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1. Dell'Aringa AH, Sena LF, Teixeira R, Dell'Aringa AR, Nardi JC: The importance of the auditory evoked potential in acoustic neuromas. Braz J Otorhinolaryngol; 2008 Jul-Aug;74(4):639
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The importance of the auditory evoked potential in acoustic neuromas.
  • [MeSH-major] Evoked Potentials, Auditory, Brain Stem / physiology. Hearing Loss, Sensorineural / diagnosis. Neuroma, Acoustic / diagnosis

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  • (PMID = 18852999.001).
  • [ISSN] 1808-8694
  • [Journal-full-title] Brazilian journal of otorhinolaryngology
  • [ISO-abbreviation] Braz J Otorhinolaryngol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Brazil
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2. Patrinou A, Malindretos P, Koutroubas G, Anagnostou N, Argiraki E, Syrganis C: A rare retroperitoneal schwannoma in a patient with neurofibromatosis Type 2. NDT Plus; 2010 Jun;3(3):288-290

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A rare retroperitoneal schwannoma in a patient with neurofibromatosis Type 2.
  • Neurofibromatosis Type 2 (NF2) is a dominantly inherited tumour-prone disorder, characterized by the development of multiple schwannomas, meningiomas and ependymomas.
  • Vestibular schwannoma (VS) is the hallmark of NF2.
  • Retroperitoneal schwannomas are expected to occur in only 3% of cases.
  • We present the case of a large retroperitoneal schwannoma in a patient with NF2.
  • Brain, orbits, cervical, thoracic and lumbar MRI revealed bilateral VS, multiple meningiomas as well as multiple schwannomas and ependymomas in the cervical, thoracic and lumbar spine.
  • The retroperitoneal mass represents a schwannoma probably derived from an intercostal nerve.

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  • (PMID = 28657039.001).
  • [ISSN] 1753-0784
  • [Journal-full-title] NDT plus
  • [ISO-abbreviation] NDT Plus
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Keywords] NOTNLM ; meningioma / neurofibromatosis Type 2 / retroperitoneal / schwannoma
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3. Benson VS, Green J, Pirie K, Beral V: Cigarette smoking and risk of acoustic neuromas and pituitary tumours in the Million Women Study. Br J Cancer; 2010 May 25;102(11):1654-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cigarette smoking and risk of acoustic neuromas and pituitary tumours in the Million Women Study.
  • BACKGROUND: The relationship between cigarette smoking and incidence of acoustic neuromas and pituitary tumours is uncertain.
  • METHODS: We examined the relation between smoking and risk of acoustic neuromas and pituitary tumours in a prospective study of 1.2 million middle-aged women in the United Kingdom.
  • RESULTS: Over 10.2 million person years of follow-up, 177 women were diagnosed with acoustic neuromas and 174 with pituitary tumours.
  • Current smokers at recruitment were at significantly reduced risk of incident acoustic neuroma compared with never smokers (adjusted relative risk (RR)=0.41, 95% confidence interval (CI)=0.24-0.70, P=0.001).
  • Past smokers did not have significantly different risk of acoustic neuroma than never smokers (RR=0.87, 95% CI=0.62-1.22, P=0.4).
  • CONCLUSION: Women who smoke are at a significantly reduced risk of acoustic neuromas, but not of pituitary tumours, compared with never smokers.
  • Acoustic neuromas are much rarer than the cancers that are increased among smokers.
  • [MeSH-major] Adenoma / epidemiology. Neuroma, Acoustic / epidemiology. Pituitary Neoplasms / epidemiology. Smoking / epidemiology

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  • (PMID = 20461083.001).
  • [ISSN] 1532-1827
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Grant] United Kingdom / Medical Research Council / / G0700474; United Kingdom / Cancer Research UK / / ; United Kingdom / Medical Research Council / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2883161
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4. Tella OI, Stavale JN, Herculano MA, Paiva Neto MA, Onishi FJ, Guimarães Filho Fde A, Silva LR: [Size and proliferative index correlation in acoustic neuromas]. Arq Neuropsiquiatr; 2006 Mar;64(1):72-6
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  • [Title] [Size and proliferative index correlation in acoustic neuromas].
  • [Transliterated title] Associação entre tamanho e potencial proliferativo em neurinomas do acústico.
  • Acoustic neuromas are the most common tumors in the cerebellopontine angle.
  • The molecular mechanisms involved in generation and growth of these tumors are not completely elucidated.
  • Many radiological, clinic and immunohistochemistry data were correlated to tumor growth.
  • We studied 11 acoustic neuromas surgically treated at Hospital São Paulo/Unifesp and correlated clinical and radiological data with proliferative index (Ki-67).
  • The size of the tumors were positively correlationated with proliferative index.
  • [MeSH-major] Cerebellar Neoplasms / pathology. Cerebellopontine Angle / pathology. Ki-67 Antigen / analysis. Neoplasm Proteins / analysis. Neuroma, Acoustic / pathology
  • [MeSH-minor] Adult. Age Distribution. Age Factors. Aged. Cell Proliferation. Cell Size. Female. Humans. Immunohistochemistry. Middle Aged. Mitotic Index. Neoplasm Invasiveness. Statistics, Nonparametric

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  • (PMID = 16622557.001).
  • [ISSN] 0004-282X
  • [Journal-full-title] Arquivos de neuro-psiquiatria
  • [ISO-abbreviation] Arq Neuropsiquiatr
  • [Language] por
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 0 / Neoplasm Proteins
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5. 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

  • [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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6. Owers C, Stewart Dj, Stone J, Kelty C: Hearing loss as an unusual consequence of metastatic gastric adenocarcinoma. J Surg Case Rep; 2010;2010(8):6

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  • Despite the absence of metastatic disease on computed tomography, positron emission tomography demonstrated multiple vertebral and sternal deposits.
  • Magnetic resonance imaging identified bilateral 2cm lesions at the internal auditory meatus, consistent with a diagnosis of bilateral acoustic neuromas.
  • The patient subsequently died of carcinomatosis and, because of the potential familial significance of bilateral acoustic neuromas, a limited post-mortem examination was carried out.
  • Unexpectedly, this revealed bilateral adenocarcinoma metastases infiltrating the internal auditory meatus affecting the acoustic nerves.
  • The authors believe this a very rare presentation of metastatic gastric disease.

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  • [Copyright] © JSCR.
  • (PMID = 24946349.001).
  • [ISSN] 2042-8812
  • [Journal-full-title] Journal of surgical case reports
  • [ISO-abbreviation] J Surg Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3649159
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7. Vernimmen FJ, Slabbert JP: Assessment of the alpha/beta ratios for arteriovenous malformations, meningiomas, acoustic neuromas, and the optic chiasma. Int J Radiat Biol; 2010 Jun;86(6):486-98
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  • [Title] Assessment of the alpha/beta ratios for arteriovenous malformations, meningiomas, acoustic neuromas, and the optic chiasma.
  • PURPOSE: To determine alpha/beta (alpha/beta) values of arteriovenous malformations (AVM), meningiomas, acoustic neuromas (AN), and the optic chiasma using clinical data.
  • RESULTS: With the FE plot method, an alpha/beta value of 3.76 Gray (Gy) (95% confidence level [CL]: 2.8-4.6 Gy) for meningiomas, 2.4 Gy (95% CL: 0.8-3.9 Gy) for acoustic neuroma, and 14.7 Gy (95% CL: 3.8-25.7 Gy) for arteriovenous malformations were determined.
  • CONCLUSION: Acoustic neuromas with a low alpha/beta value would show no lesion intrinsic benefit from fractionation.
  • [MeSH-major] Arteriovenous Malformations / radiotherapy. Dose Fractionation. Meningeal Neoplasms / radiotherapy. Meningioma / radiotherapy. Neuroma, Acoustic / radiotherapy. Optic Chiasm / radiation effects

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  • (PMID = 20470198.001).
  • [ISSN] 1362-3095
  • [Journal-full-title] International journal of radiation biology
  • [ISO-abbreviation] Int. J. Radiat. Biol.
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis
  • [Publication-country] England
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8. Philip R, Prepageran N, Raman R, Jennifer LP, Waran V: Surgical management of large acoustic neuromas: a review. Med J Malaysia; 2009 Dec;64(4):294-7
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  • [Title] Surgical management of large acoustic neuromas: a review.
  • Acoutic neuromas operated at UMMC from 2001 to 2006 were retrospectively reviewed.
  • All tumors were large, measuring more than 2 cm.
  • The one-year facial nerve outcome was good to acceptable in 62% (House-Brackmann Grade I - IV) of patients.
  • A literature review of current management of acoustic neuromas is presented.
  • [MeSH-major] Neuroma, Acoustic / surgery

