middle cranial fossa vs translabyrinthine approaches. Otolaryngol Head Neck Surg; 2005 Dec;133(6):906-10
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  • [Title] Facial nerve outcomes in middle cranial fossa vs translabyrinthine approaches.
  • OBJECTIVE: To compare the final facial nerve outcomes between middle cranial fossa (MCF) vs translabyrinthine (TL) resection of size-matched vestibular schwannomas.
  • All patients who underwent resection utilizing either MCF or TL approaches with tumors 18 mm or smaller and complete data were included in the analysis.
  • One-week-postoperative and final facial nerve examinations were compared in the two surgical groups.
  • Patients were separately analyzed in subgroups: tumors smaller than 10 mm and those that were between 10 and 18 mm.
  • RESULTS: The tumor size range for the MCF group was 3-18 mm while it was 4-18 mm for the TL group.
  • No statistically significant difference was found in facial nerve outcomes between the two surgical groups, at the first postoperative visit week and at last follow-up.
  • CONCLUSION: Facial nerve outcomes are similar using TL and MCF approaches for resection of vestibular schwannomas up to 18 mm in size.
  • SIGNIFICANCE: Patients undergoing the MCF approach for hearing preservation can be counseled that there is no increased risk of permanent facial nerve weakness, compared to the TL approach.
  • [MeSH-major] Cranial Fossa, Middle / surgery. Ear, Inner / surgery. Facial Nerve / physiopathology. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / methods

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  • (PMID = 16360512.001).
  • [ISSN] 0194-5998
  • [Journal-full-title] Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • [ISO-abbreviation] Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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88. Cardoso AC, Fernandes YB, Ramina R, Borges G: Acoustic neuroma (vestibular schwannoma): surgical results on 240 patients operated on dorsal decubitus position. Arq Neuropsiquiatr; 2007 Sep;65(3A):605-9
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  • [Title] Acoustic neuroma (vestibular schwannoma): surgical results on 240 patients operated on dorsal decubitus position.
  • OBJECTIVE: To evaluate the result of the surgical treatment of vestibular schwannoma (VS) operated in dorsal decubitus (mastoid position).
  • METHOD: 240 patients with a VS underwent a retrosigmoid craniotomy for tumor resection in dorsal decubitus (mastoid position).
  • The function of 7th and 8th cranial nerves was monitored during surgery and the opened internal auditory canal (IAC) was reconstructed using a vascularized dura flap, muscle and fibrin glue.
  • RESULTS: Complete tumor removal was achieved in 99% of the cases, with a mortality of 1.6%.
  • The facial nerve function was preserved in 85% of cases and hearing in 40% of the patients (with preoperative hearing) with tumors of up 1.5 cm in diameter.
  • [MeSH-major] Cranial Nerve Neoplasms / surgery. Craniotomy / standards. Neuroma, Acoustic / surgery. Supine Position. Vestibulocochlear Nerve / surgery. Vestibulocochlear Nerve Diseases / surgery

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  • (PMID = 17876399.001).
  • [ISSN] 0004-282X
  • [Journal-full-title] Arquivos de neuro-psiquiatria
  • [ISO-abbreviation] Arq Neuropsiquiatr
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Fibrin Tissue Adhesive; 0 / Tissue Adhesives
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89. Lescanne E, François P, Bakhos D, Velut S, Robier A, Pollak A: Vestibular schwannoma: dissection of the tumor and arachnoidal duplication. Otol Neurotol; 2008 Oct;29(7):989-94
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  • [Title] Vestibular schwannoma: dissection of the tumor and arachnoidal duplication.
  • INTRODUCTION: In vestibular schwannoma (VS) surgery, the arachnoidal duplication, based on an epiarachnoidal origin of the tumor, is reputedly induced by medial growth of tumor and helpful in atraumatic dissection.
  • An additional series of 27 TBs without any tumor within the internal auditory meatus were also included.
  • No connective tissue or protrusion of a psammoma body was observed between the nerves and the vs. High magnification failed to demonstrate any meningeal cleavage plane between the facial or cochlear nerve and the tumor.
  • In every case, the transition zone, the vestibular ganglion, or the VS was located in the subarachnoid fluid space.
  • CONCLUSION: We were not able to identify any layer between tumor and the intrameatal contents and did not observe any conjunctive-tissue capsule surrounding the intrameatal VS, as an epiarachnoidal tumor origin would suggest.
  • [MeSH-major] Arachnoiditis / pathology. Neuroma, Acoustic / surgery. Temporal Bone / pathology. Vestibular Diseases / surgery

