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1. Coca Pelaz A, Fernández Lisa C, Gómez JR, Rodrigo JP, Llorente JL, Suárez C: [Complete facial palsy following surgery for acoustic nerve neurinoma: evolution and associated ophthalmological complications]. Acta Otorrinolaringol Esp; 2008 May;59(5):223-7
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  • [Title] [Complete facial palsy following surgery for acoustic nerve neurinoma: evolution and associated ophthalmological complications].
  • [Transliterated title] Parálisis facial completa tras cirugía de neurinoma del acústico: evolución y complicaciones oftalmológicas asociadas.
  • OBJECTIVE: To evaluate the fraction of patients recovering to normal function after complete facial nerve paralysis secondary to acoustic neuroma surgery, and also to address the ophthalmologic complications associated with it and the therapeutic options.
  • MATERIAL AND METHOD: We performed a retrospective review of 30 cases operated on in our department for acoustic neuroma and who, despite anatomical preservation of the facial nerve, developed a complete post-operative facial nerve paralysis (grade VI of House-Brackmann [HB]).
  • RESULTS: Only 5 of the 30 cases studied (16.6 %) recovered to normal facial nerve function (HB grade I).
  • [MeSH-major] Cochlear Nerve / pathology. Cochlear Nerve / surgery. Corneal Ulcer / etiology. Facial Paralysis / etiology. Facial Paralysis / physiopathology. Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Peripheral Nervous System Neoplasms / pathology. Peripheral Nervous System Neoplasms / surgery. Postoperative Complications
  • [MeSH-minor] Adult. Aged. Disease Progression. Female. Humans. Male. Middle Aged. Retrospective Studies

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  • (PMID = 18501157.001).
  • [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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2. Coca Pelaz A, Rodrigo JP, Llorente JL, Gómez JR, Suárez C: [Unusual clinical presentations of vestibular schwannomas]. Acta Otorrinolaringol Esp; 2008 Apr;59(4):187-9
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  • [Title] [Unusual clinical presentations of vestibular schwannomas].
  • [Transliterated title] Formas clínicas inusuales de presentación de los neurinomas del acústico.
  • The aim of this study is evaluate the unusual ways of initial presentation of the vestibular schwannomas.
  • We performed a retrospective study of the patients who underwent resection of acoustic neuromas on our service, including for analysis only the cases which initial symptom was not the hearing loss.
  • Tumor size, localization, clinical presentation, and age of the patients were considered.
  • A significant group of patients did not present with the otological symptoms classically associated with vestibular schwannoma.
  • [MeSH-major] Cerebellopontine Angle / pathology. Hearing Loss / etiology. Neuroma, Acoustic / complications. Neuroma, Acoustic / pathology

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  • (PMID = 18447978.001).
  • [ISSN] 0001-6519
  • [Journal-full-title] Acta otorrinolaringológica española
  • [ISO-abbreviation] Acta Otorrinolaringol Esp
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
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3. Choy NL, Johnson N, Treleaven J, Jull G, Panizza B, Brown-Rothwell D: Balance, mobility and gaze stability deficits remain following surgical removal of vestibular schwannoma (acoustic neuroma): an observational study. Aust J Physiother; 2006;52(3):211-6
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  • [Title] Balance, mobility and gaze stability deficits remain following surgical removal of vestibular schwannoma (acoustic neuroma): an observational study.
  • QUESTION: Are there residual deficits in balance, mobility, and gaze stability after surgical removal of vestibular schwannoma?
  • PARTICIPANTS: Twelve people with a mean age of 52 years who had undergone surgical removal of vestibular schwannoma at least three months previously and had not undergone vestibular rehabilitation.
  • CONCLUSION: A prospective study is required to evaluate vestibular rehabilitation to ameliorate dizziness and to improve balance, mobility, and gaze stability for this clinical group.
  • [MeSH-major] Mobility Limitation. Neuroma, Acoustic / complications. Neuroma, Acoustic / surgery. Ocular Motility Disorders / etiology. Postural Balance. Sensation Disorders / etiology


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4. Propp JM, McCarthy BJ, Davis FG, Preston-Martin S: Descriptive epidemiology of vestibular schwannomas. Neuro Oncol; 2006 Jan;8(1):1-11
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  • [Title] Descriptive epidemiology of vestibular schwannomas.
  • Vestibular schwannomas, commonly termed acoustic neuromas, arise from the vestibular branch of the eighth cranial nerve (acoustic nerve) and are benign, slow-growing brain tumors that negatively impact patient quality of life.
  • They are thought to account for the majority of intracranial nerve sheath tumors.
  • To describe incidence rate patterns and trends of primary nerve sheath tumors of the brain/CNS and the subset of vestibular schwannomas in two population-based incidence registries, data were obtained from 11 Central Brain Tumor Registry of the United States (CBTRUS) collaborating state registries and the Los Angeles County Cancer Surveillance Program (LACCSP) (1975-1998).
  • Multiplicative Poisson regression models were used to compare trends in primary nerve sheath tumors of the brain/CNS overall and in subgroups, including vestibular schwannomas, controlling for age, gender, race, microscopic confirmation, and region.
  • The overall incidence of primary nerve sheath tumors of the brain/CNS was 1.1 per 100,000 person-years (CBTRUS, 1995-1999 and LACCSP, 1995-1998).
  • The incidence of vestibular schwannomas was similar for both data sets: 0.6 per 100,000 person-years (CBTRUS, 1995-1999) and 0.8 per 100,000 person-years (LACCSP, 1995-1998).
  • Moreover, the incidence of primary nerve sheath tumors of the brain/CNS overall (CBTRUS, 1985-1999 and LACCSP, 1975-1998) and of vestibular schwannomas (CBTRUS, 1992-1999 and LACCSP, 1992-1998) increased over time.
  • However, the incidence of benign schwannomas in sites other than the acoustic nerve either decreased (CBTRUS, 1992-1999) or experienced no significant change (LACCSP, 1992-1998).
  • [MeSH-major] Neuroma, Acoustic / epidemiology. Registries

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  • (PMID = 16443943.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC1871924
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5. Arthurs BJ, Lamoreaux WT, Giddings NA, Fairbanks RK, Mackay AR, Demakas JJ, Cooke BS, Lee CM: Gamma Knife radiosurgery for vestibular schwannoma: case report and review of the literature. World J Surg Oncol; 2009;7:100
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  • [Title] Gamma Knife radiosurgery for vestibular schwannoma: case report and review of the literature.
  • Vestibular schwannomas, also called acoustic neuromas, are benign tumors of the vestibulocochlear nerve.
  • Unfortunately, definitive guidelines for treating vestibular schwannomas are lacking, because of insufficient evidence comparing the outcomes of therapeutic modalities.We present a contemporary case report, describing the finding of a vestibular schwannoma in a patient who presented with dizziness and a "clicking" sensation in the ear, but no hearing deficit.
  • Audible clicking is a symptom that, to our knowledge, has not been associated with vestibular schwannoma in the literature.
  • This case highlights an atypical presentation of vestibular schwannoma, associated with audible "clicks" and normal hearing.
  • We also provide a concise review of the available literature on modern vestibular schwannoma treatment, which may be useful in guiding treatment decisions.
  • [MeSH-major] Neurilemmoma / surgery. Neuroma, Acoustic / surgery. Radiosurgery. Vestibular Nerve / surgery

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  • (PMID = 20021676.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2803477
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6. Archibald DJ, Neff BA, Voss SG, Splinter PL, Driscoll CL, Link MJ, Dong H, Kwon ED: B7-H1 expression in vestibular schwannomas. Otol Neurotol; 2010 Aug;31(6):991-7
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  • [Title] B7-H1 expression in vestibular schwannomas.
  • HYPOTHESIS: B7-H1 is expressed in vestibular schwannomas.
  • BACKGROUND: Little is known about how benign human vestibular schwannomas interact with antibody-mediated or cell-mediated immunity.
  • We report on the aberrant expression of a novel T-cell coregulatory molecule, B7 homolog 1 (B7-H1), in vestibular schwannomas and discuss the implications of B7-H1 expression and tumor aggressiveness and a potential regulator of B7-H1 expression.
  • METHODS: Immunohistochemical staining for B7-H1, CD8+, CD3+, and CD4+ lymphocytes were performed on 48 fresh-frozen vestibular schwannoma tissue specimens.
  • A clinical review of patient presenting symptoms and tumor characteristics was performed.
  • Real-time polymerase chain reaction was used to determine if there was differential expression of B7-H1 messenger RNA and microRNA-513, a known regulator of B7-H1, in several strongly positive and negative B7-H1 vestibular schwannomas.
  • RESULTS: Nine (19%) of 48 tumors were negative, 23 (48%) tumors were 1+ mildly positive (<20% section area), and 16 (33%) stained 2+ strongly positive (>or=20% section area) for B7-H1.
  • The average number of CD8 cells per high-power field was 2.1 for positive-staining tumors and 1.0 for negative tumors (p = 0.16).
  • Failure of tumor control with stereotactic radiation (p = 0.029) was significantly greater in the strongly positive B7-H1 tumors.
  • Real-time polymerase chain reaction did not show significant differential expression of microRNA-513 (p = 0.62) or B7-H1 messenger RNA (p = 0.35) between the tumors showing strong and negative immunohistochemical staining for B7-H1 protein.
  • CONCLUSION: Vestibular schwannoma tumors express B7-H1, which has been associated with immune tolerance and adverse disease characteristics in several malignancies.
  • Growing tumors that were surgically removed after failed stereotactic radiation therapy were significantly more likely to strongly express B7-H1 protein, which lends some credibility to the hypothesis that immuno-evasion may play some role in their continued growth.
  • Although clinical trends were seen, greater statistical power is required to evaluate whether B7-H1 expression correlates with more aggressive tumor growth or poorer hearing class.
  • B7-H1 seems to be expressed in equal amounts at the RNA level in all vestibular schwannoma tumors that suggests that differential protein expression is occurring at the posttranscriptional level.
  • However, microRNA-513 does not regulate B7-H1 protein expression in these tumors.

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  • (PMID = 20601920.001).
  • [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
  • [Grant] United States / NCI NIH HHS / CA / CA134345-03; United States / NCI NIH HHS / CA / R01 CA134345; United States / NCI NIH HHS / CA / R01 CA134345-03
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD; 0 / Antigens, CD274; 0 / CD274 protein, human; 0 / RNA, Messenger
  • [Other-IDs] NLM/ NIHMS242934; NLM/ PMC4810681
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7. Piedra MP, Scheithauer BW, Driscoll CL, Link MJ: Primary Melanocytic Tumor of the Cerebellopontine Angle Mimicking a Vestibular Schwannoma. Neurosurgery; 2006 Jul 01;59(1):E206
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  • [Title] Primary Melanocytic Tumor of the Cerebellopontine Angle Mimicking a Vestibular Schwannoma.

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  • (PMID = 28180621.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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8. Myrseth E, Møller P, Wentzel-Larsen T, Goplen F, Lund-Johansen M: Untreated Vestibular Schwannoma: Vertigo is a Powerful Predictor for Health-Related Quality of Life. Neurosurgery; 2006 Jul 01;59(1):67-76
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  • [Title] Untreated Vestibular Schwannoma: Vertigo is a Powerful Predictor for Health-Related Quality of Life.

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  • (PMID = 28180608.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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9. Hasegawa T, Kida Y, Yoshimoto M, Koike J, Goto K: TABLEEvaluation of Tumor Expansion after Stereotactic Radiosurgery in Patients Harboring Vestibular Schwannomas. Neurosurgery; 2006 Jun 01;58(6):1119-1128
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  • [Title] TABLEEvaluation of Tumor Expansion after Stereotactic Radiosurgery in Patients Harboring Vestibular Schwannomas.

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  • (PMID = 28173267.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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10. Chang LS, Welling DB: Molecular biology of vestibular schwannomas. Methods Mol Biol; 2009;493:163-77
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Molecular biology of vestibular schwannomas.
  • Recent advances in molecular biology have led to a better understanding of the etiology of vestibular schwannomas.
  • The underlying purpose of vestibular schwannoma research is the development of new treatment options; however, such options have not yet been established.
  • A fundamental understanding of the underlying molecular events leading to tumor formation began when mutations in the neurofibromatosis type 2 (NF2) tumor suppressor gene were identified in vestibular schwannomas.
  • The clinical characteristics of vestibular schwannomas and neurofibromatosis type 2 (NF2) syndromes have both been related to alterations in the NF2 gene.
  • When utilized with clinical screening, such as magnetic resonance imaging (MRI), conventional audiometry, and auditory brainstem response (ABR), the early detection of NF2 can be made, which consequently makes a significant difference in the ability to successfully treat vestibular schwannomas.
  • Nf2-transgenic and knockout mice as well as vestibular schwannoma xenograft models are now ready for novel therapeutic testing.
  • [MeSH-major] Mutation. Neurofibromin 2 / genetics. Neuroma, Acoustic / genetics
  • [MeSH-minor] Animals. DNA Mutational Analysis. Genetic Predisposition to Disease. Humans. Magnetic Resonance Imaging. Mice. Mice, Knockout. Mice, SCID. Mice, Transgenic. Neurofibromatosis 2 / genetics. Neurofibromatosis 2 / pathology

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  • (PMID = 18839347.001).
  • [ISSN] 1064-3745
  • [Journal-full-title] Methods in molecular biology (Clifton, N.J.)
  • [ISO-abbreviation] Methods Mol. Biol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Neurofibromin 2
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11. Mackle T, Rawluk D, Walsh RM: Atypical clinical presentations of vestibular schwannomas. Otol Neurotol; 2007 Jun;28(4):526-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Atypical clinical presentations of vestibular schwannomas.
  • A significant number of patients with vestibular schwannomas present atypically, with none of the classical symptoms of unilateral sensorineural hearing loss, tinnitus, and/or dysequilibrium.
  • STUDY DESIGN: The clinical data of all patients who presented to the vestibular schwannoma clinic at Beaumont Hospital over the past 12 years was prospectively recorded in a computerized database.
  • CONCLUSION: A significant subgroup, 3.7% in our study, did not present with the audiovestibular symptoms classically associated with vestibular schwannoma.
  • [MeSH-major] Neuroma, Acoustic / diagnosis

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  • (PMID = 17414179.001).
  • [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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12. Régis J, Roche PH, Delsanti C, Thomassin JM, Ouaknine M, Gabert K, Pellet W: Modern management of vestibular schwannomas. Prog Neurol Surg; 2007;20:129-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Modern management of vestibular schwannomas.
  • Within the last 3 decades, microsurgery and stereotactic radiosurgery (SRS) have become well-established management options for vestibular schwannomas (VSs).
  • A long-term tumor control rate of 97%, transient facial palsy lower than 1%, and a probability of functional hearing preservation between 50 and 95% was achieved in this large series of patients treated with state-of-the-art SRS.
  • [MeSH-major] Neuroma, Acoustic / surgery. Postoperative Complications / epidemiology. Radiosurgery

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  • (PMID = 17317981.001).
  • [ISSN] 0079-6492
  • [Journal-full-title] Progress in neurological surgery
  • [ISO-abbreviation] Prog Neurol Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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13. 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%.
  • 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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14. Wowra B, Muacevic A, Jess-Hempen A, Hempel JM, Müller-Schunk S, Tonn JC: Outpatient gamma knife surgery for vestibular schwannoma: definition of the therapeutic profile based on a 10-year experience. J Neurosurg; 2005 Jan;102(s_supplement):114-118
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outpatient gamma knife surgery for vestibular schwannoma: definition of the therapeutic profile based on a 10-year experience.
  • OBJECT: The purpose of the study was to define the therapeutic profile of outpatient gamma knife surgery (GKS) for vestibular schwannoma (VS) by using sequential tumor volumetry to quantify changes following treatment.
  • The actuarial 6-year tumor control rate after a single GKS treatment was 95%.
  • Tumor swelling was observed in 43 patients (38.7%).
  • Recurrence was significantly associated with NF2 (p < 0.003) and the reduced dose (p < 0.03) delivered to these tumors.
  • The incidence of facial nerve neuropathy was mainly determined by surgery prior to GKS (p < 0.0001).
  • Facial nerve radiation toxicity was mild and transient.
  • No permanent facial nerve toxicity was observed.
  • The risk of hearing loss was correlated with age and transient tumor swelling (p < 0.05) but not with dose parameters or NF2.

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  • (PMID = 28306422.001).
  • [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 ; gamma knife surgery / tumor volumetry / vestibular schwannoma
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15. Lunsford LD, Niranjan A, Flickinger JC, Maitz A, Kondziolka D: Radiosurgery of vestibular schwannomas: summary of experience in 829 cases. J Neurosurg; 2005 Jan;102(s_supplement):195-199
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radiosurgery of vestibular schwannomas: summary of experience in 829 cases.
  • OBJECT: Management options for vestibular schwannomas (VSs) have greatly expanded since the introduction of stereotactic radiosurgery.
  • Optimal outcomes reflect long-term tumor control, preservation of cranial nerve function, and retention of quality of life.
  • The average tumor volume was 2.5 cm<sup>3</sup>.
  • The median margin dose to the tumor was 13 Gy (range 10-20 Gy).
  • Unchanged hearing preservation was possible in 50 to 77% of patients (up to 90% in those with intracanalicular tumors).
  • Trigeminal symptoms were detected in less than 3% of patients whose tumors reached the level of the trigeminal nerve.
  • Tumor control rates at 10 years were 97% (no additional treatment needed).
  • Gamma knife surgery provides a low risk, minimally invasive treatment option for patients with newly diagnosed or residual vs. Cranial nerve preservation and quality of life maintenance are possible in long-term follow up.