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  • (PMID = 20954553.001).
  • [ISSN] 0300-5283
  • [Journal-full-title] The Medical journal of Malaysia
  • [ISO-abbreviation] Med. J. Malaysia
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Malaysia
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9. Maire JP, Huchet A, Milbeo Y, Darrouzet V, Causse N, Célérier D, Liguoro D, Bébéar JP: Twenty years' experience in the treatment of acoustic neuromas with fractionated radiotherapy: a review of 45 cases. Int J Radiat Oncol Biol Phys; 2006 Sep 1;66(1):170-8
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  • [Title] Twenty years' experience in the treatment of acoustic neuromas with fractionated radiotherapy: a review of 45 cases.
  • PURPOSE: To evaluate very long-term results of fractionated radiotherapy (FRT) of acoustic neuromas (AN).
  • Indications were as follows: poor general condition contraindicating surgery, hearing preservation in bilateral neuromas, partial resection, nonsurgical recurrence.
  • The median tumor diameter was 31 mm (range, 11-55 mm).
  • Nineteen patients died, two with progressive disease, and 17 from non-AN causes.
  • Tumor shrinkage was observed in 27 (59%) and stable disease in 16 (35%).
  • Tumor progression occurred in three patients, 12 to 15 months after FRT.
  • Two additional tumors recurred after shrinkage 20 and 216 months after treatment and were operated on.
  • Actuarial local tumor control rates at 5 and 15 years were 86%.
  • For the patient who had a tumor recurrence at 216 months, histologic examination documented transformation to a low-grade malignant peripheral nerve sheath tumor.
  • [MeSH-major] Neuroma, Acoustic / radiotherapy

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  • (PMID = 16904521.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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10. Combs SE, Volk S, Schulz-Ertner D, Huber PE, Thilmann C, Debus J: Management of acoustic neuromas with fractionated stereotactic radiotherapy (FSRT): long-term results in 106 patients treated in a single institution. Int J Radiat Oncol Biol Phys; 2005 Sep 1;63(1):75-81
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  • [Title] Management of acoustic neuromas with fractionated stereotactic radiotherapy (FSRT): long-term results in 106 patients treated in a single institution.
  • PURPOSE: To assess the long-term outcome and toxicity of fractionated stereotactic radiotherapy for acoustic neuromas in 106 patients treated in a single institution.
  • PATIENTS AND METHODS: Between October 1989 and January 2004, fractionated stereotactic radiotherapy (FSRT) was performed in 106 patients with acoustic neuroma (AN).
  • The median irradiated tumor volume was 3.9 mL (range, 2.7-30.7 mL).
  • Actuarial local tumor control rates at 3- and 5- years after FSRT were 94.3% and 93%, respectively.
  • Cranial nerve toxicity other than hearing impairment was rare.
  • The rate of radiation induced toxicity to the trigeminal and facial nerve was 3.4% and 2.3%, respectively.
  • CONCLUSION: Fractionated stereotactic radiotherapy is safe and efficacious for the treatment of AN, with mild toxicity with regard to hearing loss and cranial nerve function.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Dose Fractionation. Female. Follow-Up Studies. Hearing. Humans. Male. Middle Aged. Neurofibromatosis 2 / complications. Treatment Outcome. Trigeminal Nerve Diseases / etiology

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  • (PMID = 16111574.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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11. 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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12. Nedzelski JM, Schessel DA, Pfleiderer A, Kassel EE, Rowed DW: Conservative management of acoustic neuromas. 1992. Neurosurg Clin N Am; 2008 Apr;19(2):207-16, v
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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 acoustic neuromas. 1992.
  • An expectant, nontreatment strategy for acoustic neuromas implies an understanding of the natural biologic behavior of these tumors.
  • This study describes the long-term follow-up of a group of unoperated acoustic neuroma patients.
  • Patterns of tumor growth are discussed in light of clinical outcome.
  • [MeSH-major] Neuroma, Acoustic / history

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  • (PMID = 18534335.001).
  • [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] Nedzelski JM; Schessel DA; Pfleiderer A; Kassel EE; Rowed DW
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13. Meyer TA, Canty PA, Wilkinson EP, Hansen MR, Rubinstein JT, Gantz BJ: Small acoustic neuromas: surgical outcomes versus observation or radiation. Otol Neurotol; 2006 Apr;27(3):380-92
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  • [Title] Small acoustic neuromas: surgical outcomes versus observation or radiation.
  • OBJECTIVE: Evaluate factors affecting outcomes of small acoustic neuroma (AN) removal via a middle cranial fossa (MCF) approach, and compare results to published data on observation and radiation therapy.
  • METHODS: 162 consecutive patients (ages 19-70) with unilateral AN (0.2-2.5 cm in largest dimension) removed through a MCF approach were reviewed focusing on preservation of hearing, facial nerve function and complications.
  • RESULTS: Both tumor size and pre-operative WRS were related to post-operative WRS (p<0.01).
  • When the patients were stratified by tumor size, the patients with small tumors (2-10 mm) faired better than the overall group.
  • When the tumor was 1.1-1.4 cm (N=34), the chance of preserving some hearing decreased to 42% (14/33).
  • When the tumor reached 1.5-2.5 cm (N=35), the hearing preservation rate was 43%.
  • The addition of intra-operative whole eighth nerve near field monitoring improved results during small tumor (<or=1.0 cm) removal preserving some hearing in 80% (32/40) and preserving >70% WRS in 76% (22/29) of those with >70% pre-operative WRS.
  • Good facial nerve function (HB I-II) was achieved in 97% (86% HB I).
  • When tumor size was <or=1.0 cm (N=93), however, good facial nerve function was obtained in 100% (94% HB I).
  • CONCLUSION: Our results suggest that removal of unilateral AN through an MCF approach when the tumor is small and hearing is good provides the best opportunity for hearing preservation and normal facial nerve function.
  • Observation historically results in tumor growth in young and middle-age patients with subsequent hearing loss.
  • Radiation may prevent most tumors from growing, and more data are needed to determine long-term tumor control and hearing preservation rates.
  • [MeSH-major] Auditory Threshold. Facial Nerve / physiology. Hearing Loss / prevention & control. Neuroma, Acoustic / radiotherapy. Neuroma, Acoustic / surgery
  • [MeSH-minor] Action Potentials. Adult. Aged. Analysis of Variance. Evoked Potentials, Auditory, Brain Stem. Female. Follow-Up Studies. Humans. Linear Models. Male. Middle Aged. Monitoring, Intraoperative. Retrospective Studies. Speech Perception. Treatment Outcome

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  • (PMID = 16639278.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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14. Shamji MF, Schramm DR, Benoit BG: Clinical predictors of facial nerve outcome after translabyrinthine resection of acoustic neuromas. Clin Invest Med; 2007;30(6):E233-9
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  • [Title] Clinical predictors of facial nerve outcome after translabyrinthine resection of acoustic neuromas.
  • PURPOSE: The translabyrinthine approach to acoustic neuroma resection offers excellent exposure for facial nerve dissection with 95% preservation of anatomic continuity.
  • The objective of this study was to identify preoperative clinical presentation and intraoperative surgical findings that predispose patients to facial nerve dysfunction after acoustic neuroma surgery.
  • METHODS: The charts of 128 consecutive translabyrinthine patients were examined retrospectively to identify new clinical and intraoperative predictors of facial nerve outcome.
  • Intraoperative nerve stimulation was performed in all cases, and clinical grading was performed by a single neurosurgeon in all cases.
  • RESULTS: Among patients with no preoperative facial nerve deficit, 87% had an acceptable result.
  • Small size (P < 0.01) and low intraoperative nerve stimulation of < 0.10 mA (P< 0.01) were reaffirmed as predictive of functional nerve preservation.
  • 01), and lack of subjective tumour adherence to the facial nerve (P = 0.02) were independently correlated with positive outcome.
  • CONCLUSIONS: Our experience with the translabyrinthine approach reveals the previously unestablished associations of facial nerve outcome to include presence of tinnitus and duration of hypoacusis.
  • Independent predictors of tumour size and nerve stimulation thresholds were reaffirmed, and the subjective description of tumour adherence to the facial nerve making dissection more difficult appears to be important.
  • [MeSH-major] Facial Nerve / surgery. Neuroma, Acoustic / surgery. Reconstructive Surgical Procedures / methods