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  • (PMID = 18667937.001).
  • [ISSN] 1537-4505
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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90. Strauss C, Romstöck J, Fahlbusch R, Rampp S, Scheller C: Preservation of facial nerve function after postoperative vasoactive treatment in vestibular schwannoma surgery. Neurosurgery; 2006 Sep;59(3):577-84; discussion 577-84
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  • [Title] Preservation of facial nerve function after postoperative vasoactive treatment in vestibular schwannoma surgery.
  • OBJECTIVE: Facial nerve paresis and hearing loss are common complications after vestibular schwannoma surgery.
  • Experimental and clinical studies point to a beneficial effect of nimodipine and hydroxyethyl starch for preservation of cochlear nerve function.
  • A retrospective analysis was undertaken to evaluate the effect of vasoactive treatment on facial nerve outcome.
  • PATIENTS AND METHODS: Forty-five patients with vestibular schwannoma removal, intraoperative electromyographic monitoring, and postoperative deterioration of facial nerve function were evaluated.
  • Facial nerve function was evaluated before and after surgery, as well as 1 year after the surgical procedure.
  • Patients were comparable regarding age, tumor size, and preoperative facial nerve function.
  • RESULTS: Long-term results of facial nerve function were significantly improved in those patients who experienced severe postoperative deterioration of facial nerve function and received vasoactive treatment as compared with patients who did not receive nimodipine and hydroxyethyl starch after surgery.
  • CONCLUSION: The study points to a potential effect of vasoactive treatment for facial nerve function after vestibular schwannoma surgery.
  • In particular, patients with postoperative disfiguring facial nerve palsy clearly benefit from intravenous hydroxyethyl starch and nimodipine with respect to a long-term socially acceptable facial nerve function.
  • [MeSH-major] Facial Nerve / drug effects. Facial Nerve / physiology. Neuroma, Acoustic / surgery. Postoperative Complications / drug therapy. Vasodilator Agents / therapeutic use
  • [MeSH-minor] Adult. Aged. Facial Nerve Injuries / physiopathology. Facial Nerve Injuries / prevention & control. Follow-Up Studies. Hearing Loss / drug therapy. Hearing Loss / prevention & control. Humans. Middle Aged. Monitoring, Intraoperative / methods. Retrospective Studies

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  • (PMID = 16955040.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Vasodilator Agents
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91. Yang I, Sughrue ME, Han SJ, Fang S, Aranda D, Cheung SW, Pitts LH, Parsa AT: Facial nerve preservation after vestibular schwannoma Gamma Knife radiosurgery. J Neurooncol; 2009 May;93(1):41-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Facial nerve preservation after vestibular schwannoma Gamma Knife radiosurgery.
  • OBJECTIVE: Facial nerve preservation is a critical measure of clinical outcome after vestibular schwannoma treatment.
  • Gamma Knife radiosurgery has evolved into a practical treatment modality for vestibular schwannoma patients, with several reported series from a variety of centers.
  • In this study, we report the results of an objective analysis of reported facial nerve outcomes after the treatment of vestibular schwannomas with Gamma Knife radiosurgery.
  • MATERIALS AND METHODS: A Boolean Pub Med search of the English language literature revealed a total of 23 published studies reporting assessable and quantifiable outcome data regarding facial nerve function in 2,204 patients who were treated with Gamma Knife radiosurgery for vestibular schwannoma.
  • (1) Facial nerve preservation rates were reported specifically for vestibular schwannoma, (2) Facial nerve functional outcome was reported using the House-Brackmann classification (HBC) for facial nerve function, (3) Tumor size was documented, and (4) Gamma Knife radiosurgery was the only radiosurgical modality used in the report.
  • The data were then aggregated and analyzed based on radiation doses delivered, tumor volume, and patient age.
  • RESULTS: An overall facial nerve preservation rate of 96.2% was found after Gamma Knife radiosurgery for vestibular schwannoma in our analysis.
  • Patients receiving less than or equal to 13 Gy of radiation at the marginal dose had a better facial nerve preservation rate than those who received higher doses (<or=13 Gy = 98.5% vs. >13 Gy = 94.7%, P < 0.0001).
  • Patients with a tumor volume less than or equal to 1.5 cm(3) also had a greater facial nerve preservation rate than patients with tumors greater than 1.5 cm(3) (<or=1.5 cm(3) 99.5% vs. >1.5 cm(3) 95.5%, P < 0.0001).
  • Superior facial nerve preservation was also noted in patients younger than or equal to 60 years of age (96.8 vs. 89.4%, P < 0.0001).
  • CONCLUSION: Our analysis of case series data aggregated from multiple centers suggests that a facial nerve preservation rate of 96.2% can be expected after Gamma knife radiosurgery for vestibular schwannoma.
  • Younger patients with smaller tumors less than 1.5 cm(3) and treated with lower doses of radiation less than 13 Gy will likely have better facial nerve preservation rates after Gamma Knife radiosurgery for vestibular schwannoma.
  • [MeSH-major] Facial Nerve / radiation effects. Facial Nerve Injuries / epidemiology. Facial Nerve Injuries / etiology. Neuroma, Acoustic / surgery. Radiosurgery / adverse effects