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  • (PMID = 28306432.001).
  • [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 ; gamma knife surgery / radiosurgery / vestibular schwannoma
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16. Chung WY, Liu KD, Shiau CY, Wu HM, Wang LW, Guo WY, Ming-Tak Ho D, Hung-Chi Pan D: Gamma knife surgery for vestibular schwannoma: 10-year experience of 195 cases. J Neurosurg; 2005 Jan;102(s_supplement):87-97
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Gamma knife surgery for vestibular schwannoma: 10-year experience of 195 cases.
  • OBJECT: The authors conducted a study to determine the optimal radiation dose for vestibular schwannoma (VS) and to examine the histopathology in cases of treatment failure for better understanding of the effects of irradiation.
  • Seventy-two patients (37%) had undergone partial or total excision of their tumor prior to gamma knife surgery (GKS).
  • The mean tumor volume was 4.1 cm<sup>3</sup> (range 0.04-23.1 cm<sup>3</sup>).
  • Multiisocenter dose planning placed a prescription dose of 11 to 18.2 Gy on the 50 to 94% isodose located at the tumor margin.
  • At the latest MR imaging assessment decreased or stable tumor volume was demonstrated in 93.6% of the patients.
  • Uncontrolled tumor swelling was noted in five patients at 3.5, 17, 24, 33, and 62 months after GKS, respectively.
  • Histopathological examination of specimens in three cases (one at 62 months after GKS) revealed a long-lasting radiation effect on vessels inside the tumor.
  • A margin 12-Gy dose with homogeneous distribution is effective in preventing tumor progression, while posing no serious threat to normal cranial nerve function.

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  • (PMID = 28306447.001).
  • [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 ; gamma knife surgery / stereotaxy / vestibular schwannoma
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17. Tlachacova D, Schmitt M, Novotny J Jr, Novotny J, Majali M, Liscak R: A comparison of the gamma knife model C and the Automatic Positioning System with Leksell model B. J Neurosurg; 2005 Jan;102(s_supplement):25-28
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Data were analyzed in patients in whom the following diagnoses had been made: vestibular schwannoma, pituitary adenoma, meningioma, solitary metastasis, and other benign and malignant solitary tumors.
  • CONCLUSIONS: With the C model there was a better conformity for most treated targets, such as vestibular schwannomas (p = 0.005) and meningiomas (p = 0.015).

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  • (PMID = 28306471.001).
  • [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 ; conformity index / extracranial exposure / staff exposure / stereotactic radiosurgery
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18. Inoue HK: Low-dose radiosurgery for large vestibular schwannomas: long-term results of functional preservation. J Neurosurg; 2005 Jan;102(s_supplement):111-113
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Low-dose radiosurgery for large vestibular schwannomas: long-term results of functional preservation.
  • OBJECT: The author conducted a study to assess the long-term results obtained in patients who underwent GKS for large vestibular schwannomas (> cochlear nerve functions were evaluated.
  • METHODS: Twenty consecutive large tumors in 18 patients (including two cases of neurofibromatosus Type 2 [NF2]) were followed for more than 6 years.
  • There were eight tumors that were more than 4 cm in maximum diameter.
  • Microsurgery had already been performed prior to GKS in 11 patients (nine recurrent and two residual tumors).
  • Fourteen of 15 tumors were stable or decreased in size.
  • Facial nerve function was preserved in all patients and hearing preserved in four of five patients with cochlear nerve function prior to radiosurgery.
  • CONCLUSIONS: Gamma knife surgery seems to have a place in the low-dose treatment of selected large vestibular schwannoma in patients with a reasonable chance of retaining facial function and pretreatment hearing level.

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  • (PMID = 28306427.001).
  • [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 ; facial function / gamma knife surgery / outcome / vestibular schwannoma
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19. Roche PH, Bouvier C, Chinot O, Figarella-Branger D: Genesis and biology of vestibular schwannomas. Prog Neurol Surg; 2008;21:24-31
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Genesis and biology of vestibular schwannomas.
  • This review chapter is a synthesis of the recent literature about pathogenesis of schwannomas with emphasis on vestibular schwannomas (VSs).
  • The cornerstone of cellular transformation and proliferation of Schwann cells toward schwannomas has been attributed to the nonexpression of normal schwannomin/merlin (S/M) by these cells.
  • The understanding of this mechanism has been gained from molecular genetic studies of neurofibromatosis type 2 (NF2) patients, in whom mutations of a tumor suppressor gene (NF2 gene) was clearly identified.
  • Lack of normal S/M protein in the schwannoma cell is due to gene mutation in 50% of sporadic VSs.
  • The exact interactions of S/M with extracellular matrix, membranous glycoprotein and cytoskeleton are not fully understood.
  • However, it is recognized that these interactions activate several pathways that might regulate cell-cycle process, apoptosis and intercellular interaction.
  • Apart from the involvement of the S/M pathway, the authors review the potential role of other genetic abnormalities and growing factors that are supposed to be involved in the pathogenesis of vs. Understanding the pathways of action and regulation of S/M may provide the basics for identifying potential therapeutic targets, which is of paramount importance for a better management of NF2 patients.
  • [MeSH-major] Genes, Neurofibromatosis 2 / physiology. Neurofibromin 2 / physiology. Neuroma, Acoustic / genetics. Neuroma, Acoustic / pathology

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  • (PMID = 18810196.001).
  • [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
  • [Chemical-registry-number] 0 / Neurofibromin 2
  • [Number-of-references] 43
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20. Ambett R, Rupa V, Rajshekhar V: Analysis of causes for late presentation of Indian patients with vestibular schwannoma. J Laryngol Otol; 2009 May;123(5):502-8
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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 causes for late presentation of Indian patients with vestibular schwannoma.
  • OBJECTIVE: To determine the causes of delay in diagnosis and treatment of Indian patients with vestibular schwannomas.
  • METHODS: In a prospective study from 2003 to 2005, 50 patients with a confirmed diagnosis of vestibular schwannoma were interviewed to determine the causes for (1) the delay between the patient noting the initial symptom and the definitive diagnosis, and (2) the reasons for delayed diagnosis.
  • After the patient had noted symptoms, the diagnosis of vestibular schwannoma was delayed due to doctor-related causes in 80 per cent of cases, and due to patient-related causes in 20 per cent.
  • CONCLUSIONS: Delay in the diagnosis of vestibular schwannoma in Indian patients is due to both doctor- and patient-related factors.
  • [MeSH-major] Hearing Loss, Sensorineural / etiology. Neuroma, Acoustic / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Disease Progression. Female. Health Knowledge, Attitudes, Practice. Humans. India. Male. Middle Aged. Prospective Studies. Referral and Consultation / standards. Time Factors. Tinnitus / etiology. Vertigo / etiology. Vestibular Function Tests. Young Adult

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  • (PMID = 18808730.001).
  • [ISSN] 1748-5460
  • [Journal-full-title] The Journal of laryngology and otology
  • [ISO-abbreviation] J Laryngol Otol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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21. Battista RA: Gamma knife radiosurgery for vestibular schwannoma. Otolaryngol Clin North Am; 2009 Aug;42(4):635-54
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Gamma knife radiosurgery for vestibular schwannoma.
  • Since Leksell first treated a patient who had a vestibular schwannoma in 1967, there has been a year-to-year increase in the number of patients treated with the gamma knife for vestibular schwannoma.
  • This article outlines the technique of GKRS and discusses the current results of its use to treat vestibular schwannomas.
  • Other topics discussed include tumor control, treatment of recurrent/residual and cystic vestibular schwannomas, and the results of treatment of neurofibromatosis type 2.
  • [MeSH-major] Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Radiation Injuries / prevention & control. Radiosurgery / methods
  • [MeSH-minor] Biopsy, Needle. Female. Follow-Up Studies. Humans. Immunohistochemistry. Male. Neoplasm Invasiveness / pathology. Neoplasm Staging. Patient Selection. Postoperative Complications / mortality. Postoperative Complications / physiopathology. Radiotherapy Dosage. Radiotherapy Planning, Computer-Assisted. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 19751869.001).
  • [ISSN] 1557-8259
  • [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] 62
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22. Lobato-Polo J, Kondziolka D, Zorro O, Kano H, Flickinger JC, Lunsford LD: Gamma knife radiosurgery in younger patients with vestibular schwannomas. Neurosurgery; 2009 Aug;65(2):294-300; discussion 300-1
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Gamma knife radiosurgery in younger patients with vestibular schwannomas.
  • OBJECTIVE: Management options for patients with vestibular schwannoma include observation, surgical resection, stereotactic radiosurgery (SRS), and stereotactic radiation therapy.
  • We studied tumor response and clinical outcomes after SRS in such patients.
  • METHODS: We reviewed long-term outcomes in 55 patients with vestibular schwannomas.
  • The median tumor volume was 1.7 mm.
  • The median tumor margin dose was 13.0 Gy (range, 11-20 Gy).
  • At the last assessment, facial and trigeminal nerve function was preserved in 98.2% and 96.4% of patients, respectively; the only facial deficit (House-Brackmann grade III) occurred in a patient who received a tumor dose of 20 Gy early in our experience (1988).
  • No patient developed a secondary radiation-related tumor.
  • CONCLUSION: Our experience indicates that GK SRS is an effective management strategy for younger patients with vestibular schwannoma, most of whom have no additional cranial nerve dysfunction.
  • [MeSH-major] Cranial Nerve Neoplasms / surgery. Neuroma, Acoustic / surgery. Postoperative Complications / epidemiology. Radiosurgery / statistics & numerical data. Vestibular Nerve / surgery
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Age Factors. Cochlear Nerve / physiopathology. Cochlear Nerve / radiation effects. Facial Nerve / physiopathology. Facial Nerve / radiation effects. Facial Nerve Injuries / epidemiology. Facial Nerve Injuries / prevention & control. Female. Hearing Loss, Sensorineural / epidemiology. Hearing Loss, Sensorineural / prevention & control. Humans. Male. Neoplasm Recurrence, Local / epidemiology. Neoplasm Recurrence, Local / prevention & control. Neoplasm Recurrence, Local / surgery. Outcome Assessment (Health Care). Radiation Dosage. Retrospective Studies. Treatment Outcome. Trigeminal Nerve / physiopathology. Trigeminal Nerve / radiation effects. Trigeminal Nerve Diseases / epidemiology. Trigeminal Nerve Diseases / prevention & control. Young Adult

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  • (PMID = 19625908.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Shchekut'ev GA, Shimanskiĭ VN, Ogurtsova AA, Semenov MS: [Identification of the cochlear nerve in surgical removal of vestibular schwannomas]. Zh Vopr Neirokhir Im N N Burdenko; 2009 Jul-Sep;(3):10-3; discussion 13-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Identification of the cochlear nerve in surgical removal of vestibular schwannomas].
  • Review of methods which allow intraoperative identifying and monitoring of cochlear and facial nerves in resection of vestibular schwannomas is presented.
  • We describe a case of successful identification and functional preservation of facial and cochlear nerves in a patient with acoustic neuroma.
  • According to some authors, application of intraoperative neurophysiological techniques in surgery of vestibular schwannomas allows to preserve not only anatomical but also functional integrity of neural structures as well.
  • [MeSH-major] Cochlear Nerve / physiology. Hearing Loss, Sensorineural / prevention & control. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods

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  • (PMID = 20088443.001).
  • [ISSN] 0042-8817
  • [Journal-full-title] Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
  • [ISO-abbreviation] Zh Vopr Neirokhir Im N N Burdenko
  • [Language] rus
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Russia (Federation)
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24. Jaiswal S, Agrawal V, Jaiswal AK, Pandey R, Mahapatra AK: Expression of estrogen and progesterone receptors in vestibular schwannomas and their clinical significance. J Negat Results Biomed; 2009;8:9
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  • [Title] Expression of estrogen and progesterone receptors in vestibular schwannomas and their clinical significance.
  • OBJECTIVE: The objective was to determine the expression of estrogen and progesterone receptors in vestibular schwannomas as well as to determine predictive factors for estrogen and progesterone receptor positivity.
  • MATERIALS AND METHODS: The study included 100 cases of vestibular schwannomas operated from January 2006 to June 2009.
  • Formaldehyde-fixed parafiin-embedded archival vestibular schwannomas specimens were used for the immunohistochemical assessment of estrogen and progesterone receptors.
  • CONCLUSION: No estrogen and progesterone receptor could be found in any of our 100 cases of vestibular schwannomas.
  • Hence our study does not support a causative role of estrogen and progesterone in the growth of vestibular schwannoma as well as hormonal manipulation in the treatment of this tumor.
  • [MeSH-major] Neurilemmoma / metabolism. Receptors, Estrogen / metabolism. Receptors, Progesterone / metabolism. Vestibular Diseases / metabolism

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  • (PMID = 19889208.001).
  • [ISSN] 1477-5751
  • [Journal-full-title] Journal of negative results in biomedicine
  • [ISO-abbreviation] J Negat Results Biomed
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Receptors, Estrogen; 0 / Receptors, Progesterone
  • [Other-IDs] NLM/ PMC2777842
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25. Bennett M, Haynes DS: Surgical approaches and complications in the removal of vestibular schwannomas. Otolaryngol Clin North Am; 2007 Jun;40(3):589-609, ix-x
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgical approaches and complications in the removal of vestibular schwannomas.
  • Vestibular schwannomas are benign tumors that usually originate from the balance portion of cranial nerve VIII.
  • The treatment options currently available for vestibular schwannomas include observation with serial imaging, stereotactic radiation, and microsurgical removal.
  • Although the ultimate goal in treatment of vestibular schwannomas is preservation of life, the best option for each patient depends on symptoms, tumor size, tumor location, and the patient's general health and age.
  • Surgical exposure of the cerebellopontine angle for removal of vestibular schwannomas can be performed safely via a translabyrinthine, retrosigmoid, and middle fossa approach.
  • The goal of surgery is complete eradication of tumor with preservation of hearing and facial nerve function when possible.
  • [MeSH-major] Ear Neoplasms / surgery. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / methods
  • [MeSH-minor] Cerebrospinal Fluid Otorrhea / epidemiology. Cerebrospinal Fluid Otorrhea / etiology. Facial Nerve Diseases / epidemiology. Facial Nerve Diseases / etiology. Headache / epidemiology. Headache / etiology. Humans. Meningitis / epidemiology. Meningitis / etiology. Neoplasm Recurrence, Local. Postoperative Complications. Postural Balance / physiology. Tinnitus / epidemiology. Tinnitus / etiology

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  • (PMID = 17544697.001).
  • [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] 33
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26. Sahu RN, Behari S, Agarwal VK, Giri PJ, Jain VK: Taste dysfunction in vestibular schwannomas. Neurol India; 2008 Jan-Mar;56(1):42-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Taste dysfunction in vestibular schwannomas.
  • BACKGROUND: Gustatory dysfunction associated with vestibular schwannomas (VS) is a poorly represented clinical presentation.
  • Preoperatively, taste disturbance was found in 29 (37.2%) giant, 28 (45.9%) large and one (33.3%) medium-sized tumors, respectively.
  • Among patients with anatomically preserved facial nerve, postoperative taste disturbances were found in 55 (42.3%) patients whereas nine (6.9%) patients reported improvement in taste sensations.
  • CONCLUSIONS: Taste dysfunction is common following vestibular schwannoma surgery.
  • Taste dysfunction should be included in the facial nerve functional grading system while assessing outcome.
  • [MeSH-major] Neuroma, Acoustic / complications. Taste Disorders / etiology

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  • (PMID = 18310836.001).
  • [ISSN] 0028-3886
  • [Journal-full-title] Neurology India
  • [ISO-abbreviation] Neurol India
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
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27. Stangerup SE, Thomsen J, Tos M, Cayé-Thomasen P: Long-term hearing preservation in vestibular schwannoma. Otol Neurotol; 2010 Feb;31(2):271-5
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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 hearing preservation in vestibular schwannoma.
  • OBJECTIVE: The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas.
  • SUBJECTS: During a 33-year period, from 1976 to 2008, 1,144 patients with vestibular schwannoma were allocated to observation by the wait and scan policy, with annual magnetic resonance imaging and audiologic examination.
  • CONCLUSION: Most vestibular schwannoma patients with 100% speech discrimination at diagnosis maintain good hearing even after many years of observation.
  • [MeSH-major] Hearing Loss / etiology. Hearing Loss / prevention & control. Neuroma, Acoustic / complications. Neuroma, Acoustic / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Audiometry, Pure-Tone. Databases, Factual. Denmark / epidemiology. Disease Progression. Female. Hearing / physiology. Humans. Male. Middle Aged. Speech Perception. Young Adult