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  • (PMID = 18053390.001).
  • [ISSN] 1488-2353
  • [Journal-full-title] Clinical and investigative medicine. Médecine clinique et experimentale
  • [ISO-abbreviation] Clin Invest Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Canada
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15. Martin TP, Tzifa K, Kowalski C, Holder RL, Walsh R, Irving RM: Conservative versus primary surgical treatment of acoustic neuromas: a comparison of rates of facial nerve and hearing preservation. Clin Otolaryngol; 2008 Jun;33(3):228-35
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  • [Title] Conservative versus primary surgical treatment of acoustic neuromas: a comparison of rates of facial nerve and hearing preservation.
  • OBJECTIVES: To determine whether patients with small to medium sized acoustic neuromas managed conservatively suffer reduced rates of facial nerve and hearing preservation when compared with patients undergoing primary surgery.
  • PARTICIPANTS: Data were drawn from our database of 487 sporadic acoustic neuromas managed from 1997 to present day.
  • MAIN OUTCOME MEASURES: Facial nerve status (assessed using the House-Brackmann system) was collated for all conservatively managed patients (n = 167) and compared with that expected when calculated from primarily surgically managed tumours of equivalent size (n = 121).
  • RESULTS: Observed facial nerve preservation in conservatively managed patients was significantly better (P < 0.001) than expected when calculated from rates of facial nerve preservation in surgically managed patients.
  • CONCLUSIONS: An initial period of conservative management is a safe and reasonable management policy in all acoustic neuromas up to 2 cm in size at the cerebello-pontine angle.
  • Given that there are no failsafe ways of deciding potential for growth in acoustic neuromas, initial conservative management of these tumours offers superior hearing and facial nerve preservation when compared with primary surgical treatment.
  • [MeSH-major] Facial Nerve. Hearing. Neuroma, Acoustic / therapy

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  • [CommentIn] Clin Otolaryngol. 2008 Jun;33(3):236-8 [18559029.001]
  • (PMID = 18559028.001).
  • [ISSN] 1749-4486
  • [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] Comparative Study; Journal Article
  • [Publication-country] England
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16. Astner ST, Nieder C, Stock K, Gaa J, Grosu AL: Carcinomatous meningitis appearing as acoustic neuromas: two cases. Strahlenther Onkol; 2007 May;183(5):279-83
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Carcinomatous meningitis appearing as acoustic neuromas: two cases.
  • BACKGROUND: For acoustic neuromas, stereotactic radiotherapy (radiosurgery or stereotactic fractionated radiotherapy) has been established as an important alternative to microsurgery.
  • MRI scan shows a contrast-enhancing tumor within the inner auditory channel.
  • If medical history does not match with acoustic neuroma, further diagnostics are necessary to rule out infectious disease or carcinomatous meningitis.
  • CASE REPORT: Two patients with hearing loss, vertigo and the diagnosis of acoustic neuromas by MRI scan were referred for radiotherapy.
  • In both cases the symptoms progressed very rapidly, not typical of acoustic neuromas, and in both patients repeated liquor puncture finally revealed carcinomatous meningitis.
  • This is especially true for bilateral lesions suspicious for acoustic neuromas and rapid progression and persistence of clinical symptoms where carcinomatous meningitis has to be taken into account.
  • [MeSH-major] Esophageal Neoplasms / diagnosis. Meningeal Neoplasms / secondary. Neoplasms, Multiple Primary / diagnosis. Neuroma, Acoustic / diagnosis

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  • (PMID = 17497100.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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17. Andrews DW, Werner-Wasik M, Den RB, Paek SH, Downes-Phillips B, Willcox TO, Bednarz G, Maltenfort M, Evans JJ, Curran WJ Jr: Toward dose optimization for fractionated stereotactic radiotherapy for acoustic neuromas: comparison of two dose cohorts. Int J Radiat Oncol Biol Phys; 2009 Jun 1;74(2):419-26
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Toward dose optimization for fractionated stereotactic radiotherapy for acoustic neuromas: comparison of two dose cohorts.
  • PURPOSE: To describe our initial experience of fractionated stereotactic radiotherapy dose reduction comparing two dose cohorts with examination of tumor control rates and serviceable hearing preservation rates.
  • METHODS AND MATERIALS: After institutional review board approval, we initiated a retrospective chart review to study the hearing outcomes and tumor control rates.
  • The tumor control rate was 100% in both cohorts, and the pure tone average was significantly improved in the low-dose cohort (33 dB vs. 40 dB, p = 0.023, chi-square).
  • CONCLUSION: A lower total dose at 46.8 Gy was associated with a 100% local control tumor rate and a greater hearing preservation rate.
  • An additional dose reduction is justified to achieve the optimal dose that will yield the greatest hearing preservation rate without compromising tumor control for these patients.
  • [MeSH-major] Hearing / radiation effects. Neuroma, Acoustic / surgery. Radiosurgery / methods

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  • (PMID = 19042095.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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18. 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

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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19. Kano H, Kondziolka D, Niranjan A, Flannery TJ, Flickinger JC, Lunsford LD: Repeat stereotactic radiosurgery for acoustic neuromas. Int J Radiat Oncol Biol Phys; 2010 Feb 1;76(2):520-7
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  • [Title] Repeat stereotactic radiosurgery for acoustic neuromas.
  • PURPOSE: To evaluate the outcome of repeat stereotactic radiosurgery (SRS) for acoustic neuromas, we assessed tumor control, clinical outcomes, and the risk of adverse radiation effects in patients whose tumors progressed after initial management.
  • METHODS AND MATERIALS: During a 21-year experience at our center, 1,352 patients underwent SRS as management for their acoustic neuromas.
  • We retrospectively identified 6 patients who underwent SRS twice for the same tumor.
  • All patients had imaging evidence of tumor progression despite initial SRS.
  • RESULTS: At a median follow-up of 29 months after the second SRS (range, 13-71 months), tumor control or regression was achieved in all 6 patients.
  • CONCLUSIONS: With this limited experience, we found that repeat SRS for a persistently enlarging acoustic neuroma can be performed safely and effectively.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery
  • [MeSH-minor] Adult. Aged. Disease Progression. Humans. Magnetic Resonance Imaging. Middle Aged. Radiotherapy Dosage. Reoperation / utilization. Retrospective Studies

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • (PMID = 19783373.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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20. Limb CJ, Long DM, Niparko JK: Acoustic neuromas after failed radiation therapy: challenges of surgical salvage. Laryngoscope; 2005 Jan;115(1):93-8
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  • [Title] Acoustic neuromas after failed radiation therapy: challenges of surgical salvage.
  • OBJECTIVES: As stereotactic radiation has emerged as a treatment option for acoustic neuromas, cases that require surgical salvage after unsuccessful radiation have emerged.
  • We present a comparison of the technical challenges faced by the surgeons in the treatment of irradiated versus nonirradiated acoustic neuromas.
  • METHODS: We identified nine patients with acoustic neuromas that required surgical resection after radiation therapy.
  • Nine nonirradiated case-control subjects matched for age, sex, tumor size, and surgical approach were identified for purposes of general comparison.
  • Excessive scarring hindered identification of the facial nerve and added uncertainty as to the completeness of tumor removal.
  • Decompression of the internal auditory canal (IAC) dura and resection of neoplasm in the IAC before cerebellopontine angle dissection was required for facial nerve identification.
  • Operative time was significantly longer for irradiated cases, and facial nerve outcomes tended to be poorer, particularly when facial nerve dysfunction prompted the salvage procedure.
  • CONCLUSIONS: Surgical salvage of acoustic neuromas after radiation therapy is feasible, but it presents technical challenges beyond that associated with primary surgical therapy.
  • Poorer outcomes of postoperative cranial nerve status were caused primarily by anatomic changes at the nerve/tumor interface.
  • As surgical experience with the irradiated acoustic neuroma grows, operative observations should be incorporated into the counsel provided to patients with acoustic neuromas as they weigh different management options.
  • [MeSH-major] Neuroma, Acoustic / surgery