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  • (PMID = 19430881.001).
  • [ISSN] 1573-7373
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 85
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92. Tamura M, Murata N, Hayashi M, Roche PH, Régis J: Facial nerve function insufficiency after radiosurgery versus microsurgery. Prog Neurol Surg; 2008;21:108-18
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  • [Title] Facial nerve function insufficiency after radiosurgery versus microsurgery.
  • BACKGROUND: Due to the synergic role of the facial nerve and the nervus intermedius in the mechanical protection of the eye and taste, vestibular schwannomas and/or their treatment may prove to be dangerous for the visual function and taste.
  • Our goal was to evaluate and compare the impact of the tumor itself and the impact of microsurgery (MS) or Gamma Knife radiosurgery (GKS).
  • MATERIALS AND METHODS: A functional questionnaire evaluating, among other items, patient complaints related to the eye and taste has been given out to a series of 200 patients 3 years after the GKS of a unilateral vestibular schwannoma not previously resected.
  • Thus, 14% of patients with no clinical signs of impairment of the VIIth motor nerve presented signs indicating the injury of the intermedius nerve, with the same probability whatever the kind of surgery.
  • This suggests an early lesion of the VIIth motor nerve and nervus intermedius and a subsequent abnormal regrowth.
  • The only patient reporting a crocodile tear syndrome after GKS turned out to have a transiently presented mild deficit of the orbicular muscle signing a transient partial facial nerve injury.
  • In the absence of FP, a 'crying eye' was reported more frequently after MS (16/42 vs. 9/64; p = 0.01) leading us to suspect a frequent subclinical injury of the VIIth nerve in those patients operated on using MS with no obvious FP.
  • However, symptoms related to the eye and taste either due to the injury of the nervus intermedius or the VIIth motor nerve or both are much more frequent after MS than after RS.
  • [MeSH-major] Eye Diseases / epidemiology. Facial Nerve / physiopathology. Microsurgery / adverse effects. Neuroma, Acoustic / surgery. Radiosurgery / adverse effects. Taste Disorders / epidemiology


93. Ciric I, Zhao JC, Rosenblatt S, Wiet R, O'Shaughnessy B: Suboccipital retrosigmoid approach for removal of vestibular schwannomas: facial nerve function and hearing preservation. Neurosurgery; 2005 Mar;56(3):560-70; discussion 560-70
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  • [Title] Suboccipital retrosigmoid approach for removal of vestibular schwannomas: facial nerve function and hearing preservation.
  • In this report, we discuss the pertinent bony, arachnoid, and neurovascular anatomy of vestibular schwannomas that has an impact on the surgical technique for removal of these tumors, with the goal of facial nerve and hearing preservation.
  • The surgical technique is described in detail starting with anesthesia, positioning, and neurophysiological monitoring and continuing with the exposure, technical nuances of tumor removal, hemostasis, and closure.
  • [MeSH-major] Facial Nerve Injuries / prevention & control. Hearing Loss, Sensorineural / prevention & control. Neuroma, Acoustic / surgery. Postoperative Complications / prevention & control
  • [MeSH-minor] Anesthesia, General. Arachnoid / anatomy & histology. Cochlear Nerve / anatomy & histology. Dura Mater / surgery. Electromyography. Endolymphatic Duct / anatomy & histology. Evoked Potentials, Auditory, Brain Stem. Facial Nerve / anatomy & histology. Humans. Mastoid / anatomy & histology. Monitoring, Intraoperative. Neurosurgical Procedures / methods. Prognosis. Semicircular Canals / anatomy & histology