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  • (PMID = 19887973.001).
  • [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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28. Tan M, Myrie OA, Lin FR, Niparko JK, Minor LB, Tamargo RJ, Francis HW: Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007. Laryngoscope; 2010 Jan;120(1):144-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007.
  • OBJECTIVES/HYPOTHESIS: To assess trends in the management of unilateral vestibular schwannomas over an 11-year period and to identify disease- and provider-related influences.
  • METHODS: Subjects presented to the Department of Otolaryngology-Head and Neck Surgery and the Department of Neurosurgery for management of unilateral vestibular schwannoma from 1997 through 2007, with at least two visits within the first year of presentation.
  • The proportion of patients for whom initial management consisted of observation, surgical resection, or radiation therapy was determined, and the relative influence of study year, patient age, hearing status, and tumor size was analyzed.
  • There were no changes in mean age or hearing status at diagnosis, but mean tumor size declined significantly.
  • Tumors that were surgically removed were on average 11.6 mm larger than those that were observed.
  • The increasing frequency over time of observation relative to surgery was significant even after controlling for age, hearing status, and tumor size.
  • CONCLUSIONS: Among patients managed by our center, there has been a significant shift in management of vestibular schwannomas over the last decade, with increasing tendency towards observation.
  • [MeSH-major] Ear Neoplasms / therapy. Neuroma, Acoustic / therapy

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  • (PMID = 19877188.001).
  • [ISSN] 1531-4995
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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29. Whitehouse K, Foroughi M, Shone G, Hatfield R: Vestibular schwannomas - when should conservative management be reconsidered? Br J Neurosurg; 2010 Apr;24(2):185-90
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  • [Title] Vestibular schwannomas - when should conservative management be reconsidered?
  • OBJECTIVE: To document the natural history of vestibular schwannomas treated conservatively, and to find if there are any predictive factors for growth and need for active intervention.
  • SUBJECTS: Eighty-eight patients managed conservatively for unilateral vestibular schwannoma and that have had at least two radiological investigations.
  • RESULTS: Of the 88 patients, the average size of schwannoma at diagnosis was 10.88 mm.
  • 51.1% of schwannomas grew, 12.5% shrank and 36.4% remained the same size.
  • [MeSH-major] Microsurgery / methods. Neuroma, Acoustic / pathology. Neuroma, Acoustic / radiography. Radiosurgery / methods
  • [MeSH-minor] Aged. Disease Progression. Female. Humans. Magnetic Resonance Imaging / methods. Male. Middle Aged. Retrospective Studies. Risk Factors. Treatment Outcome. Tumor Burden

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  • (PMID = 19886818.001).
  • [ISSN] 1360-046X
  • [Journal-full-title] British journal of neurosurgery
  • [ISO-abbreviation] Br J Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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30. Bennett M, Haynes DS: Surgical approaches and complications in the removal of vestibular schwannomas. 2007. Neurosurg Clin N Am; 2008 Apr;19(2):331-43, vii
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  • [Title] Surgical approaches and complications in the removal of vestibular schwannomas. 2007.
  • Vestibular schwannomas are benign tumors that usually originate from the balance portion of cranial nerve VIII.
  • The treatment options currently available for vestibular schwannomas include observation with serial imaging, stereotactic radiation, and microsurgical removal.
  • Although the ultimate goal in treatment of vestibular schwannomas is preservation of life, the best option for each patient depends on symptoms, tumor size, tumor location, and the patient's general health and age.
  • Surgical exposure of the cerebellopontine angle for removal of vestibular schwannomas can be performed safely via a translabyrinthine, retrosigmoid, and middle fossa approach.
  • The goal of surgery is complete eradication of tumor with preservation of hearing and facial nerve function when possible.
  • [MeSH-major] Neuroma, Acoustic / history. Neurosurgical Procedures / history. Otologic Surgical Procedures / history

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  • (PMID = 18534343.001).
  • [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] Bennett M; Haynes DS
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31. Friedman WA: Linear accelerator radiosurgery for vestibular schwannomas. Prog Neurol Surg; 2008;21:228-37
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  • [Title] Linear accelerator radiosurgery for vestibular schwannomas.
  • The treatment paradigm uses the rotating high-energy X-ray output of the LINAC to focus many hundreds of 'beam equivalents' on intracranial or spinal targets.
  • At the University of Florida, 450 vestibular schwannomas have been treated.
  • Tumor control has been achieved in 90% (5- year actuarial data).
  • Since reducing the treatment dose to 1,250 cGy, in 1994, the incidence of facial and trigeminal nerve injury has been <1%.
  • No instance of malignant tumor transformation has been observed.
  • We believe that radiosurgery is the treatment of choice for smaller vestibular schwannomas.
  • [MeSH-major] Neuroma, Acoustic / surgery. Particle Accelerators / instrumentation. Radiosurgery / instrumentation

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  • (PMID = 18810224.001).
  • [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] 22
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32. Ferri GG, Modugno GC, Pirodda A, Fioravanti A, Calbucci F, Ceroni AR: Conservative management of vestibular schwannomas: an effective strategy. Laryngoscope; 2008 Jun;118(6):951-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Conservative management of vestibular schwannomas: an effective strategy.
  • OBJECTIVES: Stimulated by the availability of a larger sample of patients and a longer follow-up period, we update our experience with conservative management of vestibular schwannomas.
  • STUDY DESIGN: Patients with intracanalicular and small/medium-sized tumors have been followed prospectively at a tertiary referral center.
  • METHODS: One hundred twenty-three patients affected by sporadic vestibular schwannoma were primarily observed by means of magnetic resonance imaging scans.
  • In case of significant tumor growth (> or =2 mm), patients were either surgically treated or submitted to radiotherapy, but, not rarely, they continued to follow the "wait-and-scan" policy.
  • Tumor-size changes over time were also evaluated with hearing function.
  • RESULTS: Almost two thirds (64.5%) of the cases did not show tumor growth during the entire period of observation (mean follow-up period, 4.8 yrs).
  • Among growing tumors, 16 patients were surgically treated with no complications or facial nerve palsy.
  • Less than half (45.5%) of the patients presented useful hearing (classes A and B of the American Academy of Otolaryngology-Head and Neck Surgery classification) at diagnosis, and 41 (73.2%) patients had preserved hearing during follow-up independently from the tumor growth rate.
  • CONCLUSIONS: Conservative management of vestibular schwannoma appears to be a safe procedure because most tumors do not grow and surgical outcomes are not affected by possible delays.
  • Because of the irregular behavior of the tumor, periodic neuroradiologic scans are mandatory to limit late surgical risks.
  • [MeSH-major] Ear Neoplasms / surgery. Neurilemmoma / surgery. Vestibule, Labyrinth

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  • (PMID = 18438269.001).
  • [ISSN] 1531-4995
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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33. Doherty JK, Friedman RA: Controversies in building a management algorithm for vestibular schwannomas. Curr Opin Otolaryngol Head Neck Surg; 2006 Oct;14(5):305-13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Controversies in building a management algorithm for vestibular schwannomas.
  • PURPOSE OF REVIEW: The present review examines the various mainstream treatment options, benefits and risks, and controversies involved in developing a management algorithm for treatment of vestibular schwannoma.
  • RECENT FINDINGS: Advances in microsurgery and radiosurgery have made tremendous contributions to management of vestibular schwannoma; however, considerable controversy still exists.
  • The auditory and facial nerve functional outcomes have improved with use of intraoperative monitoring for vestibular schwannoma removal and with lower radiosurgery doses; however, risks to the facial and auditory nerves still exist.
  • Observing vestibular schwannomas for growth with serial magnetic resonance imaging is an increasingly popular option for small vestibular schwannomas that allows patients to enjoy hearing and facial function.
  • SUMMARY: The risks and benefits of each treatment option must be weighed for each patient, and management decisions regarding vestibular schwannomas should be individualized for each patient depending on tumor anatomy, patient preferences, and symptoms.
  • [MeSH-major] Algorithms. Ear, Inner / surgery. Neuroma, Acoustic / therapy
  • [MeSH-minor] Cochlear Nerve / physiology. Facial Nerve / physiology. Hearing Loss / prevention & control. Humans. Magnetic Resonance Imaging. Microsurgery. Neurofibromatosis 2 / surgery. Neurofibromatosis 2 / therapy. Radiosurgery. Treatment Outcome

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  • [CommentIn] Curr Opin Otolaryngol Head Neck Surg. 2006 Oct;14(5):297-8 [16974140.001]
  • (PMID = 16974142.001).
  • [ISSN] 1068-9508
  • [Journal-full-title] Current opinion in otolaryngology & head and neck surgery
  • [ISO-abbreviation] Curr Opin Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 63
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34. Roche PH, Ribeiro T, Khalil M, Soumare O, Thomassin JM, Pellet W: Recurrence of vestibular schwannomas after surgery. Prog Neurol Surg; 2008;21:89-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Recurrence of vestibular schwannomas after surgery.
  • The issue of recurrence of vestibular schwannomas is poorly studied by the surgical literature and is probably underestimated.
  • This long-term event is mainly due to regrowth of microfragments that have been left in the operative field along the course of the facial nerve or at the surface of the pons.
  • Management of recurrence depends on the tumor size and patient's condition.
  • Prospective long-term follow-up studies using serial MR imaging after radical removal should bring reliable data about the incidence of vestibular schwannoma recurrence.
  • [MeSH-major] Neoplasm Recurrence, Local / epidemiology. Neuroma, Acoustic / surgery

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  • (PMID = 18810204.001).
  • [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] 7
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35. Welling DB, Packer MD, Chang LS: Molecular studies of vestibular schwannomas: a review. Curr Opin Otolaryngol Head Neck Surg; 2007 Oct;15(5):341-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Molecular studies of vestibular schwannomas: a review.
  • PURPOSE OF REVIEW: To summarize advances in understanding the molecular biology of vestibular schwannomas over the past year.
  • RECENT FINDINGS: The role of the neurofibromatosis type 2 protein, denoted as merlin or schwannomin, in embryonic development, cellular adherence, and in cell proliferation has become better elucidated in the past year.
  • Likewise, the role of merlin in Schwann cell-axon interaction has been studied.
  • Neurofibromatosis type 2 screening guidelines for young patients with solitary vestibular schwannomas have been published.
  • The role of electromagnetic radiation via cellular and portable telephones as a predisposing factor to vestibular schwannoma formation has also been the topic of several studies.
  • [MeSH-major] Neuroma, Acoustic / genetics
  • [MeSH-minor] Animals. Cell Phones. Embryonic Development. Genetic Testing. Humans. Mutation. Neurofibromatosis 2 / genetics. Neurofibromin 2 / metabolism. Oligonucleotide Array Sequence Analysis

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  • (PMID = 17823551.001).
  • [ISSN] 1068-9508
  • [Journal-full-title] Current opinion in otolaryngology & head and neck surgery
  • [ISO-abbreviation] Curr Opin Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Neurofibromin 2
  • [Number-of-references] 36
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36. Yomo S, Arkha Y, Delsanti C, Roche PH, Thomassin JM, Régis J: Repeat gamma knife surgery for regrowth of vestibular schwannomas. Neurosurgery; 2009 Jan;64(1):48-54; discussion 54-5
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  • [Title] Repeat gamma knife surgery for regrowth of vestibular schwannomas.
  • OBJECTIVE: Gamma knife surgery (GKS) has become established as a minimally invasive treatment modality for patients with vestibular schwannomas.
  • Treatment failure and/or tumor regrowth, however, is occasionally encountered, and microsurgical resection is usually warranted in such cases.
  • The goal of this study was to investigate whether repeat GKS is an effective treatment for recurrent vestibular schwannomas and to assess the conservation of residual neurological function.
  • METHODS: Between July 1992 and December 2007, 1951 patients harboring a unilateral vestibular schwannoma were treated with GKS.
  • Of these, 48 patients (2.5%) had to undergo a subsequent intervention because of progression or regrowth of the tumor.
  • Repeat GKS was performed in a total of 15 patients, 8 of whom had more than 2 years of follow-up and were eligible to be enrolled in the present study.
  • The median tumor volume was 0.51 and 1.28 mL at the initial and second GKS treatments, respectively.
  • Six patients demonstrated a significant reduction in tumor volume.
  • In 1 patient, the final tumor volume was less than the initial volume.
  • The other 2 patients showed stabilization of tumor growth.
  • Neither aggravation of facial nerve dysfunction nor other neurological deficits secondary to GKS were observed.
  • CONCLUSION: This is the first report to address repeat GKS for vestibular schwannomas.
  • After long-term follow-up, repeat GKS with a low marginal dose seems to be a safe and effective treatment in selected patients harboring regrowth of small vestibular schwannomas that have previously been treated with GKS.
  • [MeSH-major] Neoplasm Recurrence, Local / surgery. Neuroma, Acoustic / surgery. Radiosurgery

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  • (PMID = 19050660.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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37. Goddard JC, Oliver ER, Lambert PR: Prevention of cerebrospinal fluid leak after translabyrinthine resection of vestibular schwannoma. Otol Neurotol; 2010 Apr;31(3):473-7
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  • [Title] Prevention of cerebrospinal fluid leak after translabyrinthine resection of vestibular schwannoma.
  • OBJECTIVE: Evaluate the rate of cerebrospinal fluid (CSF) leak after translabyrinthine craniotomy for the removal of vestibular schwannoma and describe details of closure technique.
  • PATIENTS: All individuals undergoing translabyrinthine craniotomy for removal of vestibular schwannoma from January 2000 to October 2008.
  • INTERVENTION: Translabyrinthine craniotomy for removal of vestibular schwannoma with abdominal fat graft harvest and layered closure.
  • RESULTS: Sixty-one patients underwent translabyrinthine craniotomy for the removal of vestibular schwannoma during a 9-year period.
  • CONCLUSION: Successful wound closure and CSF leak prevention after translabyrinthine craniotomy for the removal of vestibular schwannomas do not require the creation of a facial recess, manipulation of the ossicles, direct Eustachian tube plugging, or the use of alloplastic space-occupying materials.
  • [MeSH-major] Cerebrospinal Fluid Otorrhea / prevention & control. Cerebrospinal Fluid Rhinorrhea / prevention & control. Craniotomy / adverse effects. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / adverse effects. Vestibule, Labyrinth / surgery

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  • (PMID = 20084041.001).
  • [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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38. Mick P, Westerberg BD, Ngo R, Akagami R: Growing vestibular schwannomas: what happens next? Otol Neurotol; 2009 Jan;30(1):101-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Growing vestibular schwannomas: what happens next?
  • OBJECTIVE: To determine the subsequent growth patterns in vestibular schwannomas shown to be growing on serial imaging.
  • PATIENTS: Patients with tumors that demonstrated growth of greater than 1 mm/yr between 2 consecutive scans (magnetic resonance or computed tomography) and had at least 1 follow-up scan were included.
  • MAIN OUTCOME MEASURE(S): Maximum dimension along the axis of the internal auditory canal was measured for intracanalicular tumors, whereas for extracanalicular tumors, maximal dimension along any orientation was used.
  • Of the growing tumors, 63.9% continued to grow, 30.6% stayed the same size, and 5.6% regressed in size.
  • CONCLUSION: Most vestibular schwannomas identified to be growing are likely to continue to grow on subsequent serial imaging.
  • These results are useful in clinical decision making and counseling patients with growing vestibular schwannomas.
  • [MeSH-major] Neuroma, Acoustic / pathology
  • [MeSH-minor] Cell Division. Ear Canal / pathology. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Patient Selection. Remission, Spontaneous. Tomography, X-Ray Computed

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  • (PMID = 19108071.001).
  • [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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39. Møller MN, Werther K, Nalla A, Stangerup SE, Thomsen J, Bøg-Hansen TC, Nielsen HJ, Cayé-Thomasen P: Angiogenesis in vestibular schwannomas: expression of extracellular matrix factors MMP-2, MMP-9, and TIMP-1. Laryngoscope; 2010 Apr;120(4):657-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Angiogenesis in vestibular schwannomas: expression of extracellular matrix factors MMP-2, MMP-9, and TIMP-1.
  • OBJECTIVES/HYPOTHESIS: Vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) are potent mediators of tumor angiogenesis.
  • It has been demonstrated that vestibular schwannoma VEGF expression correlates with tumor growth pattern, whereas knowledge on the expression of MMPs is lacking.
  • This study targets the angiogenic process by investigation of tumor expression of MMP-2, MMP-9, and tissue inhibitors of metalloproteinase (TIMP)-1.
  • A possible correlation with gender, patient age, symptom duration, tumor size, and the absolute and relative growth rate is explored.
  • STUDY DESIGN: Prospective vestibular schwannoma tissue sampling for ELISA and immunohistochemical determination of MMP-2, MMP-9 and TIMP-1.
  • METHODS: Thirty-four patients with a sporadic, noncystic, vestibular schwannoma were selected prospectively.
  • Repeated, preoperative magnetic resonance imaging determined the tumor growth pattern.
  • Following translabyrinthine resection, an enzyme-linked immunosorbent assay was used for determination of the MMP-2, MMP-9, and TIMP-1 concentration in tumor sample homogenates.
  • Immunohistochemical labeling was performed in 12 randomly selected tumors.
  • RESULTS: : All tumor homogenates expressed measurable MMP-9, MMP-2, and TIMP-1.
  • Immunolabeling localized MMP-9 expression to the tumor cells, whereas MMP-2 and TIMP-1 was found interstitially.
  • A significant correlation existed between the concentration MMP-9 and absolute tumor growth rate, whereas a weak correlation occurred for the relative growth rate.
  • CONCLUSIONS: Vestibular schwannomas express MMP-2, MMP-9, and TIMP-1 and the tumor concentration of MMP-9 correlates with absolute tumor growth rate, but not with age, gender, symptom duration, or preoperative tumor size.
  • We conclude that MMP-9 appears to be involved in the growth of vestibular schwannomas.
  • [MeSH-major] Matrix Metalloproteinase 2 / biosynthesis. Matrix Metalloproteinase 9 / biosynthesis. Neovascularization, Pathologic / enzymology. Neuroma, Acoustic / blood supply. RNA, Neoplasm / genetics. Tissue Inhibitor of Metalloproteinase-1 / genetics
  • [MeSH-minor] Adult. Aged. Enzyme-Linked Immunosorbent Assay. Female. Follow-Up Studies. Humans. Immunohistochemistry. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Staging. Prospective Studies