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  • (PMID = 15630374.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Flint D, Fagan P, Panarese A: Conservative management of sporadic unilateral acoustic neuromas. J Laryngol Otol; 2005 Jun;119(6):424-8
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  • [Title] Conservative management of sporadic unilateral acoustic neuromas.
  • Our objective was to review retrospectively patients with a unilateral acoustic neuroma managed by observation.
  • Thirty-six acoustic neuromas grew with four growth patterns.
  • [MeSH-major] Neuroma, Acoustic / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease Progression. Female. Hearing Disorders / etiology. Humans. Long-Term Care / methods. Male. Middle Aged. Prognosis. Retrospective Studies

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  • (PMID = 15992466.001).
  • [ISSN] 0022-2151
  • [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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22. Xiao H, Au DK, Hui Y, Chow CK, Fan YW, Wei WI: [Auditory brainstem implantation in patient with bilateral acoustic neuromas]. Lin Chuang Er Bi Yan Hou Ke Za Zhi; 2005 Nov;19(22):1017-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Auditory brainstem implantation in patient with bilateral acoustic neuromas].
  • OBJECTIVE: To restore auditory sensation for patient suffering loss of hearing due to bilateral acoustic neuromas.
  • METHOD: One patient of bilateral acoustic neuromas received auditory brainstem implant (ABI) at the same surgery for resection of the second tumor.
  • The retrosigmoid approach was used for resection of the tumor and to exposure the lateral recess of the fourth ventricle for placement of ABI electrode array.
  • CONCLUSION: The multichannel ABI could effectively restore auditory sensation for patient deafened by bilateral acoustic neuromas.
  • [MeSH-major] Auditory Brain Stem Implantation. Deafness / rehabilitation. Neurofibromatosis 2 / surgery
  • [MeSH-minor] Auditory Brain Stem Implants. Humans. Male. Middle Aged

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  • (PMID = 16463763.001).
  • [Journal-full-title] Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology
  • [ISO-abbreviation] Lin Chuang Er Bi Yan Hou Ke Za Zhi
  • [Language] chi
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] China
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23. 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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  • 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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24. Vernimmen FJ, Mohamed Z, Slabbert JP, Wilson J: Long-term results of stereotactic proton beam radiotherapy for acoustic neuromas. Radiother Oncol; 2009 Feb;90(2):208-12
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  • [Title] Long-term results of stereotactic proton beam radiotherapy for acoustic neuromas.
  • BACKGROUND AND PURPOSE: A retrospective study evaluating the role of hypofractionated stereotactic proton beam therapy for acoustic neuromas.
  • Mean minimum tumor dose was 21.4 CGyE/3.
  • Cranial nerve functions were evaluated clinically.
  • RESULTS: With a mean clinical and radiological follow-up of 72 and 60 months respectively, the 5-year results showed a 98% local control, with a hearing preservation of 42%, a facial nerve preservation of 90.5% and a trigeminal nerve preservation of 93%.
  • CONCLUSION: For those patients harboring large acoustic neuromas that are inoperable, hypofractionated stereotactic proton beam offers long-term control with minimal side-effects.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Dose Fractionation. Facial Nerve Diseases / etiology. Female. Hearing. Humans. Male. Middle Aged. Protons. Radiotherapy Dosage. Trigeminal Nerve. Trigeminal Nerve Diseases / etiology. Young Adult

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  • (PMID = 19054586.001).
  • [ISSN] 0167-8140
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Protons
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25. Likhterov I, Allbright RM, Selesnick SH: LINAC radiosurgery and radiotherapy treatment of acoustic neuromas. Otolaryngol Clin North Am; 2007 Jun;40(3):541-70, ix
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] LINAC radiosurgery and radiotherapy treatment of acoustic neuromas.
  • This article provides an introduction to radiation therapy as it applies to intracranial tumors.
  • It also provides a review of the natural growth progression of acoustic neuromas and accuracy of tumor size determination.
  • Literature on the use of linear accelerator stereotactic radiosurgery and fractionated radiotherapy in acoustic neuroma management is reviewed and summarized.
  • Specifically, the rates of reported tumor control, hearing preservation, facial and trigeminal nerve complications, and hydrocephalus are analyzed.
  • Although the complication rates associated with linear accelerator therapy are relatively low, hearing preservation is poor and acoustic neuroma control is variable.
  • [MeSH-major] Ear Neoplasms / radiotherapy. Ear Neoplasms / surgery. Neuroma, Acoustic / radiotherapy. Neuroma, Acoustic / surgery. Radiosurgery / instrumentation

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  • (PMID = 17544695.001).
  • [ISSN] 0030-6665
  • [Journal-full-title] Otolaryngologic clinics of North America
  • [ISO-abbreviation] Otolaryngol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 29
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26. Battaglia A, Mastrodimos B, Cueva R: Comparison of growth patterns of acoustic neuromas with and without radiosurgery. Otol Neurotol; 2006 Aug;27(5):705-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Comparison of growth patterns of acoustic neuromas with and without radiosurgery.
  • OBJECTIVE: To compare the natural history of acoustic neuroma growth to the reported growth rate of acoustic neuromas after radiosurgical therapy, a retrospective review and meta-analysis of the literature was performed.
  • The retrospective review was of one hundred eleven patients (average age, 71 yr) who chose to have their acoustic neuromas managed conservatively in our institution.
  • These patients underwent serial magnetic resonance imaging for assessment of tumor growth for an average period of 38 months.
  • Growth patterns if these untreated tumors were compared to that of radiosurgically treated acoustic neuromas reported in the literature.
  • DATA SOURCES: The English-language literature on the topic was searched systematically by Medline and Pubmed using the following key words: acoustic neuroma, vestibular schwannoma, conservative management, conservative treatment, nonsurgical, age, elderly, growth, observation, untreated, radio-surgery, gamma knife, 13 Gy and 12 Gy.
  • CONCLUSION: The average growth rate of the untreated tumors was 0.7 +/- 1.4 mm/yr.
  • This represents an 87% control rate if tumor control rate is defined as less than 2-mm growth/yr.
  • Meta-analysis indicates that tumor control rates range in the radiosurgical literature from 86% to 100%.
  • Tumor control is not uniformly defined.
  • Based on the results of this study, there is no discernable significant difference between growth patterns of untreated acoustic neuromas and those treated radiosurgically.
  • To establish a significant difference, longer-term follow-up studies with larger sample sizes and tumor control rates are needed.
  • Tumor control should be defined as zero growth.
  • [MeSH-major] Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Radiosurgery / methods

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  • (PMID = 16868519.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Meta-Analysis; Review
  • [Publication-country] United States
  • [Number-of-references] 20
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27. Likhterov I, Allbright RM, Selesnick SH: LINAC radiosurgery and radiotherapy treatment of acoustic neuromas. 2007. Neurosurg Clin N Am; 2008 Apr;19(2):345-65, vii
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] LINAC radiosurgery and radiotherapy treatment of acoustic neuromas. 2007.
  • This article provides an introduction to radiation therapy as it applies to intracranial tumors.
  • It also provides a review of the natural growth progression of acoustic neuromas and accuracy of tumor size determination.
  • Literature on the use of linear accelerator stereotactic radiosurgery and fractionated radiotherapy in acoustic neuroma management is reviewed and summarized.
  • Specifically, the rates of reported tumor control, hearing preservation, facial and trigeminal nerve complications, and hydrocephalus are analyzed.
  • Although the complication rates associated with linear accelerator therapy are relatively low, hearing preservation is poor and acoustic neuroma control is variable.
  • [MeSH-major] Neuroma, Acoustic / history. Radiosurgery / history