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  • (PMID = 15730582.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 19
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94. Chen L, Chen L, Liu L, Ling F, Yuan X, Fang J, Liu Y: Vestibular schwannoma microsurgery with special reference to facial nerve preservation. Clin Neurol Neurosurg; 2009 Jan;111(1):47-53
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  • [Title] Vestibular schwannoma microsurgery with special reference to facial nerve preservation.
  • OBJECTIVE: To retrospectively study the outcomes of vestibular schwannoma (VS) resection.
  • The relationship between tumor size, location, and topography relative to the facial nerve bundles was studied for a mean duration of 16 months (range: 3-39 months).
  • RESULTS: Complete tumor resection in combination with anatomic preservation of the facial nerve was achieved in 101 (98.1%) cases.
  • The facial nerve was fully preserved in 100% of cases with small or medium tumors and in 37/39 patients with large tumors.
  • Overall, 83.5% of patients had normal or near-normal facial nerve function 3-12 months post-surgically.
  • CONCLUSIONS: Even in large VS, preservation of facial nerve function (H-B Grade I or II) should be prioritized over total resection.
  • For tumors >3cm, the goal of low morbidity and maintenance of normal facial nerve function can be attained with the retrosigmoid transmeatal approach, refined microsurgical technique, and intraoperative facial nerve monitoring.
  • [MeSH-major] Facial Nerve / physiopathology. Microsurgery / adverse effects. Neuroma, Acoustic / surgery. Postoperative Complications / physiopathology


95. Perrot X, Fischer C: [Functional assessment of cochlear nerve and hearing]. Neurochirurgie; 2009 Apr;55(2):142-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Functional assessment of cochlear nerve and hearing].
  • Hearing and cochlear nerve exploration can be carried out using three principal methods: pure-tone and speech audiometry, evoked otoacoustic emissions (EOAEs), and brainstem auditory evoked potentials (BAEPs).
  • CONCLUSION: Auditory functional assessment is essential for optimal care of tumor or functional pathologies involving the cochlear nerve and/or the cerebellopontine angle.
  • [MeSH-major] Audiometry. Cochlear Nerve / surgery. Hearing / physiology. Neurosurgical Procedures. Vestibulocochlear Nerve Diseases / surgery
  • [MeSH-minor] Acoustic Stimulation. Audiometry, Pure-Tone. Auditory Threshold / physiology. Electroencephalography. Evoked Potentials, Auditory / physiology. Evoked Potentials, Auditory, Brain Stem / physiology. Humans. Preoperative Care. Treatment Outcome

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  • (PMID = 19298983.001).
  • [ISSN] 0028-3770
  • [Journal-full-title] Neuro-Chirurgie
  • [ISO-abbreviation] Neurochirurgie
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Meta-Analysis; Review
  • [Publication-country] France
  • [Number-of-references] 61
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96. Seol HJ, Kim CH, Park CK, Kim CH, Kim DG, Chung YS, Jung HW: Optimal extent of resection in vestibular schwannoma surgery: relationship to recurrence and facial nerve preservation. Neurol Med Chir (Tokyo); 2006 Apr;46(4):176-80; discussion 180-1
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  • [Title] Optimal extent of resection in vestibular schwannoma surgery: relationship to recurrence and facial nerve preservation.
  • Surgical treatment of vestibular schwannoma is targeted at complete removal with preserved neurological function.
  • Complete removal may cause significant deficits, whereas subtotal tumor removal is associated with a high recurrence rate.
  • The present study assessed the risk of tumor recurrence and postoperative facial nerve function in relation to the extent of surgical resection by reviewing the clinical records and radiological findings of 116 patients with vestibular schwannoma treated between 1990 and 1999.
  • Facial nerve function was graded using the modified House-Brackmann grade, and patients grouped into good (grades 1-2) and intermediate or poor (grades 3-6).
  • Immediately postoperative facial nerve function was good in 15.4% of patients after GTR, 40.6% after NTR, and 46.6% after STR.
  • The STR and NTR carried a lower risk of facial nerve palsy than GTR in the immediately postoperative stage (p=0.006 and 0.036, respectively).
  • Nevertheless, no statistical significance was observed in extent of resection and postoperative facial nerve outcome between the groups at last follow up (p=0.227).
  • GTR is the ideal surgical treatment for vestibular schwannoma, but NTR is a good option, with better facial nerve function preservation than GTR without significantly increasing the risk of recurrence.
  • [MeSH-major] Facial Nerve Injuries / etiology. Facial Paralysis / etiology. Neoplasm Recurrence, Local / etiology. Neoplasm, Residual / etiology. Neuroma, Acoustic / surgery. Postoperative Complications / etiology