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  • (PMID = 20205165.001).
  • [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 / RNA, Neoplasm; 0 / Tissue Inhibitor of Metalloproteinase-1; EC 3.4.24.24 / Matrix Metalloproteinase 2; EC 3.4.24.35 / Matrix Metalloproteinase 9
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40. Fukuda M, Oishi M, Kawaguchi T, Watanabe M, Takao T, Tanaka R, Fujii Y: Etiopathological factors related to hydrocephalus associated with vestibular schwannoma. Neurosurgery; 2007 Dec;61(6):1186-92; discussion 1192-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Etiopathological factors related to hydrocephalus associated with vestibular schwannoma.
  • OBJECTIVE: We retrospectively analyzed various clinical factors to determine whether or not these factors are etiopathologically related to the development of hydrocephalus in patients with vestibular schwannomas.
  • METHODS: There were 68 patients (29 men, 39 women) in this study who underwent resection of a vestibular schwannoma.
  • The maximum diameter of the tumor in the cerebellopontine cistern ranged from 0 (localized within the internal auditory canal) to 56 mm (mean, 32.0 +/- 12.9 mm).
  • Univariate analysis of various factors revealed that both tumor size and CSF protein concentration were positively related to development of hydrocephalus (P < 0.05 and P < 0.01, respectively).
  • There was a trend toward increased CSF protein concentration in patients with a large tumor (> or = 40 mm) compared with those with a small tumor (< 40 mm) (P = 0.06).
  • CONCLUSION: A high CSF protein concentration in fluid from the cerebellomedullary cistern is one of the most important factors contributing to hydrocephalus associated with vestibular schwannoma.
  • It is important to judge whether or not any further treatment is required for hydrocephalus, in addition to tumor resection, especially in patients with communicating hydrocephalus.
  • [MeSH-major] Brain Neoplasms / complications. Hydrocephalus / etiology. Hydrocephalus / pathology. Neuroma, Acoustic / complications


41. Samii M, Gerganov V, Samii A: Hearing preservation after complete microsurgical removal in vestibular schwannomas. Prog Neurol Surg; 2008;21:136-41
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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 after complete microsurgical removal in vestibular schwannomas.
  • AIM: To evaluate and present the treatment strategy and hearing preservation in a recent series of vestibular schwannoma cases.
  • RESULTS: The anatomical integrity of the cochlear nerve was preserved in 75.8% of the cases.
  • It was highest in small tumors--60% in class T1 and 72% in class T2.
  • In tumors extending to and compressing the brain stem, preservation of some hearing was possible in up to 43%.
  • CONCLUSIONS: Vestibular schwannomas are benign lesions whose total removal leads to definitive healing of the patient.
  • Using the retrosigmoid approach with the patient in the semi-sitting position, hearing preservation is possible even for large schwannomas.
  • [MeSH-major] Hearing Loss / prevention & control. Microsurgery. Neuroma, Acoustic / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Audiometry. Cochlear Nerve / physiopathology. Cohort Studies. Humans. Middle Aged. Retrospective Studies. Treatment Outcome. Young Adult

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  • (PMID = 18810211.001).
  • [ISSN] 0079-6492
  • [Journal-full-title] Progress in neurological surgery
  • [ISO-abbreviation] Prog Neurol Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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42. Nicoucar K, Momjian S, Vader JP, De Tribolet N: Surgery for large vestibular schwannomas: how patients and surgeons perceive quality of life. J Neurosurg; 2006 Aug;105(2):205-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgery for large vestibular schwannomas: how patients and surgeons perceive quality of life.
  • OBJECT: The aim of this study was to assess the consequences of total removal of a large vestibular schwannoma on the patient's symptoms and quality of life (QOL).
  • METHODS: A questionnaire regarding preoperative and postoperative symptoms with measures of both daily and global QOL and a modified 36-Item Short Form Health Survey (SF-36) QOL instrument were sent to 103 patients who had undergone surgery via a retrosigmoid approach for total removal of a Grade III or IV vestibular schwannoma.
  • Forty-six (64%) of the schwannomas were Grade IV and 26 (36%) were Grade III.
  • Patients with large vestibular schwannomas had lower scores in all SF-36 categories except pain compared with data from other studies.
  • CONCLUSIONS: Surgery for a large vestibular schwannoma has a significant impact on the patient's QOL.
  • [MeSH-major] Attitude of Health Personnel. Neuroma, Acoustic / surgery. Postoperative Complications / psychology. Quality of Life / psychology

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  • (PMID = 17219824.001).
  • [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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43. Gharabaghi A, Samii A, Koerbel A, Rosahl SK, Tatagiba M, Samii M: Preservation of function in vestibular schwannoma surgery. Neurosurgery; 2007 Feb;60(2 Suppl 1):ONS124-7; discussion ONS127-8
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  • [Title] Preservation of function in vestibular schwannoma surgery.
  • The management and surgical technique for microsurgical tumor removal of vestibular schwannomas (acoustic neuroma) with the suboccipital retrosigmoid approach and semi-sitting patient positioning is described.
  • An emphasis is placed on the preservation of auditory and facial nerve function with a stepwise description of the technical and operative nuances, including presurgical evaluation, positioning, anesthesiological and neurophysiological aspects, approach, microsurgical techniques, and postsurgical care.
  • [MeSH-major] Microsurgery / methods. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods. Otologic Surgical Procedures / methods

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  • (PMID = 17297374.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 18
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44. Lassaletta L, Bello MJ, Del Río L, Alfonso C, Roda JM, Rey JA, Gavilan J: DNA methylation of multiple genes in vestibular schwannoma: Relationship with clinical and radiological findings. Otol Neurotol; 2006 Dec;27(8):1180-5
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  • [Title] DNA methylation of multiple genes in vestibular schwannoma: Relationship with clinical and radiological findings.
  • HYPOTHESIS: The purpose of this study was to examine the DNA methylation profile of several genes in a series of vestibular schwannomas, and to analyze its relationship with clinical and radiological features.
  • BACKGROUND: Aberrant methylation of promoter regions is a major mechanism for silencing of tumor suppressor genes in several tumors.
  • There is limited information about methylation status in vestibular schwannoma, with no clinical or radiological implications described to date.
  • METHODS: The methylation status of 16 tumor-related genes including RASSF1A, RAR-B, VHL, PTEN, HMLH1, RB1, TP16, CASP8, ER, TIMP3, MGMT, DAPK, TP73, GSTP1, TP14, and THBS1 was examined in a series of 22 vestibular schwannomas.The bisulfite modification of genomic DNA was performed.
  • Methylation of CASP8 was associated with the patient's age and the tumor size.
  • CONCLUSION: Aberrant methylation of tumor-related genes may play a role in the development of vestibular schwannomas.
  • Our results may provide useful clues to the development of prognostic assays for these tumors.
  • [MeSH-major] DNA Methylation. Neuroma, Acoustic / genetics
  • [MeSH-minor] Adolescent. Adult. Aged. Auditory Threshold / physiology. Female. Genes, Tumor Suppressor / physiology. Hearing Loss / genetics. Humans. Male. Middle Aged. Promoter Regions, Genetic / genetics


45. Lavrova SA, Leshchinskiĭ VG, Shershever AS, Iazov OA, Gerasimov MV: [Predictive value of intraoperative monitoring of brainstem acoustic evoked potentials during removal of parabrainstem tumors]. Zh Vopr Neirokhir Im N N Burdenko; 2005 Apr-Jun;(2):8-12; discussion 12
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  • [Title] [Predictive value of intraoperative monitoring of brainstem acoustic evoked potentials during removal of parabrainstem tumors].
  • The data of intraoperative monitoring of brainstem acoustic evoked potentialities (BAEP) during parabrainstem tumors are analyzed.
  • Of the 24 cases, 16 patients were found to have neurinoma of the acoustic nerve, 4 had petroclival meningioma, 2, tentorial meningioma, 1, cholesteatoma of the cerebellopontine angle, and 1, brainstem angioma.
  • The authors proposed to identify the favorable and unfavorable patterns of BAEP as predictors of an early postoperative period, by comparing the patterns of BAEP, the data on the monitoring vital functions and outcomes of disease.
  • By taking into account the high coincidence of actual and predictable outcomes (79.16%), it can be suggested that the data of intraoperative monitoring of BAEP are not only of value for obtaining information at the moment of surgery, but also informative as a predictor of an early postoperative period and outcomes of disease.
  • [MeSH-major] Brain Stem Neoplasms / surgery. Evoked Potentials, Auditory, Brain Stem. Monitoring, Intraoperative / methods

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  • (PMID = 16078627.001).
  • [ISSN] 0042-8817
  • [Journal-full-title] Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
  • [ISO-abbreviation] Zh Vopr Neirokhir Im N N Burdenko
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Russia (Federation)
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46. Koerbel A, Gharabaghi A, Safavi-Abbasi S, Tatagiba M, Samii M: Evolution of vestibular schwannoma surgery: the long journey to current success. Neurosurg Focus; 2005 Apr 15;18(4):e10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evolution of vestibular schwannoma surgery: the long journey to current success.
  • The extraordinary improvement of patient outcome after surgical treatment for vestibular schwannomas is relatively recent and has occurred mainly over the last 30 years.
  • Whereas in the past the primary goal of vestibular schwannoma management was to preserve the patient's life, the objective in vestibular schwannoma treatment today is to preserve neurological function.
  • Long-term follow-up examinations show negligible recurrence rates, indicating that the aim of preservation of nerve function does not limit the completeness of tumor removal with modern neurosurgical techniques.
  • Despite these advances in preserving the anatomical integrity of, for example, the cochlear nerve, losses of function and even deafness may occur postoperatively in some cases.
  • In this article, the authors report in detail the developments achieved in vestibular schwannoma surgery and the great clinicians to whom these results can be credited.
  • [MeSH-major] Microsurgery / history. Neuroma, Acoustic / history. Neuroma, Acoustic / surgery. Neurosurgery / history. Neurosurgical Procedures / history. Vestibulocochlear Nerve / surgery
  • [MeSH-minor] Deafness / etiology. Deafness / prevention & control. Facial Nerve Injuries / etiology. Facial Nerve Injuries / prevention & control. History, 18th Century. History, 19th Century. History, 20th Century. Humans. Neoplasm Recurrence, Local / prevention & control. Postoperative Complications / etiology. Postoperative Complications / pathology. Postoperative Complications / prevention & control. Vestibulocochlear Nerve Injuries

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  • (PMID = 15844862.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Historical Article; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 70
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47. Huang CF, Tu HT, Lo HK, Wang KL, Liu WS: Radiosurgery for vestibular schwannomas. J Chin Med Assoc; 2005 Jul;68(7):315-20
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  • [Title] Radiosurgery for vestibular schwannomas.
  • We report our experience with radiosurgery for tumor control and the complications of unilateral vestibular schwannomas.
  • METHODS: We reviewed our early experience regarding clinical presentation, management and outcomes in 45 patients with acoustic schwannomas who underwent gamma knife stereotactic radiosurgery.
  • Median tumor volume was 4.5 mL (range, 0.5-30.0), and median radiotherapy dose was 11.5 Gy (range, 10.5-14.0 Gy).
  • RESULTS: Tumor control was achieved in 43 patients (95.6%).
  • Reduction in tumor size was shown in 15 patients (33.3%).
  • No patients had delayed facial palsy or lower cranial nerve dysfunction, but one had delayed trigeminal sensory loss.
  • CONCLUSION: Radiosurgery achieved a high tumor control rate and a relatively low post-radiosurgical complication rate for acoustic neuromas.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery

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  • (PMID = 16038371.001).
  • [ISSN] 1726-4901
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China (Republic : 1949- )
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48. Mohammed TA, Ahuja MS, Ju SS, Thomas J: Normal pressure hydrocephalus after gamma knife radiosurgery for vestibular schwannoma. J Postgrad Med; 2010 Jul-Sep;56(3):213-5
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  • [Title] Normal pressure hydrocephalus after gamma knife radiosurgery for vestibular schwannoma.
  • Vestibular schwannomas are not uncommon, and gamma knife radiosurgery is one of the treatment options for symptomatic tumors.
  • Hydrocephalus is a complication of gamma knife treatment of vestibular schwannoma, though the mechanism of the development of hydrocephalus remains controversial.
  • We present an unusual case of normal pressure hydrocephalus (NPH) after gamma knife radiosurgery of a vestibular schwannoma in which the timeline of events strongly suggests that gamma knife played a contributory role in the development of the hydrocephalus.
  • [MeSH-major] Hydrocephalus, Normal Pressure / etiology. Neuroma, Acoustic / surgery. Radiosurgery / adverse effects


49. Silk PS, Lane JI, Driscoll CL: Surgical approaches to vestibular schwannomas: what the radiologist needs to know. Radiographics; 2009 Nov;29(7):1955-70
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  • [Title] Surgical approaches to vestibular schwannomas: what the radiologist needs to know.
  • Vestibular schwannomas account for 85% of cerebellopontine angle tumors in adults and most commonly arise from the inferior division of the vestibular nerve.
  • Three main surgical techniques are currently being used for the removal of vestibular schwannomas: middle cranial fossa, suboccipital, and translabyrinthine approaches.
  • A good understanding of the main surgical approaches, relevant anatomic considerations, surgical complications, and likelihood of tumor recurrence is essential for interpreting magnetic resonance images to the advantage of both the surgeon and the patient, particularly when hearing preservation is a consideration.
  • [MeSH-major] Magnetic Resonance Imaging / methods. Neuroma, Acoustic / diagnosis. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / methods. Surgery, Computer-Assisted / methods. Tomography, X-Ray Computed / methods

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  • (PMID = 19926756.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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50. Lunsford LD, Niranjan A, Flickinger JC, Maitz A, Kondziolka D: Radiosurgery of vestibular schwannomas: summary of experience in 829 cases. J Neurosurg; 2005 Jan;102 Suppl:195-9
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  • [Title] Radiosurgery of vestibular schwannomas: summary of experience in 829 cases.
  • OBJECT: Management options for vestibular schwannomas (VSs) have greatly expanded since the introduction of stereotactic radiosurgery.
  • Optimal outcomes reflect long-term tumor control, preservation of cranial nerve function, and retention of quality of life.
  • The average tumor volume was 2.5 cm3.
  • The median margin dose to the tumor was 13 Gy (range 10-20 Gy).
  • Unchanged hearing preservation was possible in 50 to 77% of patients (up to 90% in those with intracanalicular tumors).
  • Trigeminal symptoms were detected in less than 3% of patients whose tumors reached the level of the trigeminal nerve.
  • Tumor control rates at 10 years were 97% (no additional treatment needed).
  • Gamma knife surgery provides a low risk, minimally invasive treatment option for patients with newly diagnosed or residual vs. Cranial nerve preservation and quality of life maintenance are possible in long-term follow up.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / instrumentation
  • [MeSH-minor] Female. Follow-Up Studies. Hearing Disorders / diagnosis. Hearing Disorders / etiology. Humans. Magnetic Resonance Imaging. Male. Neoplasm Staging. Radiation Dosage. Severity of Illness Index. Trigeminal Neuralgia / etiology. Tumor Burden / radiation effects

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  • (PMID = 15662809.001).
  • [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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51. Khrais T, Romano G, Sanna M: Nerve origin of vestibular schwannoma: a prospective study. J Laryngol Otol; 2008 Feb;122(2):128-31
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Nerve origin of vestibular schwannoma: a prospective study.
  • OBJECTIVE: The origin of vestibular schwannoma has always been a matter of debate.
  • The aim of our study was to identify the nerve origin of this tumour.
  • METHODS: A total of 200 cases of vestibular schwannoma were included in the study.
  • The origin of the tumour was limited to one nerve at the fundus in 152 cases (76 per cent).
  • Out of these cases, the tumour originated from the inferior vestibular nerve in 139 cases (91.4 per cent), from the superior vestibular nerve in nine cases (6 per cent), from the cochlear nerve in two cases (1.3 per cent) and from the facial nerve in two cases (1.3 per cent).
  • CONCLUSION: The vast majority of vestibular schwannomas originate from the inferior vestibular nerve; the incidence of involvement of this nerve increases as the tumour size increases.
  • An origin of vestibular schwannoma from the inferior vestibular nerve can be considered as one of the explanatory factors for the poor functional outcome of the extended middle cranial fossa approach, and probably accounts also for the better hearing preservation rate reported in some series for the retrosigmoid approach.
  • [MeSH-major] Neuroma, Acoustic / pathology. Otologic Surgical Procedures / methods. Vestibular Nerve / pathology
  • [MeSH-minor] Disease Progression. Female. Humans. Magnetic Resonance Imaging. Male. Prospective Studies