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  • (PMID = 18534344.001).
  • [ISSN] 1558-1349
  • [Journal-full-title] Neurosurgery clinics of North America
  • [ISO-abbreviation] Neurosurg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Biography; Classical Article; Historical Article; Journal Article
  • [Publication-country] United States
  • [Personal-name-as-subject] Likhterov I; Allbright RM; Selesnick SH
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28. 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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  • [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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29. Combs SE, Thilmann C, Debus J, Schulz-Ertner D: Long-term outcome of stereotactic radiosurgery (SRS) in patients with acoustic neuromas. Int J Radiat Oncol Biol Phys; 2006 Apr 1;64(5):1341-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term outcome of stereotactic radiosurgery (SRS) in patients with acoustic neuromas.
  • PURPOSE: To evaluate the effectiveness and long-term outcome of stereotactic radiosurgery (SRS) for acoustic neuromas (AN).
  • RESULTS: The overall actuarial 5-year and 10-year tumor control probability in all patients was 91%.
  • Two patients developed tumor progression after SRS at 36 and 48 months.
  • Nineteen patients (73%) were at risk of treatment-related facial nerve toxicity; of these, 1 patient developed a complete facial nerve palsy after SRS (5%).
  • Two patients (8%) developed mild dysesthesia of the trigeminal nerve after SRS.
  • CONCLUSION: Stereotactic radiosurgery results in good local control rates of AN and the risk of cranial nerve toxicities is acceptable.
  • [MeSH-major] Hearing / radiation effects. Neuroma, Acoustic / surgery. Radiosurgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Facial Nerve / radiation effects. Facial Paralysis / etiology. Female. Hearing Loss / etiology. Humans. Male. Middle Aged. Neurofibromatosis 2 / complications. Radiation Injuries / etiology. Trigeminal Neuralgia / etiology

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  • (PMID = 16464537.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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30. 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

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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31. 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

  • [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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32. Hardell L, Mild KH: Mobile phone use and acoustic neuromas. Epidemiology; 2005 May;16(3):415; author reply 417-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mobile phone use and acoustic neuromas.
  • [MeSH-major] Cell Phones. Neuroma, Acoustic / etiology

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  • [CommentOn] Epidemiology. 2004 Nov;15(6):653-9 [15475713.001]
  • (PMID = 15824564.001).
  • [ISSN] 1044-3983
  • [Journal-full-title] Epidemiology (Cambridge, Mass.)
  • [ISO-abbreviation] Epidemiology
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] United States
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33. Iwai Y, Yamanaka K, Yamagata K, Yasui T: Surgery after radiosurgery for acoustic neuromas: surgical strategy and histological findings. Neurosurgery; 2007 Feb;60(2 Suppl 1):ONS75-82; discussion ONS82
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgery after radiosurgery for acoustic neuromas: surgical strategy and histological findings.
  • OBJECTIVE: To retrospectively review the authors' experience with surgical resections after failed radiosurgery for acoustic neuromas.
  • METHODS: The study group consisted of six patients with acoustic neuromas.
  • The operative indications were cerebellar ataxia and symptoms associated with increased intracranial pressure.
  • RESULTS: The tumors were subtotally removed (> or = 80%) in four patients and partially removed (< 80%) in the other two patients.
  • Preexisting facial nerve palsy improved in two patients and deteriorated in one patient, and one patient experienced new facial palsy.
  • Histological features were typical of acoustic schwannoma, and some tumors were associated with foamy macrophages, myxoid degeneration, and necrosis attributed to radiation effects.
  • At follow-up, the residual tumor was decreased in five patients and increased in one patient with an expanding intratumoral hematoma.
  • CONCLUSION: Surgical resection after radiosurgery is indicated in the presence of such symptoms as cerebellar ataxia and increased intracranial pressure.
  • It must be carefully considered because of the natural regression of transient tumor swelling over time.
  • In patients with tumor enlargement several years after radiosurgery, the possibility of chronic intratumoral bleeding resulting from delayed radiation injury must be considered.
  • [MeSH-major] Neoplasm Recurrence, Local / surgery. Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Radiosurgery

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  • (PMID = 17297369.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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34. Lee WT, Weber PC: Melanoma metastasis masquerading as bilateral acoustic neuromas. Otolaryngol Head Neck Surg; 2005 Mar;132(3):505-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Melanoma metastasis masquerading as bilateral acoustic neuromas.
  • [MeSH-major] Cranial Nerve Neoplasms / diagnosis. Cranial Nerve Neoplasms / secondary. Melanoma / diagnosis. Melanoma / secondary. Neurofibromatosis 2 / diagnosis. Vestibular Nerve. Vestibulocochlear Nerve Diseases / diagnosis

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  • (PMID = 15746871.001).
  • [ISSN] 0194-5998
  • [Journal-full-title] Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • [ISO-abbreviation] Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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35. Stang A, Schmidt-Pokrzywniak A, Jöckel KH: Mobile phone use and acoustic neuromas. Epidemiology; 2005 May;16(3):414-5; author reply 417-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mobile phone use and acoustic neuromas.
  • [MeSH-major] Cell Phones. Neuroma, Acoustic / etiology
  • [MeSH-minor] Brain Neoplasms / etiology. Case-Control Studies. Humans

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  • [CommentOn] Epidemiology. 2004 Nov;15(6):653-9 [15475713.001]
  • (PMID = 15824561.001).
  • [ISSN] 1044-3983
  • [Journal-full-title] Epidemiology (Cambridge, Mass.)
  • [ISO-abbreviation] Epidemiology
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] United States
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36. Johnston SA, Scherb H: Mobile phone use and acoustic neuromas. Epidemiology; 2005 May;16(3):416-7; author reply 417-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mobile phone use and acoustic neuromas.
  • [MeSH-major] Cell Phones. Neuroma, Acoustic / etiology

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  • [CommentOn] Epidemiology. 2004 Nov;15(6):653-9 [15475713.001]
  • (PMID = 15824565.001).
  • [ISSN] 1044-3983
  • [Journal-full-title] Epidemiology (Cambridge, Mass.)
  • [ISO-abbreviation] Epidemiology
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] United States
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37. Thomas BN, Flowers D, Caswell J, Robbé IJ: Mobile phone use and acoustic neuromas. Epidemiology; 2005 May;16(3):415-6; author reply 417-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mobile phone use and acoustic neuromas.
  • [MeSH-major] Cell Phones. Neuroma, Acoustic / etiology

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  • [CommentOn] Epidemiology. 2004 Nov;15(6):653-9 [15475713.001]
  • (PMID = 15824563.001).
  • [ISSN] 1044-3983
  • [Journal-full-title] Epidemiology (Cambridge, Mass.)
  • [ISO-abbreviation] Epidemiology
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] United States
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38. Bush ML, Shinn JB, Young AB, Jones RO: Long-term hearing results in gamma knife radiosurgery for acoustic neuromas. Laryngoscope; 2008 Jun;118(6):1019-22
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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 results in gamma knife radiosurgery for acoustic neuromas.
  • This study analyzed the long-term hearing results of Gamma Knife radiosurgery in the treatment of acoustic neuromas.
  • METHODS: Seventeen patients were selected from our acoustic neuroma Gamma Knife registry of 113 patients treated from 1991 to 2005.
  • RESULTS: The tumor size ranged from 0.5 to 2.8 cm (mean, 1.33 cm) and patients received a range of 12.5-16 Gy (mean, 13.82 Gy) to 50% isodose line.
  • CONCLUSION: Gamma Knife radiosurgery remains a noninvasive treatment option for patients with acoustic neuromas; however, they may experience a delayed hearing loss.
  • [MeSH-major] Hearing / physiology. Neuroma, Acoustic / surgery

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  • (PMID = 18364592.001).
  • [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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39. Tarone RE, Inskip PD: Mobile phone use and acoustic neuromas. Epidemiology; 2005 May;16(3):414; author reply 417-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mobile phone use and acoustic neuromas.
  • [MeSH-major] Brain Neoplasms / etiology. Cell Phones. Functional Laterality. Neuroma, Acoustic / etiology

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  • [CommentOn] Epidemiology. 2004 Nov;15(6):653-9 [15475713.001]
  • (PMID = 15824562.001).
  • [ISSN] 1044-3983
  • [Journal-full-title] Epidemiology (Cambridge, Mass.)
  • [ISO-abbreviation] Epidemiology
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] United States
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40. Inoue HK: Low-dose radiosurgery for large vestibular schwannomas: long-term results of functional preservation. J Neurosurg; 2005 Jan;102(s_supplement):111-113