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  • [CommentIn] Neurol Med Chir (Tokyo). 2006 Jun;46(6):318 [16794356.001]
  • (PMID = 16636507.001).
  • [ISSN] 0470-8105
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
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97. Sasaki T, Shono T, Hashiguchi K, Yoshida F, Suzuki SO: Histological considerations of the cleavage plane for preservation of facial and cochlear nerve functions in vestibular schwannoma surgery. J Neurosurg; 2009 Apr;110(4):648-55
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  • [Title] Histological considerations of the cleavage plane for preservation of facial and cochlear nerve functions in vestibular schwannoma surgery.
  • OBJECT: The authors analyzed the tumor capsule and the tumor-nerve interface in vestibular schwannomas (VSs) to define the ideal cleavage plane for maximal tumor removal with preservation of facial and cochlear nerve functions.
  • RESULTS: The authors observed a continuous thin connective tissue layer enveloping the surfaces of the tumors.
  • Some nerve fibers, which were immunopositive to myelin basic protein and considered to be remnants of vestibular nerve fibers, were also identified widely beneath the connective tissue layer.
  • These findings indicated that the socalled "tumor capsule" in VSs is the residual vestibular nerve tissue itself, consisting of the perineurium and underlying nerve fibers.
  • There was no structure bordering the tumor parenchyma and the vestibular nerve fibers.
  • In specimens of tumors removed en bloc with the cochlear nerves, the authors found that the connective tissue layer, corresponding to the perineurium of the cochlear nerve, clearly bordered the nerve fibers and tumor tissue.
  • CONCLUSIONS: Based on these histological observations, complete tumor resection can be achieved by removal of both tumor parenchyma and tumor capsule when a clear border between the tumor capsule and facial or cochlear nerve fibers can be identified intraoperatively.
  • Conversely, when a severe adhesion between the tumor and facial or cochlear nerve fibers is observed, dissection of the vestibular nerve-tumor interface (the subcapsular or subperineurial dissection) is recommended for preservation of the functions of these cranial nerves.
  • [MeSH-major] Cochlear Nerve / anatomy & histology. Facial Nerve / anatomy & histology. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods