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  • (PMID = 18039415.001).
  • [ISSN] 1748-5460
  • [Journal-full-title] The Journal of laryngology and otology
  • [ISO-abbreviation] J Laryngol Otol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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52. Sughrue ME, Yang I, Rutkowski MJ, Aranda D, Parsa AT: Preservation of facial nerve function after resection of vestibular schwannoma. Br J Neurosurg; 2010 Dec;24(6):666-71
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  • [Title] Preservation of facial nerve function after resection of vestibular schwannoma.
  • OBJECTIVE: Most data regarding facial nerve function in patients undergoing microsurgical resection of vestibular schwannomas predominantly include series performed at a single institution.
  • In an effort to minimise individual surgeon or institutional bias, we performed an analysis of the published literature on facial nerve outcomes following microsurgical resection of vestibular schwannomas.
  • The objective of this study was to provide a comprehensive assessment of reported outcomes for facial nerve preservation after VS surgery.
  • MATERIALS AND METHODS: We identified a total of 296 studies involving over 25,000 patients that included outcome data for facial nerve function of vestibular schwannoma patients treated surgically.
  • Data regarding surgical approach, tumour size, patient age, and use of intra-operative monitoring were extracted and correlated with facial nerve function after surgery.
  • Patients with preoperative facial nerve dysfunction (House-Brackmann score 3 or higher) were excluded and 'facial nerve preservation' was defined as grade I or II House-Brackmann function at last follow-up visit.
  • Patients treated with the middle cranial fossa approach had a trend towards higher overall facial nerve preservation rate (85%), compared to the translabyrinthine approach (81%, p = 0.07) , and did statistically better than the retrosigmoid approach (78%, p < 0.0001).
  • Patients with an average tumour size <20 mm had significantly improved facial nerve preservation rates, compared to larger tumours (90% vs. 67%, p < 0.0001).
  • Patients under 65 years of age had a lower facial nerve preservation rate (71% vs. 84%, p < 0.001).
  • Finally, the use of intra-operative monitoring improved the facial nerve preservation rate (76% vs. 71%, p < 0.001).
  • CONCLUSION: Factors that appear to be associated with facial nerve preservation after microsurgical resection of a vestibular schwannoma include tumour size <20 mm, use of the middle fossa approach and use of neuromonitoring during surgery.
  • These data provide a summary assessment of the published literature regarding facial nerve preservation after microsurgical resection of vestibular schwannoma.
  • [MeSH-major] Facial Nerve / physiopathology. Facial Nerve Injuries / prevention & control. Neuroma, Acoustic / physiopathology. Radiation Injuries / prevention & control. Radiosurgery / methods


53. Conley GS, Hirsch BE: Stereotactic radiation treatment of vestibular schwannoma: indications, limitations, and outcomes. Curr Opin Otolaryngol Head Neck Surg; 2010 Oct;18(5):351-6
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  • [Title] Stereotactic radiation treatment of vestibular schwannoma: indications, limitations, and outcomes.
  • PURPOSE OF REVIEW: Stereotactic radiation treatment is an increasingly performed procedure for patients with vestibular schwannoma and other benign skull base tumors.
  • The specific role of radiation in current management strategies for vestibular schwannoma continues to evolve as long-term outcome data are analyzed and standardized studies are performed.
  • Observation of small vestibular schwannomas is recommended over early radiation or microsurgical intervention.
  • Radiation may be used as adjunctive therapy for large tumors and in certain postradiation treatment failures.
  • Current evidence supports its use for small to medium sized primary and recurrent vestibular schwannomas with optimal dosing below 13 Gy.
  • It is also recommended for adjunctive therapy, recurrent tumors, in poor surgical candidates, and for those who do not desire observation or surgery.
  • [MeSH-major] Neuroma, Acoustic / radiotherapy. Radiosurgery. Skull Base Neoplasms / radiotherapy

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  • (PMID = 20613529.001).
  • [ISSN] 1531-6998
  • [Journal-full-title] Current opinion in otolaryngology & head and neck surgery
  • [ISO-abbreviation] Curr Opin Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
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54. 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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  • [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.
  • Brain stem evoked potential was monitored intraoperatively.
  • 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.
  • Using the retrosigmoid approach with small craniotomy is possible even for large schwannomas.
  • 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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55. 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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  • [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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56. Jain VK, Mehrotra N, Sahu RN, Behari S, Banerji D, Chhabra DK: Surgery of vestibular schwannomas: an institutional experience. Neurol India; 2005 Mar;53(1):41-5; discussion 45
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  • [Title] Surgery of vestibular schwannomas: an institutional experience.
  • AIMS: To report management results of vestibular schwannomas (VS) treated surgically in our institute, with particular reference to completeness of tumor excision, facial nerve and hearing preservation and complications of surgery.
  • MATERIALS AND METHODS: The facial nerve function and hearing assessment was done according to House-Brackmann [HB] grading and pure tone audiometry (PTA) respectively.
  • RESULTS: Most patients had large tumors and had no useful hearing (90%), had disabling cerebellar ataxia (88%) and presented with features of raised intra-cranial pressure (45%).
  • Large sized tumors were in 41.3% and giant sized tumors were in 56% cases.
  • Complete tumor excision was carried out in 96.5% and anatomical preservation of facial nerve was achieved in 79.2% cases.
  • Cerebrospinal fluid leak with or without meningitis and transient lower cranial nerve paresis were common complications.
  • CONCLUSIONS: With experience, complete tumor excision with good facial nerve preservation can be achieved in large tumors.
  • Hearing preservation is difficult in bigger tumors.
  • [MeSH-major] Facial Nerve / physiology. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods. Postoperative Complications

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  • (PMID = 15805654.001).
  • [ISSN] 0028-3886
  • [Journal-full-title] Neurology India
  • [ISO-abbreviation] Neurol India
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
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57. Slattery WH 3rd: Microsurgery after radiosurgery or radiotherapy for vestibular schwannomas. Otolaryngol Clin North Am; 2009 Aug;42(4):707-15
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  • [Title] Microsurgery after radiosurgery or radiotherapy for vestibular schwannomas.
  • Radiosurgery or radiotherapy for vestibular schwannomas has become a common practice with a high chance for tumor control.
  • Despite the high rate of tumor control, there are some tumors that cannot be controlled with radiation therapy.
  • Surgical treatment after radiosurgery or radiotherapy may be necessary for tumors that continue to grow, or for patients who develop brainstem compressive symptoms, disabling hemifacial spasm, or hydrocephalus.
  • The House Ear Clinic (Los Angeles, California) experience with microsurgery after irradiation has demonstrated that the facial nerve is different once it has been radiated.
  • An irradiated facial nerve's regeneration potential is diminished, and the recovery from microsurgical trauma is not as robust.
  • [MeSH-major] Microsurgery / methods. Neoplasm Invasiveness / pathology. Neuroma, Acoustic / radiotherapy. Neuroma, Acoustic / surgery. Radiosurgery / methods
  • [MeSH-minor] Combined Modality Therapy. Cranial Irradiation / methods. Dose-Response Relationship, Radiation. Female. Humans. Male. Neoadjuvant Therapy. Neoplasm Staging. Postoperative Complications / mortality. Postoperative Complications / physiopathology. Prognosis. Radiotherapy Dosage. Radiotherapy, Conformal / methods. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 19751874.001).
  • [ISSN] 1557-8259
  • [Journal-full-title] Otolaryngologic clinics of North America
  • [ISO-abbreviation] Otolaryngol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 12
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58. Bian LG, Tirakotai W, Sun QF, Zhao WG, Shen JK, Luo QZ: Molecular genetics alterations and tumor behavior of sporadic vestibular schwannoma from the People's Republic of China. J Neurooncol; 2005 Jul;73(3):253-60
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  • [Title] Molecular genetics alterations and tumor behavior of sporadic vestibular schwannoma from the People's Republic of China.
  • OBJECTIVES: To analyze the molecular genetic alteration of sporadic vestibular schwannomas from the People's Republic of China and to correlate these alterations with the tumor behaviors.
  • The proliferative index (LI) of vestibular schwannoma was evaluated by proliferative cell nuclear antigen investigation.
  • RESULTS: Sixteen vestibular schwannomas (44.4%) showed allele loss.
  • We found 22 mutations in 36 schwannomas.
  • The LI and the growth rate of schwannomas with LOH or mutation were significantly higher than those without LOH or mutation.
  • All of these vestibular schwannomas showed no immunoreaction to anti-NF2(A-19) IgG by immunohistochemistry.
  • By immunoblotting technique, reduced expression of S/M was found in 31 cases (86%).
  • The growth index of schwannomas with severely reduced expression of S/M was significantly higher than those with moderately reduced or normal expression.
  • CONCLUSION: The molecular genetic changes in sporadic vestibular schwannomas from Chinese patients were similar to the previous reports.
  • We demonstrate the relationship between tumor behaviors and genetic alteration (including LOH and mutation of NF2 gene).
  • We propose that inactivation of S/M, may be an important step in tumorigenesis of sporadic vestibular schwannoma.
  • [MeSH-major] Chromosomes, Human, Pair 22 / genetics. Genes, Neurofibromatosis 2. Neuroma, Acoustic / genetics. Neuroma, Acoustic / metabolism

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  • (PMID = 15980976.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Neurofibromin 2
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59. Mandl ES, Vandertop WP, Meijer OW, Peerdeman SM: Imaging-documented repeated intratumoral hemorrhage in vestibular schwannoma: a case report. Acta Neurochir (Wien); 2009 Oct;151(10):1325-7
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  • [Title] Imaging-documented repeated intratumoral hemorrhage in vestibular schwannoma: a case report.
  • Intratumoral hemorrhage in vestibular schwannomas is rare.
  • Intratumoral hemorrhage is probably caused by vascular fragility associated with tumor characteristics and growth.
  • The present report details the case of acute neurological deterioration in a patient with repeated intratumoral hemorrhage inside a vestibular schwannoma with computed tomography and magnetic resonance imaging confirmation.
  • To our knowledge, repeated hemorrhage in vestibular schwannoma with radiological confirmation has not been reported before.
  • [MeSH-major] Cerebellopontine Angle / pathology. Intracranial Hemorrhages / diagnosis. Intracranial Hemorrhages / etiology. Neuroma, Acoustic / complications. Neuroma, Acoustic / diagnosis. Vestibular Nerve / pathology
  • [MeSH-minor] Disease Progression. Facial Nerve Injuries / etiology. Female. Humans. Hydrocephalus / etiology. Hydrocephalus / pathology. Hydrocephalus / surgery. Magnetic Resonance Imaging. Middle Aged. Neurosurgical Procedures. Postoperative Complications. Radiotherapy. Tomography, X-Ray Computed. Treatment Outcome. Ventriculoperitoneal Shunt

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  • [Cites] Neurosurgery. 2003 Aug;53(2):282-87; discussion 287-8 [12925242.001]
  • [Cites] Clin Neurol Neurosurg. 1998 Mar;100(1):68-74 [9637211.001]
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  • [Cites] Neurol Med Chir (Tokyo). 1989 Apr;29(4):328-32 [2478916.001]
  • (PMID = 19255715.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Austria
  • [Other-IDs] NLM/ PMC2760714
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60. Fukuoka S, Takanashi M, Hojyo A, Konishi M, Tanaka C, Nakamura H: Gamma knife radiosurgery for vestibular schwannomas. Prog Neurol Surg; 2009;22:45-62
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  • [Title] Gamma knife radiosurgery for vestibular schwannomas.
  • The purpose of this study was to analyze tumor control and possible complications of gamma knife radiosurgery (GKRS) in patients with vestibular schwannomas using low marginal doses and conformal multiple shots to fit irregular tumor shapes.
  • The actuarial tumor control rates were 94% at 5 years and 92.4% at 8 years.
  • Larger tumors (p < 0.0001) and those in younger patients (p = 0.018) tended to recur significantly more often.
  • Fifty-six other patients not included in the long-term evaluation consecutively underwent caloric testing and static stabilometry as well as neurological examinations to evaluate vestibular function in detail, both before and after GKRS.
  • The results revealed 90% of the patients to have already developed vestibular dysfunction prior to the treatment despite reported symptoms of dizziness.
  • GKRS did not significantly affect vestibular function.
  • Hydrocephalus was recognized in 5.3% of all patients, and tended to occur in cases with larger tumors (p = 0.0024).
  • GKRS provides a safe and effective therapy for small to medium-sized tumors.
  • However, indications for larger tumors must be carefully considered, as they are more difficult to control and liable to produce ataxia due to transient expansion.
  • [MeSH-major] Hearing. Neuroma, Acoustic / surgery. Radiosurgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Facial Nerve / physiology. Female. Follow-Up Studies. Humans. Hydrocephalus / diagnosis. Magnetic Resonance Imaging. Male. Middle Aged. Postoperative Complications / diagnosis. Radiation Dosage. Tomography, Emission-Computed, Single-Photon. Treatment Outcome. Trigeminal Nerve / physiology. Vestibular Nerve / physiology. Young Adult

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  • (PMID = 18948719.001).
  • [ISSN] 0079-6492
  • [Journal-full-title] Progress in neurological surgery
  • [ISO-abbreviation] Prog Neurol Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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61. Cauley KA, Ratkovits B, Braff SP, Linnell G: Communicating hydrocephalus after gamma knife radiosurgery for vestibular schwannoma: an MR imaging study. AJNR Am J Neuroradiol; 2009 May;30(5):992-4
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  • [Title] Communicating hydrocephalus after gamma knife radiosurgery for vestibular schwannoma: an MR imaging study.
  • Vestibular schwannomas are common, and gamma knife radiosurgery is a treatment option of symptomatic tumors.
  • Hydrocephalus may be a complication of gamma knife treatment of vestibular schwannoma, though the cause-and-effect relationship can be debated because tumors can cause hydrocephalus without treatment.
  • We present an MR imaging study of an unusual case of communicating hydrocephalus after gamma knife radiosurgery of a vestibular schwannoma in which the timeline of events strongly suggests that gamma knife played a contributory role in the development of hydrocephalus.
  • [MeSH-major] Hydrocephalus / etiology. Hydrocephalus / pathology. Magnetic Resonance Imaging / methods. Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Radiosurgery / adverse effects


62. 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


63. Kramer F, Stöver T, Warnecke A, Diensthuber M, Lenarz T, Wissel K: BDNF mRNA expression is significantly upregulated in vestibular schwannomas and correlates with proliferative activity. J Neurooncol; 2010 May;98(1):31-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] BDNF mRNA expression is significantly upregulated in vestibular schwannomas and correlates with proliferative activity.
  • The expression of neurotrophic factors, such as artemin, glial cell line-derived neurotrophic factor (GDNF), neurturin, transforming growth factors (TGF)-beta1/beta2 and brain-derived neurotrophic factor (BDNF), is enhanced in vestibular schwannomas compared to peripheral nerves.
  • Vestibular schwannoma arising from Schwann cells of the vestibular nerve are mostly benign and slow-growing.
  • Most of the pathogenic mechanisms regulating the vestibular schwannoma growth process are unknown.
  • However, molecular mechanisms interfering with regulation of the vestibular schwannoma growth also modulated by mitogenic factors have to be identified.
  • Neurotrophic factors are involved in regulation of developmental processes in neuronal tissues and regeneration after peripheral nerve trauma and also reveal mitogenic effects on glial cell populations.
  • Gene expression profiles of artemin, BDNF, GDNF, TGF-beta1/beta2 and Ret were determined in the vestibular schwannoma in comparison to the peripheral nerve tissues by using semiquantitative RT-PCR.
  • A significant higher BDNF expression was observed in the vestibular schwannoma, whereas gene expression of artemin and GDNF was upregulated in peripheral nerves.
  • The correlation between LI and BDNF, TGF-beta1 and Ret was found to be significant in the vestibular schwannoma.
  • Our results demonstrate a coherence between BDNF expression and proliferative activity in the vestibular schwannoma.
  • Based on these results, we propose a pivotal role for BDNF in modulating the vestibular schwannoma growth.
  • [MeSH-major] Brain-Derived Neurotrophic Factor / genetics. Cell Proliferation. Gene Expression Regulation, Neoplastic / physiology. Neuroma, Acoustic / genetics. RNA, Messenger / metabolism. Up-Regulation / physiology
  • [MeSH-minor] Adult. Aged. Female. Glial Cell Line-Derived Neurotrophic Factor / genetics. Glial Cell Line-Derived Neurotrophic Factor / metabolism. Humans. Ki-67 Antigen / metabolism. Male. Middle Aged. Nerve Tissue Proteins / genetics. Nerve Tissue Proteins / metabolism. Peripheral Nerves / metabolism. Statistics as Topic / methods. Statistics, Nonparametric. Transforming Growth Factor beta1 / genetics. Transforming Growth Factor beta1 / metabolism. Transforming Growth Factor beta2 / genetics. Transforming Growth Factor beta2 / metabolism. Young Adult