  • [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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41. Zhao X, Wang Z, Ji Y, Wang C, Yu R, Ding X, Wei S: Long-term facial nerve function evaluation following surgery for large acoustic neuromas via retrosigmoid transmeatal approach. Acta Neurochir (Wien); 2010 Oct;152(10):1647-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term facial nerve function evaluation following surgery for large acoustic neuromas via retrosigmoid transmeatal approach.
  • PURPOSE: By evaluating the postoperative facial nerve function of large acoustic neuromas, the purpose of this study was to analyze the factors that influence the facial nerve function outcome and to explore the surgical strategy for large acoustic neuromas.
  • METHODS: A retrospective study of surgical outcome was performed on 89 patients with large acoustic neuromas.
  • The facial nerve was anatomically intact at the end of surgery in 83 (93.3%) patients.
  • At 1 year after surgery, 48 (53.9%) patients had good facial nerve function (House-Brackmann (HB) Grades I-II), 23 (25.8%) patients had regular facial nerve function (HB Grades III-IV), and 18 (20.2%) patients had poor facial nerve function (HB Grades V-VI).
  • CONCLUSIONS: For large acoustic neuromas, the goal of complete tumor resection and preservation of acceptable facial nerve function can be attained via the retrosigmoid transmeatal approach, using the intraoperative facial nerve monitoring.
  • The surgical strategy of near total resection is indicated for the large acoustic neuromas with severe adherence or inclusion in order to preserve facial nerve function.
  • [MeSH-major] Craniotomy / methods. Facial Nerve / surgery. Facial Nerve Injuries / physiopathology. Facial Nerve Injuries / prevention & control. Neuroma, Acoustic / physiopathology. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods. Postoperative Complications / physiopathology

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  • (PMID = 20544362.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Austria
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42. Curtin HD, Hirsch WL Jr: Imaging of acoustic neuromas. 1992. Neurosurg Clin N Am; 2008 Apr;19(2):175-205, v
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  • [Title] Imaging of acoustic neuromas. 1992.
  • Diagnosis of acoustic neuromas has been simplified considerably by computed tomography (CT) and magnetic resonance imaging (MRI).
  • Either enhanced method will visualize almost every acoustic neuroma.
  • Currently, a gadolinium-enhanced MRI scan is considered an accurate indicator of whether or not an individual has an acoustic neuroma, although there have been false-positive enhanced MRI scans recently reported.
  • [MeSH-major] Magnetic Resonance Imaging / history. Neuroma, Acoustic / history. Tomography, X-Ray Computed / history

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  • (PMID = 18534334.001).
  • [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] Curtin HD; Hirsch WL Jr
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43. Zhang X, Fei Z, Chen YJ, Fu LA, Zhang JN, Liu WP, He XS, Jiang XF: Facial nerve function after excision of large acoustic neuromas via the suboccipital retrosigmoid approach. J Clin Neurosci; 2005 May;12(4):405-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Facial nerve function after excision of large acoustic neuromas via the suboccipital retrosigmoid approach.
  • We review our results for facial nerve preservation in 105 patients with large acoustic neuromas (diameter 4.0 cm or larger) undergoing excision via the suboccipital retrosigmoid approach.
  • Microneurosurgical techniques and facial nerve monitoring were used.
  • Complete tumor removal was achieved in 91 cases (86.7%) and subtotal removal in 14 (13.3%).
  • The facial nerve was preserved anatomically in 83 (79.1%) patients.
  • Using the House-Brackmann grading system, facial nerve function was assessed immediately after surgery, at the time of discharge and 1 year after surgery.
  • The suboccipital retrosigmoid approach resulted in good anatomical and functional preservation of the facial nerve during excision of large acoustic neuromas, with minimal other morbidity and low mortality.
  • We recommend this approach for excision of large acoustic neuromas.
  • [MeSH-major] Facial Nerve / physiopathology. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods. Occipital Bone / surgery. Otologic Surgical Procedures / methods

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  • (PMID = 15925770.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Scotland
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44. Sabol Z, Kipke-Sabol L, Miklić P, Hajnsek-Propadalo S, Sabol F: [Neurofibromatosis type 2 (central neurofibromatosis or bilateral acoustic neuromas, vestibular schwannomas): from phenotype to gene]. Lijec Vjesn; 2006 Sep-Oct;128(9-10):309-16
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  • [Title] [Neurofibromatosis type 2 (central neurofibromatosis or bilateral acoustic neuromas, vestibular schwannomas): from phenotype to gene].
  • Neurofibromatosis type 2 (NF2) is an autosomal dominant disease that predisposes to bilateral vestibular schwannomas (neurinomas), other central and peripheral nervous system tumours (multiple meningeomas and neurofibromas) and ocular abnormalities (cataract).
  • NF2 has a variable clinical presentation, with two basic types: severe type having early onset and progressive growth of tumors and the milder type having later onset and less aggressive course.
  • The genotype-phenotype correlations indicate a greater variability of clinical disease expression.
  • [MeSH-major] Neurofibromatosis 2 / genetics. Neuroma, Acoustic / genetics


45. Ju DT, Lin JW, Lin MS, Lee LM, Tseng HM, Wei CP, Yen CH, Hung CC, Hung KS, Lin CM, Lin TJ, Chiu WT, Tsai JT: Hypofractionated CyberKnife stereotactic radiosurgery for acoustic neuromas with and without association to neurofibromatosis Type 2. Acta Neurochir Suppl; 2008;101:169-73
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hypofractionated CyberKnife stereotactic radiosurgery for acoustic neuromas with and without association to neurofibromatosis Type 2.
  • To treat acoustic neuroma (AN) patients with or without neurofibromatosis Type 2 (NF2) associations, the functional preservation of hearing, trigeminal nerve, and facial nerve are important.
  • Cranial nerve function, audiograms, and magnetic resonance images (MRI) were monitored.
  • Tumors with volumes ranging from 0.13 to 24.8 cm3 (mean 5.4 cm3) were irradiated with the marginal dose 1800-2000 cGy/3 fractions.
  • Tumors were treated with an 80 to 89% isodose line (mean 83%) and mean 97.9% tumor coverage.
  • No facial or trigeminal dysfunction, brain stem toxicity, or cerebellar edema occurred.
  • Tumor regression was seen in 9 patients (43%) and stable in 12 patients (57%).
  • 100% tumor control rate was achieved.
  • Hypofractionated CKSRS was not only effective in tumor control but also excellent in hearing preservation for non-NF2 AN.
  • But for NF2 patients, although the tumor control was remarkable, hearing preservation was modest as in non-NF2 patients.
  • [MeSH-major] Neurofibromatosis 2 / surgery. Neuroma, Acoustic / surgery. Radiosurgery / methods

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  • (PMID = 18642654.001).
  • [ISSN] 0065-1419
  • [Journal-full-title] Acta neurochirurgica. Supplement
  • [ISO-abbreviation] Acta Neurochir. Suppl.
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Austria
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46. Weil RS, Cohen JM, Portarena I, Brada M: Optimal dose of stereotactic radiosurgery for acoustic neuromas: A systematic review. Br J Neurosurg; 2006 Aug;20(4):195-202
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Optimal dose of stereotactic radiosurgery for acoustic neuromas: A systematic review.
  • Radiosurgery is increasingly employed in the treatment of acoustic neuroma, but the optimal dose in terms of long-term tumour control and minimal adverse effects has not been established.
  • We performed a systematic review of the published literature of radiosurgery of acoustic neuroma to assess whether the use of low dose radiosurgery is as effective as high dose treatment.
  • Reports of radiosurgery for acoustic neuroma were identified through a Medline search.
  • Although on initial inspection radiosurgery of acoustic neuroma with doses of 12 - 13 Gy seems to be as effective as higher dose treatment, the available reports are subject to a number of confounding factors, are not sufficiently statistically powered and there is only limited long-term actuarial outcome data.
  • Currently, available studies do not provide sufficient confidence to support the claim that low dose radiosurgery is equally effective as higher doses in the long-term control of acoustic neuroma.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Disease Progression. Humans. Middle Aged. Radiotherapy Dosage / standards. Treatment Outcome

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  • (PMID = 16954068.001).
  • [ISSN] 0268-8697
  • [Journal-full-title] British journal of neurosurgery
  • [ISO-abbreviation] Br J Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Number-of-references] 61
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47. Burkhart CG: Herpes and acoustic neuromas: is there a cause and effect to observe? Med Hypotheses; 2010 Jun;74(6):1013-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Herpes and acoustic neuromas: is there a cause and effect to observe?
  • Acoustic neuromas are a result of damage to the affected nerve function and can potentially press surrounding tissues.
  • Herpes has already been shown to mimic acoustic neuroma clinically, but growing evidence suggests that it is likely the cause of most cases of this entity.
  • [MeSH-major] Herpesviridae Infections / complications. Neuroma, Acoustic / etiology
  • [MeSH-minor] Herpesviridae / pathogenicity. Humans. Models, Neurological. Schwann Cells / virology. Vestibulocochlear Nerve / virology

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  • (PMID = 20153934.001).
  • [ISSN] 1532-2777
  • [Journal-full-title] Medical hypotheses
  • [ISO-abbreviation] Med. Hypotheses
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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48. Xia Y: [Bilateral acoustic neuromas]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2008 Mar;43(3):237-40

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Bilateral acoustic neuromas].