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  • (PMID = 18928359.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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98. Arts HA, Telian SA, El-Kashlan H, Thompson BG: Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: results using the middle cranial fossa approach. Otol Neurotol; 2006 Feb;27(2):234-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: results using the middle cranial fossa approach.
  • OBJECTIVE: To evaluate surgical results using the middle cranial fossa approach for hearing preservation vestibular schwannoma surgery.
  • PATIENTS: Seventy-three consecutive patients with vestibular schwannoma operated on using the middle cranial fossa approach between February 1999 and February 2005.
  • INTERVENTIONS: The tumors were removed via the middle cranial fossa approach with modifications to improve exposure.
  • Standard auditory brainstem and facial nerve monitoring were used.
  • MAIN OUTCOME MEASURES: Pre- and postoperative hearing measures and facial function, tumor size, and postoperative complications.
  • Hearing status was categorized into Classes A, B, C, and D as described by the American Academy of Otolaryngology-Head and Heck Surgery "Guidelines for the Evaluation of Hearing Preservation in Acoustic Neuroma, 1995."
  • Twenty-eight patients presented with Class B hearing preoperatively.
  • Eight patients presented in Class D and one of these improved to Class C postoperatively.
  • Nineteen patients had tumors larger than 10 mm in greatest dimension and had Class A or B hearing preoperatively.
  • At 4 months or greater follow-up, facial nerve outcome were excellent in 96%: House-Brackmann Grade I in 61 (85%), Grade II in 8 (11%), and Grade III in 3 (4%).
  • CONCLUSION: By achieving excellent exposure and using meticulous microsurgical technique, it is possible to resect small vestibular schwannomas via the middle fossa approach, with preservation of hearing at excellent or preoperative levels in the majority of patients, with excellent or satisfactory facial nerve outcomes in 96% of patients.
  • [MeSH-major] Auditory Threshold / physiology. Facial Nerve / physiology. Facial Paralysis / prevention & control. Hearing Loss, Sensorineural / prevention & control. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / methods
  • [MeSH-minor] Audiometry, Evoked Response. Audiometry, Pure-Tone. Cranial Fossa, Middle. Female. Humans. Male. Postoperative Complications / prevention & control. Regression Analysis. Retrospective Studies. Treatment Outcome

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  • (PMID = 16436995.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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99. Demetriades AK, Saunders N, Rose P, Fisher C, Rowe J, Tranter R, Hardwidge C: Malignant transformation of acoustic neuroma/vestibular schwannoma 10 years after gamma knife stereotactic radiosurgery. Skull Base; 2010 Sep;20(5):381-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant transformation of acoustic neuroma/vestibular schwannoma 10 years after gamma knife stereotactic radiosurgery.
  • Only a handful of cases of de-novo malignancies of the vestibulocochlear nerve have been reported.
  • Even rarer is the malignant transformation of a previously histologically diagnosed benign vestibular schwannoma.
  • We present the case of a young adult who had combined operative/Gamma knife treatment for a benign vestibular schwannoma, followed by further surgery 2 years later.
  • He represented 10 years after original diagnosis with facial numbness and ataxia, MRI showing gross tumor recurrence.
  • After radical resection, histology showed malignant transformation to a malignant peripheral nerve sheath tumor.
  • While awaiting radiotherapy the tumor recurred again, the patient succumbing.
  • In the literature there are 13 other cases of malignant vestibular schwannomata.
  • The tumor biology of vestibular schwannomata as well as the radiobiology in the context of malignant transformation is discussed.

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  • [Cites] Nucleic Acids Res. 1983 Oct 25;11(20):7191-203 [6634412.001]
  • (PMID = 21359005.001).
  • [ISSN] 1532-0065
  • [Journal-full-title] Skull base : official journal of North American Skull Base Society ... [et al.]
  • [ISO-abbreviation] Skull Base
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC3023338
  • [Keywords] NOTNLM ; Gamma knife radiosurgery / Vestibular schwannoma / acoustic neuroma / anaplastic sarcoma / malignant peripheral nerve sheath tumor (MPNST) / malignant transformation / radiotherapy
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100. Zhao H, Li X, Lv Q, Yuan Y, Yu H: A large dumbbell glossopharyngeal schwannoma involving the vagus nerve: a case report and review of the literature. J Med Case Rep; 2008;2:334
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A large dumbbell glossopharyngeal schwannoma involving the vagus nerve: a case report and review of the literature.
  • INTRODUCTION: Schwannoma arising from the glossopharyngeal nerve is a rare intracranial tumor.
  • Accurate pre-operative diagnosis and optimal treatment are still difficult.
  • CASE PRESENTATION: We present one case of schwannoma originating from the ninth cranial nerve with palsies of the trigeminal nerve, facial-acoustic nerve complex, and vagus nerve in addition to ninth nerve dysfunction.
  • Magnetic resonance imaging showed tumors located in the cerebellopontine angle with extracranial extension via the jugular foramen, with evident enhancement on post-contrast scan.
  • A favorable option of approach and appropriate planning of surgical strategy should be the goal of operation for this benign tumor.

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  • (PMID = 18954436.001).
  • [ISSN] 1752-1947
  • [Journal-full-title] Journal of medical case reports
  • [ISO-abbreviation] J Med Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2584006
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