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  • (PMID = 19937367.001).
  • [ISSN] 1573-7373
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / ARTN protein, human; 0 / Brain-Derived Neurotrophic Factor; 0 / Glial Cell Line-Derived Neurotrophic Factor; 0 / Ki-67 Antigen; 0 / Nerve Tissue Proteins; 0 / RNA, Messenger; 0 / Transforming Growth Factor beta1; 0 / Transforming Growth Factor beta2
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64. 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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65. Rutten I, Baumert BG, Seidel L, Kotolenko S, Collignon J, Kaschten B, Albert A, Martin D, Deneufbourg JM, Demanez JP, Stevenaert A: Long-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma. Radiother Oncol; 2007 Jan;82(1):83-9
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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 reveals low toxicity of radiosurgery for vestibular schwannoma.
  • AIM: The long-term effects of radiosurgery of vestibular schwannomas were investigated in a group of consecutively treated patients.
  • METHODS AND MATERIALS: Between 1995 and 2001, 26 patients (median age: 67, range: 30-82) with a vestibular schwannoma were treated by Linac-based stereotactic radiosurgery (SRS).
  • Five-year-probability of preservation of hearing and facial nerve function was 96% and 100%, respectively.
  • CONCLUSIONS: With the doses used, our study demonstrates that SRS provides an equivalent tumour control rate when compared to surgery, as well as on a long-term basis, an excellent preservation of the facial and the acoustic nerves.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / adverse effects

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  • (PMID = 17182142.001).
  • [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
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66. Solares CA, Panizza B: Vestibular schwannoma: an understanding of growth should influence management decisions. Otol Neurotol; 2008 Sep;29(6):829-34
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  • [Title] Vestibular schwannoma: an understanding of growth should influence management decisions.
  • BACKGROUND: Treatments for vestibular schwannomas include surgical removal and radiotherapy.
  • Observation is a reasonable alternative, given the slow growth of these tumors.
  • METHODS: Patients with unilateral vestibular schwannomas who presented in the last 10 years were reviewed.
  • The following information was recorded from the charts: age, sex, tumor size at presentation and subsequent follow-up sessions, treatment in the event of growth, and time interval between presentation and last imaging available.
  • Interestingly, 11 patients (10%) demonstrated tumor regression.
  • Patients with intracanalicular tumors had a 5-year no-growth rate of 89.8% compared with 73.9% and 45.2% for Grade I and Grade II or larger tumors, respectively.
  • The difference between intracanalicular and Grade II or larger tumors was statistically significant (p = 0.0196).
  • CONCLUSION: Our data suggest that treatment can be delayed in a large proportion of vestibular schwannoma patients and that this is particularly true in patients with small tumors.
  • [MeSH-major] Ear Neoplasms / radiotherapy. Ear Neoplasms / surgery. Neuroma, Acoustic / radiotherapy. Neuroma, Acoustic / surgery

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  • (PMID = 18636034.001).
  • [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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67. Neff BA, Welling DB, Akhmametyeva E, Chang LS: The molecular biology of vestibular schwannomas: dissecting the pathogenic process at the molecular level. Otol Neurotol; 2006 Feb;27(2):197-208
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  • [Title] The molecular biology of vestibular schwannomas: dissecting the pathogenic process at the molecular level.
  • OBJECTIVE: The goal of this article was to review concisely what is currently known about the tumorigenesis of vestibular schwannomas.
  • BACKGROUND: Recent advances in molecular biology have led to a better understanding of the cause of vestibular schwannomas.
  • Mutations in the neurofibromatosis type 2 tumor suppressor gene (NF2) have been identified in these tumors.
  • In addition, the interactions of merlin, the protein product of the NF2 gene, and other cellular proteins are beginning to give us a better idea of NF2 function and the pathogenesis of vestibular schwannomas.
  • RESULTS: The clinical characteristics of vestibular schwannomas and neurofibromatosis type 2 syndromes are reviewed and related to alterations in the NF2 gene.
  • Studies demonstrating our current understanding of tumor developmental pathways are highlighted.
  • In addition, methods of clinical and genetic screening for neurofibromatosis type 2 disease are outlined.
  • CONCLUSION: Great strides have been made to identify why vestibular schwannomas develop at the molecular level.
  • Continued research is needed to find targeted therapies with which to treat these tumors.
  • [MeSH-major] Chromosomes, Human, Pair 22. Genes, Neurofibromatosis 2. Mutation. Neurofibromin 2 / genetics. Neuroma, Acoustic / genetics
  • [MeSH-minor] Alternative Splicing. Animals. Disease Models, Animal. Genetic Testing. Humans. Immunohistochemistry. Magnetic Resonance Imaging. Mice. Promoter Regions, Genetic. RNA, Messenger / genetics. Signal Transduction / genetics

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  • (PMID = 16436990.001).
  • [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, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Neurofibromin 2; 0 / RNA, Messenger
  • [Number-of-references] 114
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68. Sughrue ME, Yang I, Han SJ, Aranda D, Kane AJ, Amoils M, Smith ZA, Parsa AT: Non-audiofacial morbidity after Gamma Knife surgery for vestibular schwannoma. Neurosurg Focus; 2009 Dec;27(6):E4
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  • [Title] Non-audiofacial morbidity after Gamma Knife surgery for vestibular schwannoma.
  • OBJECT: While many studies have been published outlining morbidity following radiosurgical treatment of vestibular schwannomas, significant interpractitioner and institutional variability still exists.
  • For this reason, the authors conducted a systematic review of the literature for non-audiofacial-related morbidity after the treatment of vestibular schwannoma with radiosurgery.
  • METHODS: The authors performed a comprehensive search of the English-language literature to identify studies that published outcome data of patients undergoing radiosurgery treatment for vestibular schwannomas.
  • All tumors included in this study were < 25 mm in their largest diameter.
  • Patients receiving > 13 Gy were significantly more likely to develop trigeminal nerve neuropathy than those receiving < 13 Gy (p < 0.001).
  • CONCLUSIONS: The results of our review of the literature provide a systematic summary of the published rates of nonaudiofacial morbidity following radiosurgery for vestibular schwannoma.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / methods
  • [MeSH-minor] Cranial Nerve Diseases / epidemiology. Cranial Nerve Diseases / etiology. Humans. Hydrocephalus / epidemiology. Hydrocephalus / etiology. Hydrocephalus / surgery. Postoperative Complications / epidemiology. Postoperative Complications / etiology. Postoperative Complications / mortality. Radiation Dosage. Radiotherapy Dosage / standards. Tinnitus / epidemiology. Tinnitus / etiology. Treatment Outcome. Trigeminal Nerve Diseases / epidemiology. Trigeminal Nerve Diseases / etiology. Trigeminal Neuralgia / epidemiology. Trigeminal Neuralgia / etiology. Vertigo / epidemiology. Vertigo / etiology

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  • (PMID = 19951057.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Grant] United States / Howard Hughes Medical Institute / /
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 87
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69. Kim KM, Park CK, Chung HT, Paek SH, Jung HW, Kim DG: Long-term Outcomes of Gamma Knife Stereotactic Radiosurgery of Vestibular Schwannomas. J Korean Neurosurg Soc; 2007 Oct;42(4):286-92
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  • [Title] Long-term Outcomes of Gamma Knife Stereotactic Radiosurgery of Vestibular Schwannomas.
  • OBJECTIVE: Gamma Knife Stereotactic Radiosurgery (GK SRS) has become an important treatment modality for vestibular schwannomas.
  • We evaluated the tumor control rate, patterns of tumor volume change and preservation of hearing following low-dose radiation for vestibular schwannomas in a homogeneous cohort group in which the mean marginal dose was 12 Gy.
  • Regular MRI, audiometry and clinical evaluations were done and tumor volumes were obtained from MRI using the OSIRIS program.
  • RESULTS: The tumor control rate was 97%.
  • We were able to classify the patterns of change in tumor volume into three categories.
  • Transient increases in tumor volume were detected in 29% of the patients and the maximum transient increase in tumor volume was identified at 6 to 30 months after GK SRS.
  • The transient increases in tumor volume ranged from 121% to 188%.
  • CONCLUSION: Low-dose GK SRS was an effective and safe mode of treatment for vestibular schwannomas in comparison to the previously used high-dose GK SRS.
  • Transient increases in tumor volume can be identified during the follow-up period after low-dose GK SRS for vestibular schwannomas.

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  • (PMID = 19096558.001).
  • [ISSN] 2005-3711
  • [Journal-full-title] Journal of Korean Neurosurgical Society
  • [ISO-abbreviation] J Korean Neurosurg Soc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2588215
  • [Keywords] NOTNLM ; Gamma knife / Long-term outcome / Low dose / Vestibular schwannomas
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70. Chin KF, Babar J, Tzifa K, Chavda SV, Irving RM: Vestibular schwannomas with fluid-fluid level. J Laryngol Otol; 2007 Sep;121(9):902-6
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  • [Title] Vestibular schwannomas with fluid-fluid level.
  • Vestibular schwannomas containing cystic parts are common, but it is extremely rare for a vestibular schwannoma to contain fluid-fluid levels.
  • In this report, we present two cases of vestibular schwannoma with magnetic resonance imaging findings of a fluid-fluid level, and we discuss the radiological features and possible mechanism of fluid-fluid level formation.
  • [MeSH-major] Cyst Fluid. Neuroma, Acoustic / diagnosis

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  • (PMID = 17320004.001).
  • [ISSN] 1748-5460
  • [Journal-full-title] The Journal of laryngology and otology
  • [ISO-abbreviation] J Laryngol Otol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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71. Akard W, Tubbs RS, Seymour ZA, Hitselberger WE, Cohen-Gadol AA: Evolution of techniques for the resection of vestibular schwannomas: from saving life to saving function. J Neurosurg; 2009 Apr;110(4):642-7
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  • [Title] Evolution of techniques for the resection of vestibular schwannomas: from saving life to saving function.
  • The current state of surgery for vestibular schwannomas (VSs) is the result of a century of step-by-step technical progress by groundbreaking surgeons who transformed the procedure from its hazardous infancy and high mortality rate to its current state of safety and low morbidity rate.
  • Harvey Cushing advocated bilateral suboccipital decompression and developed the method of intracapsular tumor enucleation.
  • Walter Dandy supported the unilateral suboccipital approach and developed the technique of gross-total tumor resection.
  • The authors examined the Cushing Brain Tumor Registry for clues regarding the bona fide intention of Cushing for the resection of these tumors.
  • [MeSH-major] Neuroma, Acoustic / history. Neurosurgical Procedures / history

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  • (PMID = 18991500.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Historical Article; Journal Article
  • [Publication-country] United States
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72. Müller S, Arnolds J, van Oosterhout A: Decision-making of vestibular schwannoma patients. Acta Neurochir (Wien); 2010 Jun;152(6):973-84
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  • [Title] Decision-making of vestibular schwannoma patients.
  • BACKGROUND: Patients suffering from vestibular schwannoma can choose between four modalities of management:.
  • METHOD: This study is based on postal questionnaire survey of 739 vestibular schwannoma patients (survey response rate, 78%).
  • CONCLUSION: The praxis of patient counselling of acoustic neuroma patients in Germany is far from the ideal condition of medical consultation: The most important shortcoming is that it is unilateral: About 69% of the patients are informed about only one treatment option, generally surgery.
  • [MeSH-major] Decision Making. Dose Fractionation. Neuroma, Acoustic / radiotherapy. Neuroma, Acoustic / surgery. Patient Participation. Radiosurgery

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  • (PMID = 20169371.001).
  • [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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73. Nouraei SA, Huys QJ, Chatrath P, Powles J, Harcourt JP: Screening patients with sensorineural hearing loss for vestibular schwannoma using a Bayesian classifier. Clin Otolaryngol; 2007 Aug;32(4):248-54
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  • [Title] Screening patients with sensorineural hearing loss for vestibular schwannoma using a Bayesian classifier.
  • OBJECTIVES: Selecting patients with asymmetrical sensorineural hearing loss for further investigation continues to pose clinical and medicolegal challenges, given the disparity between the number of symptomatic patients, and the low incidence of vestibular schwannoma as the underlying cause.
  • We developed and validated a diagnostic model using a generalisation of neural networks, for detecting vestibular schwannomas from clinical and audiological data, and compared its performance with six previously published clinical and audiological decision-support screening protocols.
  • PARTICIPANTS: Clinical and audiometric details of 129 patients with, and as many age and sex-matched patients without vestibular schwannomas, as determined with magnetic resonance imaging.
  • MAIN OUTCOME MEASURES: The ability to diagnose a patient as having or not having vestibular schwannoma.
  • RESULTS: A Gaussian Process Ordinal Regression Classifier was trained and cross-validated to classify cases as 'with' or 'without' vestibular schwannoma, and its diagnostic performance was assessed using receiver operator characteristic plots.
  • DISCUSSION: The Gaussian Process ORdinal Regression Classifier increased the flexibility and specificity of the screening process for vestibular schwannoma when applied to a sample of matched patients with and without this condition.
  • [MeSH-major] Hearing Loss, Sensorineural / diagnosis. Hearing Loss, Sensorineural / etiology. Neuroma, Acoustic / complications. Neuroma, Acoustic / diagnosis

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  • (PMID = 17651265.001).
  • [ISSN] 1749-4478
  • [Journal-full-title] Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
  • [ISO-abbreviation] Clin Otolaryngol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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74. Fuentes S, Arkha Y, Pech-Gourg G, Grisoli F, Dufour H, Régis J: Management of large vestibular schwannomas by combined surgical resection and gamma knife radiosurgery. Prog Neurol Surg; 2008;21:79-82
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  • [Title] Management of large vestibular schwannomas by combined surgical resection and gamma knife radiosurgery.
  • In this report, we evaluated the treatment results of a combination of surgery and radiosurgery for large vestibular schwannomas.
  • The series of 8 patients included in this study underwent surgery followed by radiosurgical treatment between January 2000 and January 2006.
  • The average maximum diameter of the tumor was 40 (35-45) mm.
  • The mean peripheral dose administered was 11.8 (range 11-13) Gy, and the mean dose administered in the centre of the tumor was 23.75 (22-26) Gy.
  • Excellent facial nerve function (House-Brackmann grade 1 or 2) was preserved in 7/8 patients (87.5%).
  • In the case of large vestibular schwannomas, the combined management is one option for maintaining cranial nerve function and tumor growth control.
  • [MeSH-major] Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Radiosurgery
  • [MeSH-minor] Adult. Aged. Cohort Studies. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm, Residual. Radiotherapy Dosage. Retrospective Studies. Treatment Outcome

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  • (PMID = 18810202.001).
  • [ISSN] 0079-6492
  • [Journal-full-title] Progress in neurological surgery
  • [ISO-abbreviation] Prog Neurol Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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75. Chan AW, Black P, Ojemann RG, Barker FG 2nd, Kooy HM, Lopes VV, McKenna MJ, Shrieve DC, Martuza RL, Loeffler JS: Stereotactic radiotherapy for vestibular schwannomas: favorable outcome with minimal toxicity. Neurosurgery; 2005 Jul;57(1):60-70; discussion 60-70
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  • [Title] Stereotactic radiotherapy for vestibular schwannomas: favorable outcome with minimal toxicity.
  • OBJECTIVE: To determine the outcome and toxicity in patients with vestibular schwannomas treated with conventionally fractionated stereotactic radiotherapy (SRT) and to identify prognostic factors that are predictive of outcome.
  • METHODS: Between 1992 and 2001, 70 patients with vestibular schwannomas were treated with linear accelerator-based SRT in our institutions.
  • The median tumor volume was 2.4 cm3 (range, 0.05-21.1 cm3).
  • The indications for SRT were distributed as follows: 47% newly diagnosed, 31% progressive tumors after watchful waiting, 3% adjuvant postoperative radiation, and 19% recurrent tumors after surgical resection.
  • RESULTS: Tumor recurrence was defined as progressive enlargement of tumor on follow-up magnetic resonance imaging studies.
  • One patient had a tumor recurrence at 38 months after SRT.
  • The actuarial tumor control rates were 100 and 98% at 3 and 5 years, respectively.
  • Three patients with a median tumor volume of 16.2 cm3 required surgical resection for persistent or increasing symptoms at a median of 37 months.
  • In multivariate analysis, tumor volume at time of treatment was predictive for neurosurgical intervention (surgical resection or shunt placement) after SRT (P = 0.001).
  • The 3- and 5-year actuarial rates of freedom from any neurosurgical intervention were 100 and 97% for patients with tumor volume less than 8 cm3 and 74 and 47% respectively for patients with tumor of at least 8 cm3 (P < 0.0001).
  • The 3-year actuarial rates of facial and trigeminal nerve preservation were 99 and 96%, respectively.
  • There was no difference in tumor control and cranial nerve function preservation rates seen in NF2 patients compared with non-NF2 patients.
  • Patients with large tumors are more likely to undergo neurosurgical interventions after SRT.
  • [MeSH-major] Dose Fractionation. Neuroma, Acoustic / surgery. Radiosurgery / methods. Stereotaxic Techniques. Treatment Outcome