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  • (PMID = 18630294.001).
  • [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] Journal Article
  • [Publication-country] China
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49. Sinha S, Sharma BS: Cystic acoustic neuromas: surgical outcome in a series of 58 patients. J Clin Neurosci; 2008 May;15(5):511-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cystic acoustic neuromas: surgical outcome in a series of 58 patients.
  • We aimed to analyze the clinical characteristics and surgical outcomes of surgically treated cystic acoustic neuromas, and to determine the prognostic significance of the presence of cystic components, by comparing surgical outcomes for solid and cystic tumors.
  • A total of 58 patients (20.4%) with newly diagnosed cystic tumor were studied.
  • The surgical outcome was analyzed in terms of extent of tumor removal, facial nerve preservation, morbidity and mortality; and was compared with that in patients with solid tumors.
  • Facial nerve preservation rates were much better for solid tumors (82.7%) than for cystic tumors (67.9%).
  • The extent of tumor removal was complete in 75.9% of patients with cystic tumors as compared with 90.2% for solid acoustic neuromas.
  • Cystic tumors differ from solid acoustic neuromas by having a rapid growth pattern, short clinical history and more frequent facial nerve involvement.
  • [MeSH-major] Cranial Nerve Neoplasms / surgery. Cysts / surgery. Neuroma, Acoustic / surgery. Neurosurgery / methods

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  • (PMID = 18329881.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article
  • [Publication-country] Scotland
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50. Hariharan S, Zhu J, Nadkarni MA, Donahue JE: Metastatic lung cancer in the cerebellopontine angles mimicking bilateral acoustic neuroma. J Clin Neurosci; 2005 Feb;12(2):184-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Metastatic lung cancer in the cerebellopontine angles mimicking bilateral acoustic neuroma.
  • Bilateral cerebellopontine angle (CPA) tumors identified on MRI are considered bilateral acoustic neuromas, the definitive diagnostic criterion of neurofibromatosis 2 (NF-2).
  • MRI revealed bilateral enhancing CPA lesions, which were suggestive of acoustic neuromas and a diagnosis of NF-2.
  • Therefore, metastatic carcinoma to the CPA can mimic bilateral acoustic neuromas; imaging studies alone may be insufficient to diagnose NF-2.
  • [MeSH-major] Adenocarcinoma / secondary. Brain Neoplasms / secondary. Cerebellopontine Angle / pathology. Lung Neoplasms / pathology
  • [MeSH-minor] Aged. Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Male. Neuroma, Acoustic


51. Radu A, Pica A, Villemure JG, Maire R: [Indications and results of stereotactic radiosurgery with LINAC for the treatment of acoustic neuromas: preliminary results]. Ann Otolaryngol Chir Cervicofac; 2007 Jul;124(3):110-4
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  • [Title] [Indications and results of stereotactic radiosurgery with LINAC for the treatment of acoustic neuromas: preliminary results].
  • [Transliterated title] Indications et résultats du traitement des neurinomes de l'acoustique par radiothérapie stéréotaxique avec LINAC: résultats préliminaires.
  • INTRODUCTION: Radiosurgery is presently becoming an alternative to microsurgical resection of acoustic neuromas.
  • The interest of radiosurgery consists in its lower morbidity compared to surgery and likely in similar rates of long-term tumor control.
  • The goal of our study was to assess the clinical outcome (hearing preservation and neurological complications) as well as tumor control after low-dose radiosurgery for unilateral acoustic neuromas.
  • MATERIAL AND METHODS: Since April 2002, 22 patients with untreated acoustic neuromas underwent stereotactic radiosurgery using a linear accelerator (LINAC) and a micromultileaf collimator (mMLC, Brain Lab) at a low-dose of 12 Gy.
  • Radiological tumor growth control was obtained in all patients (100%).
  • Tumor control is observed in all patients, but a longer follow-up period is needed to confirm the stability of the tumor size.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / instrumentation
  • [MeSH-minor] Adult. Aged. Equipment Design. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Staging. Treatment Outcome

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  • (PMID = 17509516.001).
  • [ISSN] 0003-438X
  • [Journal-full-title] Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris
  • [ISO-abbreviation] Ann Otolaryngol Chir Cervicofac
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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52. Klaeboe L, Blaasaas KG, Tynes T: Use of mobile phones in Norway and risk of intracranial tumours. Eur J Cancer Prev; 2007 Apr;16(2):158-64
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  • [Title] Use of mobile phones in Norway and risk of intracranial tumours.
  • To test the hypothesis that exposure to radio-frequency electromagnetic fields from mobile phones increases the incidence of gliomas, meningiomas and acoustic neuromas in adults.
  • Detailed information about mobile phone use was collected from 289 glioma (response rate 77%), 207 meningioma patients (71%), and 45 acoustic neuroma patients (68%) and from 358 (69%) controls.
  • For regular mobile phone use, defined as use on average at least once a week or more for at least 6 months, the odds ratio was 0.6 (95% confidence interval 0.4-0.9) for gliomas, 0.8 (95% confidence interval 0.5-1.1) for meningiomas and 0.5 (95% confidence interval 0.2-1.0) for acoustic neuromas.
  • Similar results were found with mobile phone use for 6 years or more for gliomas and acoustic neuromas.
  • Furthermore, no increasing trend was observed for gliomas or acoustic neuromas by increasing duration of regular use, the time since first regular use or cumulative use of mobile phones.
  • The results from the present study indicate that use of mobile phones is not associated with an increased risk of gliomas, meningiomas or acoustic neuromas.
  • [MeSH-major] Brain Neoplasms / etiology. Cell Phones. Glioma / etiology. Meningioma / etiology. Neuroma, Acoustic / etiology

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  • (PMID = 17297392.001).
  • [ISSN] 0959-8278
  • [Journal-full-title] European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP)
  • [ISO-abbreviation] Eur. J. Cancer Prev.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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53. Hsu PW, Chang CN, Lee ST, Huang YC, Chen HC, Wang CC, Hsu YH, Tseng CK, Chen YL, Wei KC: Outcomes of 75 patients over 12 years treated for acoustic neuromas with linear accelerator-based radiosurgery. J Clin Neurosci; 2010 May;17(5):556-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outcomes of 75 patients over 12 years treated for acoustic neuromas with linear accelerator-based radiosurgery.
  • The aim of this study was to investigate the efficacy of linear accelerator (LINAC)-based radiosurgery in the treatment of acoustic neuromas.
  • In this retrospective study, we enrolled 75 patients with non-neurofibromatosis type 2 acoustic neuromas who were followed-up for more than 5years.
  • The 75 patients were divided into 3 groups: patients with a newly diagnosed tumor; those with a residual tumor; and those with a recurrent tumor.
  • The overall tumor progression-free rate was 92%, and corresponding rates among those with newly diagnosed tumors was 100%, residual tumors was 84.4%, and recurrent tumors was 92.8% (p=0.028).
  • Lesion localization using CT scans correlated with a higher tendency for tumor progression than lesion localization using CT-MRI fusion images (15.6% versus 2.4%, respectively).
  • Residual tumors treated with radiosurgery have a higher progression rate, and careful lesion localization using CT-MRI image fusion is required.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / instrumentation
  • [MeSH-minor] Adult. Aged. Disease Progression. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Treatment Outcome