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  • (PMID = 15987541.001).
  • [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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76. Ito E, Saito K, Yatsuya H, Nagatani T, Otsuka G: Factors predicting growth of vestibular schwannoma in neurofibromatosis type 2. Neurosurg Rev; 2009 Oct;32(4):425-33
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  • [Title] Factors predicting growth of vestibular schwannoma in neurofibromatosis type 2.
  • We retrospectively reviewed characteristics of patients with neurofibromatosis type 2 to identify factors predicting further growth of bilateral vestibular schwannomas.
  • Subjects comprised 27 neurofibromatosis type 2 patients with 54 vestibular schwannomas, followed for 24-204 months (mean, 86 months).
  • This study investigated factors predictive of vestibular schwannoma growth in neurofibromatosis type 2.
  • Features distinguishing actively growing from quiescent VS were determined for untreated course (28 vestibular schwannomas) and posttreatment course (including either resection or radiosurgery; 33 vestibular schwannomas).
  • A general estimation equation was used to identify factors affecting tumor growth.
  • During the untreated course, 19 vestibular schwannomas showed growth and 9 vestibular schwannomas were stable.
  • [MeSH-major] Cranial Nerve Neoplasms / pathology. Neurofibromatosis 2 / pathology. Neuroma, Acoustic / pathology. Trigeminal Nerve / pathology
  • [MeSH-minor] Adolescent. Adult. Age of Onset. Analysis of Variance. Child. Child, Preschool. Disease Progression. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neurosurgical Procedures. Predictive Value of Tests. Radiosurgery. Retrospective Studies. Tomography, X-Ray Computed. Young Adult


77. Stangerup SE, Caye-Thomasen P, Tos M, Thomsen JC: [Incidence of vestibular schwannoma in Denmark]. Ugeskr Laeger; 2008 Oct 13;170(42):3335-8
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  • [Title] [Incidence of vestibular schwannoma in Denmark].
  • INTRODUCTION: During the last 30 years the number of diagnosed vestibular schwannomas (VS) has increased from 15 in 1976 to 116 in 2006.
  • CONCLUSION: With easier access to MRI, vestibular schwannomas are found earlier when they are still small.
  • [MeSH-major] Neuroma, Acoustic / epidemiology

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  • (PMID = 18940171.001).
  • [ISSN] 1603-6824
  • [Journal-full-title] Ugeskrift for laeger
  • [ISO-abbreviation] Ugeskr. Laeg.
  • [Language] dan
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Denmark
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78. Gerganov V, Nouri M, Stieglitz L, Giordano M, Samii M, Samii A: Radiological factors related to pre-operative hearing levels in patients with vestibular schwannomas. J Clin Neurosci; 2009 Aug;16(8):1009-12
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  • [Title] Radiological factors related to pre-operative hearing levels in patients with vestibular schwannomas.
  • The pathogenetic mechanism of hearing loss in patients with vestibular schwannomas (VS) remains unclear.
  • Image processing software was used to analyse the maximal tumor diameter in three planes; its volume; its extension cranially, caudally, anteriorly and posteriorly; the width and length of the intrameatal tumor portion, its shape and consistency; and the tumor-fundus distance.
  • The degree of hearing correlated significantly with the tumor size, volume and coronal diameter, the degree of intrameatal tumor growth, and the distance between the lateral tumor end and the fundus (p < 0.05).
  • No correlation was found regarding tumor extension, shape and consistency, the presence of hydrocephalus, or the extent of erosion of the internal auditory canal.
  • [MeSH-major] Cranial Nerve Neoplasms / pathology. Hearing. Neuroma, Acoustic / pathology
  • [MeSH-minor] Adult. Aging. Ear Canal / pathology. Female. Hearing Tests. Humans. Hydrocephalus / pathology. Image Processing, Computer-Assisted. Magnetic Resonance Imaging. Male. Middle Aged. Vestibulocochlear Nerve / pathology. Vestibulocochlear Nerve / surgery

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  • (PMID = 19428260.001).
  • [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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79. Wickremesekera A, Hovens CM, Kaye AH: Expression of ErbB-1 and 2 in vestibular schwannomas. J Clin Neurosci; 2007 Dec;14(12):1199-206
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  • [Title] Expression of ErbB-1 and 2 in vestibular schwannomas.
  • Using immunohistochemistry and Western blot techniques we have shown an increased expression of ErbB-2 and no expression of ErbB-1 in vestibular schwannomas (VS).
  • [MeSH-major] Cranial Nerve Neoplasms / metabolism. Neuroma, Acoustic / metabolism. Receptor, Epidermal Growth Factor / biosynthesis. Receptor, ErbB-2 / biosynthesis
  • [MeSH-minor] Animals. Blotting, Western. Brain Neoplasms / metabolism. Brain Neoplasms / pathology. Cells, Cultured. Glioblastoma / metabolism. Glioblastoma / pathology. Humans. Immunohistochemistry. Immunoprecipitation. Mice. Neoplasm Proteins / chemistry. Neoplasm Proteins / isolation & purification

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  • (PMID = 17964790.001).
  • [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; Research Support, Non-U.S. Gov't
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Neoplasm Proteins; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; EC 2.7.10.1 / Receptor, ErbB-2
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80. Lassaletta L, Gavilán J: [An update on the treatment of vestibular schwannoma]. Acta Otorrinolaringol Esp; 2009 Mar-Apr;60(2):131-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [An update on the treatment of vestibular schwannoma].
  • [Transliterated title] Actualización en el tratamiento del schwannoma vestibular.
  • The increase in the diagnosis of ever smaller vestibular schwannomas (VS), the fact that many tumours can be observed with serial MRI, and the development of radiosurgery as an alternative to microsurgery have led the neurotologic surgeon to a new global approach to patients with vs. On the other hand, the spread of internet-based information sources, often with biased or incomplete information, makes counselling patients with VS a challenging task.
  • [MeSH-major] Neuroma, Acoustic / therapy
  • [MeSH-minor] Disease Progression. Humans. Otologic Surgical Procedures / methods. Radiosurgery

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  • (PMID = 19401081.001).
  • [ISSN] 0001-6519
  • [Journal-full-title] Acta otorrinolaringológica española
  • [ISO-abbreviation] Acta Otorrinolaringol Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 50
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81. Gerganov VM, Giordano M, Herold C, Samii A, Samii M: An electrophysiological study on the safety of the endoscope-assisted microsurgical removal of vestibular schwannomas. Eur J Surg Oncol; 2010 Apr;36(4):422-7
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  • [Title] An electrophysiological study on the safety of the endoscope-assisted microsurgical removal of vestibular schwannomas.
  • METHODS: We evaluated the risk of thermal or mechanical iatrogenic nerve injury related to endoscope application during microsurgical removal of vestibular schwannomas (VS) in a prospective group of 30 patients (Group A).
  • [MeSH-major] Endoscopy / methods. Microsurgery / methods. Neuroma, Acoustic / surgery

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  • [Copyright] Copyright (c) 2009 Elsevier Ltd. All rights reserved.
  • (PMID = 19942394.001).
  • [ISSN] 1532-2157
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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82. Mautner VF, Nguyen R, Kutta H, Fuensterer C, Bokemeyer C, Hagel C, Friedrich RE, Panse J: Bevacizumab induces regression of vestibular schwannomas in patients with neurofibromatosis type 2. Neuro Oncol; 2010 Jan;12(1):14-8
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  • [Title] Bevacizumab induces regression of vestibular schwannomas in patients with neurofibromatosis type 2.
  • Bilateral vestibular schwannomas are the hallmark of neurofibromatosis type 2 (NF2), and these tumors impair hearing and frequently lead to deafness.
  • Neurosurgical intervention, the only established treatment, often damages the vestibular nerve.
  • We report 2 cases in which treatment with bevacizumab (for 3 months in one case and 6 months in the other) induced regression of progressive vestibular schwannomas by more than 40% and substantially improved hearing in the patient treated for 6 months.
  • Bevacizumab therapy may thus provide an effective treatment for progressive vestibular schwannomas in patients with NF2.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antineoplastic Agents / therapeutic use. Neurofibromatosis 2 / drug therapy. Neuroma, Acoustic / drug therapy


83. Bush ML, Jones RO, Shinn JB: Auditory brainstem response threshold differences in patients with vestibular schwannoma: a new diagnostic index. Ear Nose Throat J; 2008 Aug;87(8):458-62
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  • [Title] Auditory brainstem response threshold differences in patients with vestibular schwannoma: a new diagnostic index.
  • Auditory brainstem response (ABR) testing is less sensitive in detecting small vestibular schwannomas than medium-size tumors.
  • Magnetic resonance imaging (MRI) is more sensitive than ABR alone for small and large tumors, but it carries with it increased cost and issues of unavailability and patient discomfort.
  • We conducted a prospective pilot study of 7 patients with untreated MRI-proven, unilateral vestibular schwannoma to determine if we could increase the sensitivity of ABR testing in detecting small tumors.
  • [MeSH-major] Brain Stem / pathology. Evoked Potentials, Auditory, Brain Stem. Neuroma, Acoustic / diagnosis

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  • (PMID = 18712694.001).
  • [ISSN] 1942-7522
  • [Journal-full-title] Ear, nose, & throat journal
  • [ISO-abbreviation] Ear Nose Throat J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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84. Stangerup SE, Tos M, Thomsen J, Caye-Thomasen P: True incidence of vestibular schwannoma? Neurosurgery; 2010 Nov;67(5):1335-40; discussion 1340
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  • [Title] True incidence of vestibular schwannoma?
  • BACKGROUND: The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging.
  • OBJECTIVE: To present updated epidemiological data on VS incidence, as well as patient age, hearing acuity, tumor size, and localization at diagnosis for the last 4 decades in an unselected population, with emphasis on developments in recent years.
  • Incidence during the period, patient sex and age, data on hearing (pure tone average and speech discrimination), and tumor size at diagnosis were retrieved from the database.
  • Mean tumor size at diagnosis decreased from 30 mm in 1979 to 10 mm in 2008, whereas hearing acuity at diagnosis has improved over the years.
  • CONCLUSION: After a steady increase over the last 4 decades, the incidence of vestibular schwannomas appears to have peaked and decreased in recent years, stabilizing at about 19 tumors per million per year.
  • Whereas the sex ratio and age at diagnosis have remained grossly unchanged over the years, hearing has improved, and tumor size has decreased considerably.
  • [MeSH-major] Neuroma, Acoustic / epidemiology

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  • (PMID = 20871439.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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85. Kuo YH, Roos D, Brophy BP: Linear accelerator radiosurgery for treatment of vestibular schwannomas in neurofibromatosis 2. J Clin Neurosci; 2008 Jul;15(7):744-8
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  • [Title] Linear accelerator radiosurgery for treatment of vestibular schwannomas in neurofibromatosis 2.
  • Management of vestibular schwannomas in patients with neurofibromatosis 2 (NF2) balances growth control against preservation of hearing with the primary aim of maintaining patient quality of life.
  • Previous studies on the efficacy of stereotactic radiosurgery for vestibular schwannomas in NF2 have reported results from delivery by Gamma Knife systems.
  • Modelling studies suggest that lesional conformality is superior with Gamma Knife, but clinical studies on sporadic vestibular schwannomas show equivalent results between the two systems.
  • Our experience with LINAC radiosurgery in NF2 reported here shows good long-term growth control in four patients with vestibular schwannomas.
  • [MeSH-major] Neurofibromatosis 2 / surgery. Neuroma, Acoustic / surgery. Radiosurgery / statistics & numerical data
  • [MeSH-minor] Adult. Brain Stem / pathology. Brain Stem / physiopathology. Brain Stem / surgery. Deafness / etiology. Deafness / physiopathology. Female. Humans. Magnetic Resonance Imaging. Male. Postoperative Complications / etiology. Postoperative Complications / physiopathology. Retrospective Studies. Treatment Outcome. Vestibular Nerve / pathology. Vestibular Nerve / physiopathology. Vestibular Nerve / radiation effects

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  • (PMID = 18403208.001).
  • [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] Case Reports; Comparative Study; Journal Article
  • [Publication-country] Scotland
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86. Sweeney P, Yajnik S, Hartsell W, Bovis G, Venkatesan J: Stereotactic radiotherapy for vestibular schwannoma. Otolaryngol Clin North Am; 2009 Aug;42(4):655-63
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  • [Title] Stereotactic radiotherapy for vestibular schwannoma.
  • Vestibular schwannomas are benign tumors of the Schwann cells of the eighth (VIII) cranial nerve.
  • Precision radiotherapy techniques used to manage these tumors include stereotactic radiotherapy (SRT), which can be delivered with either a conventional or hypofractionated regimen.
  • [MeSH-major] Neoplasm Recurrence, Local / pathology. Neuroma, Acoustic / radiotherapy. Radiation Injuries / prevention & control. Radiotherapy Planning, Computer-Assisted. Stereotaxic Techniques
  • [MeSH-minor] Animals. Biopsy, Needle. Dose Fractionation. Dose-Response Relationship, Radiation. Female. Humans. Immunohistochemistry. Male. Mice. Neoplasm Staging. Prognosis. Radiobiology. Radiosurgery / adverse effects. Radiosurgery / methods. Radiotherapy Dosage. Radiotherapy, Conformal / adverse effects. Radiotherapy, Conformal / methods. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 19751870.001).
  • [ISSN] 1557-8259
  • [Journal-full-title] Otolaryngologic clinics of North America
  • [ISO-abbreviation] Otolaryngol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 26
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87. Dewan S, Norén G: Retreatment of vestibular schwannomas with Gamma Knife surgery. J Neurosurg; 2008 Dec;109 Suppl:144-8
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  • [Title] Retreatment of vestibular schwannomas with Gamma Knife surgery.
  • OBJECT: The response rate of vestibular schwannomas (VSs) to radiosurgery has reached the 97% level in several published series.
  • When failure rarely occurs, some controversy has existed as to whether the tumor has to be resected or can be safely retreated with radiosurgery.
  • Tumor control (size before and after the first and the second treatment) was evaluated using MR imaging to demonstrate the course after the 2 treatments.
  • Facial nerve function (House-Brackmann grading system), trigeminal nerve function, hearing (Gardner-Robertson classification), and any adverse radiation effects were evaluated.
  • One tumor remained unchanged over the first 6 months, but demonstrated signs of internal necrosis.
  • All patients demonstrated stable facial nerve function.
  • CONCLUSIONS: Vestibular schwannomas can be retreated with GKS with good tumor control response and low risk of toxicity.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery
  • [MeSH-minor] Aged. Facial Nerve / physiopathology. Female. Follow-Up Studies. Humans. Male. Middle Aged. Radiotherapy Dosage. Retreatment. Retrospective Studies. Treatment Outcome. Trigeminal Nerve / physiopathology. Tumor Burden

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  • (PMID = 19123901.001).
  • [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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88. Humphriss RL, Baguley DM, Axon PR, Moffat DA: Preoperative audiovestibular handicap in patients with vestibular schwannoma. Skull Base; 2006 Nov;16(4):193-9
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  • [Title] Preoperative audiovestibular handicap in patients with vestibular schwannoma.
  • OBJECTIVES: To evaluate preoperative hearing, dizziness, and tinnitus handicap in patients with unilateral vestibular schwannoma (VS).
  • PARTICIPANTS: A total of 145 consecutive patients who were admitted for excision of their vestibular schwannomas between May 1998 and July 2002.
  • There was no significant association between tumor size and any of the questionnaire scores.

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  • (PMID = 17471318.001).
  • [ISSN] 1531-5010
  • [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/ PMC1766462
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89. Dalgorf DM, Rowsell C, Bilbao JM, Chen JM: Immunohistochemical investigation of hormone receptors and vascular endothelial growth factor concentration in vestibular schwannoma. Skull Base; 2008 Nov;18(6):377-84
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  • [Title] Immunohistochemical investigation of hormone receptors and vascular endothelial growth factor concentration in vestibular schwannoma.
  • OBJECTIVES: To determine if a relationship exists between the presence of estrogen receptors (ER), progesterone receptors (PR), or vascular endothelial growth factor (VEGF) and the size, growth rate, and behavior of vestibular schwannoma tumors.
  • DESIGN: Nine tumor samples from young female patients with large vestibular schwannoma tumors were preselected because they were presumed to be faster growing, more aggressive tumors.
  • RESULTS: The mean age of the study sample was 32.3 years, mean tumor size was 3.2 cm, and the average growth rate was 0.4 cm per 2 months.
  • Eight of nine tumor samples stained positive for VEGF, with five demonstrating low intensity and three demonstrating moderate intensity staining.
  • CONCLUSIONS: There is histopathological evidence for the expression of VEGF in vestibular schwannomas but not for ER and PR.
  • Further studies are necessary to determine the role of VEGF and other molecular pathways in the growth of vestibular schwannomas and the application of anti-VEGF therapy as a potential treatment option in the future.

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  • (PMID = 19412407.001).
  • [ISSN] 1531-5010
  • [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/ PMC2637072
  • [Keywords] NOTNLM ; Vestibular schwannoma / acoustic neuroma / estrogen receptor / immunohistochemistry / progesterone receptor / vascular endothelial growth factor
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90. MacNally SP, Rutherford SA, King AT, Freeman S, Thorne J, Mawman D, O'Driscoll MP, Evans DG, Ramsden RT: Outcome from surgery for vestibular schwannomas in children. Br J Neurosurg; 2009 Jun;23(3):226-31
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  • [Title] Outcome from surgery for vestibular schwannomas in children.
  • OBJECT: A review of sporadic and NF2-related vestibular schwannoma surgery in children (under 18 years of age) with a specific interest in resection rates, recurrence, facial nerve outcomes, hearing preservation, hearing rehabilitation and genetic analysis.
  • METHODS: A retrospective analysis of prospectively collected data of 35 consecutively operated vestibular schwannomas in 29 paediatric patients that underwent 38 operations between 1992 and 2007.
  • Pre- and post-operative radiology, facial nerve function, pure tone audiogram and speech discrimination tests were performed with a mean follow-up of 4.5 years.
  • The facial nerve was anatomically preserved in 92%.
  • Facial nerve function was excellent to good (Grades 1-3) in 88% with outcome related to tumour size.
  • Hearing rehabilitation can be successful by utilising cochlear implants and auditory brain stem implants (ABI) as appropriate.
  • [MeSH-major] Facial Nerve. Neurofibromatosis 2 / surgery. Neuroma, Acoustic / surgery
  • [MeSH-minor] Adolescent. Auditory Brain Stem Implants. Auditory Threshold / physiology. Child. Cochlear Implants. Codon, Nonsense / genetics. Cranial Nerve Neoplasms / surgery. Facial Nerve Diseases / surgery. Female. Hearing Disorders / prevention & control. Humans. Male. Neoplasm Recurrence, Local / pathology. Outcome Assessment (Health Care). Postoperative Complications / prevention & control. Postoperative Complications / rehabilitation. Prognosis. Retrospective Studies. Speech Discrimination Tests

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  • [CommentIn] Br J Neurosurg. 2009 Jun;23(3):232-3 [19533455.001]
  • (PMID = 19533454.001).
  • [ISSN] 1360-046X
  • [Journal-full-title] British journal of neurosurgery
  • [ISO-abbreviation] Br J Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Codon, Nonsense
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91. Yang I, Aranda D, Han SJ, Chennupati S, Sughrue ME, Cheung SW, Pitts LH, Parsa AT: Hearing preservation after stereotactic radiosurgery for vestibular schwannoma: a systematic review. J Clin Neurosci; 2009 Jun;16(6):742-7
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  • [Title] Hearing preservation after stereotactic radiosurgery for vestibular schwannoma: a systematic review.
  • Radiosurgery has evolved into an effective alternative to microsurgical resection in the treatment of patients with vestibular schwannoma.
  • We performed a systematic analysis of the literature in English on the radiosurgical treatment of vestibular schwannoma patients.
  • A total of 254 published studies reported assessable and quantifiable outcome data of patients undergoing radiosurgery for vestibular schwannomas.
  • [MeSH-major] Hearing Loss / prevention & control. Neuroma, Acoustic / surgery. Postoperative Complications / prevention & control. Radiosurgery / adverse effects. Radiosurgery / methods
  • [MeSH-minor] Age Factors. Aged. Cochlear Nerve / physiopathology. Cochlear Nerve / radiation effects. Dose-Response Relationship, Radiation. Humans. Iatrogenic Disease / prevention & control. Middle Aged. Vestibular Nerve / pathology. Vestibular Nerve / physiopathology. Vestibular Nerve / surgery


92. Bae CW, Cho YH, Hong SH, Kim JH, Lee JK, Kim CJ: The anatomical location and course of the facial nerve in vestibular schwannomas : a study of 163 surgically treated cases. J Korean Neurosurg Soc; 2007 Dec;42(6):450-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The anatomical location and course of the facial nerve in vestibular schwannomas : a study of 163 surgically treated cases.
  • OBJECTIVE: The aim of this study was to identify the anatomical location and course of the facial nerve (FN) and their relationship to the tumor size in surgically treated vestibular schwannomas.
  • METHODS: A retrospective study was conducted on 163 patients who had been treated by the microsurgical resection for a newly diagnosed vestibular schwannoma between 1995 and 2005 (mean age of 46.1 years; 108 females and 55 males).
  • The anatomical location and course of the FN along the tumor surface were verified in each patient during the microsurgery, and were classified into 4 groups :.
  • 1) the FN displaced along the ventral and superior surface of the tumor (VS);.
  • In the subgroup with tumors less than 2 cm in diameter (n=23), the FN was displaced along the ventral and central surface of the tumor in the majority (65.2%), whereas, in the patients with tumors larger than 2cm (n=140), it was displaced along the ventral and superior surface most frequently (59.3%).
  • CONCLUSION: The FN can be displaced variably in vestibular schwannomas, and most frequently along the ventral and superior surface of the tumor, especially in large ones.

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  • (PMID = 19096588.001).
  • [ISSN] 2005-3711
  • [Journal-full-title] Journal of Korean Neurosurgical Society
  • [ISO-abbreviation] J Korean Neurosurg Soc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2588177
  • [Keywords] NOTNLM ; Facial nerve / Microsurgery / Vestibular schwannoma
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93. Lü JR, Zou J, Wu H: [Expression and localization of merlin in vestibular schwannoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2006 Jul;41(7):501-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Expression and localization of merlin in vestibular schwannoma].
  • OBJECTIVE: To clarify the expression and subcellular localization of merlin in vestibular schwannoma.
  • METHODS: Fifty four paraffin embedded vestibular schwannoma samples confirmed by pathology after resection were included in the study.
  • The expression of merlin in vestibular schwannoma was analyzed by immunohistochemistry.
  • Nerve tissues that were resected during surgical treatment for trigeminal neuralgia and Meniere's disease were used as control.
  • Western blotting was used to analyze the electrophoresis migration of merlin in the acoustic neuroma.
  • The expression percentage of merlin in the tumor tissue was compared with age and gender of the patients, clinical course of the tumor, tumor growth index, tumor diameter and clinical stage.
  • RESULTS: Merlin was expressed in 0 to 87.5% of the cells in vestibular schwannoma tissue with a mean of (46.66 +/- 5.75)%.
  • There was a negative correlation between merlin expression percentage and tumor growth index.
  • There were no correlations between merlin expression percentage and the age, gender, tumor diameter and clinical stage.
  • Merlin in the tumor tissue was shown by western blot to be in 65000 and 125000 positions.
  • CONCLUSIONS: Merlin was expressed in vestibular schwannoma tissue, with a different intra-cellular location.
  • Merlin might also exist as a complex with other proteins in the tumor tissue.
  • [MeSH-major] Neurofibromin 2 / metabolism. Neuroma, Acoustic / metabolism. Neuroma, Acoustic / pathology
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Young Adult

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  • (PMID = 17007372.001).
  • [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 / Neurofibromin 2
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94. Stankovic KM, Mrugala MM, Martuza RL, Silver M, Betensky RA, Nadol JB Jr, Stemmer-Rachamimov AO: Genetic determinants of hearing loss associated with vestibular schwannomas. Otol Neurotol; 2009 Aug;30(5):661-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Genetic determinants of hearing loss associated with vestibular schwannomas.
  • HYPOTHESIS: The severity of hearing loss (HL) associated with vestibular schwannomas (VSs) is influenced by genes expressed by the VSs.
  • Previous studies have suggested that VSs cause HL not only by inducing degeneration of the auditory nerve by compression but also by promoting degeneration of the inner ear.
  • Because of a small sample size, exact nonparametric tests were used to assess the association between good versus poor hearing and specific histological features of the tumors and patient demographics.
  • RESULTS: Using gene set enrichment analysis, the chromosomal region 3q27 was found to be significantly different between the 2 groups of tumors.
  • [MeSH-major] Genes, Neoplasm / genetics. Hearing Loss / etiology. Hearing Loss / genetics. Neuroma, Acoustic / complications. Neuroma, Acoustic / genetics

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  • (PMID = 19546833.001).
  • [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; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 63231-63-0 / RNA; 9007-49-2 / DNA
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95. 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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96. Kabil MS, Shahinian HK: A series of 112 fully endoscopic resections of vestibular schwannomas. Minim Invasive Neurosurg; 2006 Dec;49(6):362-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A series of 112 fully endoscopic resections of vestibular schwannomas.
  • We report a consecutive series of 112 patients with unilateral vestibular schwannoma (VS) having undergone fully endoscopic resection of their tumors in the period from October, 2001 to January, 2005.
  • Patients' outcomes were evaluated especially with regards to cochlear nerve (hearing) preservation, facial nerve preservation, postoperative complications and completeness of the resection.
  • The patient population consisted of 112 consecutive cases with unilateral, "de novo" VS(s); patients with neurofibromatosis type 2 (NFT2) or with a recurrent tumor were excluded from this study.
  • Tumors ranged in size from 0.6-5.7 cm, most tumors were less than 3 cm in diameter (mean: 2.6 cm).
  • This shift towards smaller and also less symptomatic tumors may be due to an increase in the awareness of patients and earlier detection of their tumors (MRI era).
  • Tumors were removed via 1.5-cm "keyhole" retrosigmoid craniotomies.
  • Utilizing the fully endoscopic technique, 106/112 (95%) tumors were completely removed; subtotal removal was performed in 6/112 (5%) patients in an attempt to preserve their hearing.
  • Anatomic preservation of the facial nerve was achieved in all of the patients and of the cochlear nerve in 83/101 (82%) hearing ears.
  • There were no major neurological complications such as quadriparesis, hemiparesis, bacterial or aseptic meningitis, lower cranial nerve deficits, or deaths.
  • From our experience, we conclude that the endoscope is ideally suited for a minimally invasive approach for the resection of vestibular schwannomas.
  • [MeSH-major] Endoscopy. Neuroma, Acoustic / surgery

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  • (PMID = 17323265.001).
  • [ISSN] 0946-7211
  • [Journal-full-title] Minimally invasive neurosurgery : MIN
  • [ISO-abbreviation] Minim Invasive Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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97. Roche PH, Robitail S, Régis J: Two- and three dimensional measures of vestibular schwannomas and posterior fossa--implications for the treatment. Acta Neurochir (Wien); 2007 Mar;149(3):267-73; discussion 273
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Two- and three dimensional measures of vestibular schwannomas and posterior fossa--implications for the treatment.
  • BACKGROUND: There is no uniformly accepted method of reporting the size of vestibular schwannomas (VS) and to evaluate the individual tumour behaviour in the posterior fossa (PF).
  • Among several parameters, the T Diam was the best measure to assess the brain shift (ROC analysis) with a cut off value at 14.5 mm (91.7% sensitivity and 93% specificity).
  • VS volume and the ratio VS volume/PF volume were also efficient to predict a brain shift.
  • CONCLUSIONS: Max Diam and T Diam are bedside measured simple data of particular interest to respectively estimate the VS volume and predict the brain shift due to the tumour.
  • The determination of cut-off values correlated to brain shift will provide guidelines at the time of the therapeutic decision between radiosurgical and microsurgical strategy.
  • [MeSH-major] Image Processing, Computer-Assisted. Imaging, Three-Dimensional. Magnetic Resonance Imaging. Neuroma, Acoustic / diagnosis. Tomography, X-Ray Computed
  • [MeSH-minor] Adult. Aged. Cranial Fossa, Posterior / pathology. Dominance, Cerebral / physiology. Female. Humans. Male. Mathematical Computing. Microsurgery. Middle Aged. Neoplasm Staging. Organ Size. Prognosis. Radiosurgery. Software. Statistics as Topic

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  • (PMID = 17342379.001).
  • [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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98. Agrawal Y, Clark JH, Limb CJ, Niparko JK, Francis HW: Predictors of vestibular schwannoma growth and clinical implications. Otol Neurotol; 2010 Jul;31(5):807-12
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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 vestibular schwannoma growth and clinical implications.
  • OBJECTIVE: Vestibular schwannomas exhibit variable and unpredictable patterns of growth.
  • We evaluated the extent to which tumor growth influences the management of these benign tumors, and we explored symptom markers present at diagnosis that may be predictive of tumor growth.
  • PATIENTS: One hundred eighty patients with unilateral vestibular schwannomas diagnosed between 1997 and 2007 who were initially managed conservatively by serial observation.
  • MAIN OUTCOME MEASURE(S): Tumor growth, defined as a 1 mm/year or greater increase in tumor size.
  • RESULTS: We observed that tumor growth was the most important predictor of a change in treatment strategy from serial observation to microsurgical or radiosurgical treatment.
  • We further noted in multivariate analyses that larger tumor size at diagnosis was associated with higher odds of tumor growth, such that each 1-mm increment in tumor size at presentation increased the odds of growth by 20%.
  • We also found that the symptom marker of tinnitus at diagnosis significantly increased the odds of tumor growth nearly 3-fold.
  • CONCLUSION: Tumor growth plays a significant role in guiding the management of vestibular schwannomas.
  • Assessment of tumor size at diagnosis and for the presence of tinnitus may allow for risk stratification of patients with newly diagnosed vestibular schwannomas and for a more rational application of the conservative management approach.
  • [MeSH-major] Ear Neoplasms / pathology. Neuroma, Acoustic / pathology

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  • (PMID = 20502379.001).
  • [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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99. Samii A, Lenarz M, Majdani O, Lim HH, Samii M, Lenarz T: Auditory midbrain implant: a combined approach for vestibular schwannoma surgery and device implantation. Otol Neurotol; 2007 Jan;28(1):31-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Auditory midbrain implant: a combined approach for vestibular schwannoma surgery and device implantation.
  • HYPOTHESIS: The lateral suboccipital approach is a well-established route for safe removal of vestibular schwannomas in neurofibromatosis Type 2 (NF2) patients.
  • The initial candidates are NF2 patients who, because of the growth and/or surgical removal of bilateral acoustic neuromas, develop neural deafness and are unable to benefit from cochlear implants.
  • The ideal surgical approach in NF2 patients must first enable safe removal of vestibular schwannomas and then provide sufficient exposure of the midbrain for AMI implantation.
  • RESULTS: The lateral suboccipital craniotomy enabled sufficient exposure of the cerebellopontine angle and internal auditory canal for tumor removal.
  • This approach did not endanger the trochlear nerve or any major midline venous structures in the quadrigeminal cistern.
  • CONCLUSION: This modified lateral suboccipital approach ensures safe removal of large vestibular schwannomas and provides sufficient exposure of the inferior colliculus for ideal AMI implantation.
  • [MeSH-major] Auditory Brain Stem Implants. Deafness / etiology. Deafness / surgery. Neuroma, Acoustic / complications. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / methods

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  • (PMID = 17195743.001).
  • [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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100. Raftopoulos C, Abu Serieh B, Duprez T, Docquier MA, Guérit JM: Microsurgical results with large vestibular schwannomas with preservation of facial and cochlear nerve function as the primary aim. Acta Neurochir (Wien); 2005 Jul;147(7):697-706; discussion 706
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Microsurgical results with large vestibular schwannomas with preservation of facial and cochlear nerve function as the primary aim.
  • OBJECTIVE: To evaluate our microsurgical results in dealing with vestibular schwannomas (VS) greater than or equal to 30 mm when preservation of cranial nerve function was considered more important than total tumour removal.
  • METHODS: Sixteen consecutive cases were operated on by the same neurosurgeon according to a prospective protocol using intraoperative neuro-monitoring (IONM) based on electromyographic and brain stem auditory evoked potential recordings.
  • Facial nerve function was evaluated on the House-Brackmann Scale and cochlear nerve function on the Gardner-Robertson Scale.
  • RESULTS: Fifteen patients showed facial nerve (FN) function of House-Brackmann grade (HBG) I or II at one year postoperatively and one kept the HBG IV she had preoperatively.
  • Two patients of four maintained a cochlear nerve function of Gardner-Robertson grade (GRG) II.
  • CONCLUSION: When dealing with VS greater than or equal to 30 mm, microsurgery guided by IONM, with a rate of total or near-total tumour excision of about 75%, can retain socially acceptable facial nerve function (HBG I or II) in all cases and serviceable hearing (GRG I or II) in two cases out of four.
  • Maintaining serviceable cranial nerve function should take precedence over total tumour excision.
  • [MeSH-major] Electromyography. Evoked Potentials, Auditory, Brain Stem / physiology. Microsurgery. Monitoring, Intraoperative. Neuroma, Acoustic / surgery. Postoperative Complications / physiopathology
  • [MeSH-minor] Adult. Aged. Brain Stem / physiopathology. Child. Cochlear Nerve / physiopathology. Facial Nerve / physiopathology. Female. Follow-Up Studies. Humans. Infant. Magnetic Resonance Imaging. Male. Middle Aged. Neurologic Examination. Prospective Studies

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  • (PMID = 15900399.001).
  • [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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