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  • (PMID = 20227884.001).
  • [ISSN] 1532-2653
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Scotland
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54. Iwai Y, Yamanaka K, Kubo T, Aiba T: Gamma knife radiosurgery for intracanalicular acoustic neuromas. J Clin Neurosci; 2008 Sep;15(9):993-7
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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 intracanalicular acoustic neuromas.
  • In the present study we reviewed our long-term experience with radiosurgery for intracanalicular acoustic neuromas.
  • The study involved 25 patients with unilateral intracanalicular acoustic neuromas.
  • No patients experienced post-radiosurgery facial palsy or other cranial nerve deficits.
  • Based on our study and long-term follow-up, radiosurgery can produce high rates of tumour growth control and hearing preservation for intracanalicular acoustic neuromas, and is an alternative to surgical resection given its low level of invasiveness.
  • When determining treatment for intracanalicular acoustic neuromas, the condition's benign natural course and the likelihood of hearing preservation must be taken into account.
  • [MeSH-major] Cranial Nerve Neoplasms / surgery. Neuroma, Acoustic / surgery. Radiosurgery / methods. Radiosurgery / standards. Vestibulocochlear Nerve / surgery. Vestibulocochlear Nerve Diseases / surgery
  • [MeSH-minor] Adult. Aged. Disease Progression. Ear, Inner / pathology. Ear, Inner / surgery. Female. Hearing Loss, Sensorineural / etiology. Hearing Loss, Sensorineural / prevention & control. Hearing Loss, Sensorineural / surgery. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local / prevention & control. Petrous Bone / pathology. Petrous Bone / surgery. Postoperative Complications / etiology. Postoperative Complications / prevention & control. Radiation Dosage. Treatment Outcome

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  • (PMID = 18617402.001).
  • [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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55. Patni AH, Kartush JM: Staged resection of large acoustic neuromas. Otolaryngol Head Neck Surg; 2005 Jan;132(1):11-9
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  • [Title] Staged resection of large acoustic neuromas.
  • OBJECTIVE: Surgical removal of large (>3 cm) acoustic neuromas is associated with poor long-term facial nerve function results and higher complication rates.
  • This study analyzes whether long term facial nerve function and the incidence of neurological and vascular complications is improved by resection of large acoustic neuromas in 2 or 3 stages.
  • PATIENTS AND METHODS: Among 660 patients who underwent surgical resection of acoustic neuromas between 1989 and 2002 by the senior author (J.M.K.
  • ), 34 (5%) patients underwent a staged resection of their large-sized tumors: stage I via a retrosigmoid craniotomy and stage II via a translabyrinthine approach.
  • Tumor size, completeness of tumor removal, tumor recurrence, facial nerve function, and any complications were noted.
  • RESULTS: The average tumor size was 4.4 cm with a mean postoperative length of follow-up of 6 years after the last surgery.
  • There were no tumor recurrences on follow-up MRI scans.
  • CONCLUSION: In conjunction with the reported technical refinements, staged resection of large tumors significantly reduces morbidity and improves long-term facial nerve function.
  • [MeSH-major] Neuroma, Acoustic / surgery
  • [MeSH-minor] Facial Nerve / physiology. Facial Nerve Diseases / prevention & control. Female. Follow-Up Studies. Humans. Male. Otologic Surgical Procedures / adverse effects. Otologic Surgical Procedures / methods. Postoperative Complications / epidemiology. Postoperative Complications / etiology. Retrospective Studies

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  • (PMID = 15632903.001).
  • [ISSN] 0194-5998
  • [Journal-full-title] Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • [ISO-abbreviation] Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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56. Kondziolka D, Lunsford LD: Future perspectives in acoustic neuroma management. Prog Neurol Surg; 2008;21:247-54
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Future perspectives in acoustic neuroma management.
  • Management options for patients with vestibular schwannomas (acoustic neuromas) include observation, resection, stereotactic radiosurgery, or fractionated radiotherapy.
  • There has been an evolution in available technologies, and an evolution in both patient and physician approaches to the management of this tumor.
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / trends

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  • (PMID = 18810226.001).
  • [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] 65
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57. Backous DD, Pham HT: Guiding patients through the choices for treating vestibular schwannomas: balancing options and ensuring informed consent. Otolaryngol Clin North Am; 2007 Jun;40(3):521-40, viii-ix
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Guiding patients through the choices for treating vestibular schwannomas: balancing options and ensuring informed consent.
  • Counseling patients who are diagnosed with vestibular schwannomas, formerly known as acoustic neuromas, can be challenging.
  • [MeSH-major] Choice Behavior. Informed Consent. Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Patient Education as Topic

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  • (PMID = 17544694.001).
  • [ISSN] 0030-6665
  • [Journal-full-title] Otolaryngologic clinics of North America
  • [ISO-abbreviation] Otolaryngol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 79
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58. Morin G, Desenclos C, Jeanpetit C, Lévy N, Deramond H, Mathieu M: Additional familial case of subtotal leukonychia and sebaceous cysts (Bauer syndrome): belong the nervous tumours to the phenotype? Eur J Med Genet; 2008 Sep-Oct;51(5):436-43

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  • Molecular basis of the disorder is unknown.
  • One of the women exhibited a cervical ependymoma and bilateral multiple inoperable acoustic neuromas.
  • [MeSH-major] Epidermal Cyst / genetics. Nails, Malformed / genetics. Neuroma / genetics
  • [MeSH-minor] Adolescent. Adult. Brain / pathology. Deafness / diagnosis. Deafness / genetics. Family Health. Female. Humans. Male. Nervous System Neoplasms / diagnosis. Nervous System Neoplasms / genetics. Pedigree. Syndrome

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  • (PMID = 18684681.001).
  • [ISSN] 1769-7212
  • [Journal-full-title] European journal of medical genetics
  • [ISO-abbreviation] Eur J Med Genet
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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59. Hartzell LD, McKelvey KD, Van Hemert RL, Dornhoffer J: Cerebellopontine angle tumor in a patient with a maternally inherited SDHD gene mutation. Int Tinnitus J; 2008;14(2):97-100
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  • [Title] Cerebellopontine angle tumor in a patient with a maternally inherited SDHD gene mutation.
  • Acoustic neuromas are the most common tumor in the cerebellopontine angle (CPA) but are rare in the general population.
  • We present the first reported case of a patient with a CPA tumor and a maternally inherited SDHD gene mutation.
  • [MeSH-major] Cerebellar Neoplasms / genetics. Cerebellopontine Angle. DNA Mutational Analysis. Genetic Predisposition to Disease / genetics. Neoplasms, Multiple Primary / genetics. Neuroma, Acoustic / genetics. Paraganglioma / genetics. Succinate Dehydrogenase / genetics

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  • (PMID = 19205158.001).
  • [ISSN] 0946-5448
  • [Journal-full-title] The international tinnitus journal
  • [ISO-abbreviation] Int Tinnitus J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Codon; 0 / SDHD protein, human; 9DLQ4CIU6V / Proline; EC 1.3.99.1 / Succinate Dehydrogenase; GMW67QNF9C / Leucine
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60. Lee KJ, Barber DC, Walton L: Automated gamma knife radiosurgery treatment planning with image registration, data-mining, and Nelder-Mead simplex optimization. Med Phys; 2006 Jul;33(7):2532-40
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  • The method was tested on a randomly selected set of 10 acoustic neuromas and 10 meningiomas.
  • In 8/10 acoustic neuromas and 8/10 meningiomas, the automatic method found plans with conformation number equal or better than that of the manual plan.
  • In 4/10 acoustic neuromas and 5/10 meningiomas, both overtreatment and undertreatment ratios were equal or better in automated plans.
  • [MeSH-minor] Automation. Data Interpretation, Statistical. Databases, Factual. Humans. Image Processing, Computer-Assisted / methods. Meningioma / radiotherapy. Neuroma, Acoustic / radiotherapy. Radiotherapy Dosage. Radiotherapy, Conformal. Software

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  • (PMID = 16898457.001).
  • [ISSN] 0094-2405
  • [Journal-full-title] Medical physics
  • [ISO-abbreviation] Med Phys
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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61. Backous DD, Pham HT: Guiding patients through the choices for treating vestibular schwannomas: balancing options and ensuring informed consent. 2007. Neurosurg Clin N Am; 2008 Apr;19(2):379-92, viii
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Guiding patients through the choices for treating vestibular schwannomas: balancing options and ensuring informed consent. 2007.
  • Counseling patients who are diagnosed with vestibular schwannomas, formerly known as acoustic neuromas, can be challenging.
  • [MeSH-major] Informed Consent / history. Neuroma, Acoustic / history. Patient Education as Topic / history

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  • (PMID = 18534346.001).
  • [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; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Personal-name-as-subject] Backous DD; Pham HT
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62. Shaffer BT, Cohen MS, Bigelow DC, Ruckenstein MJ: Validation of a disease-specific quality-of-life instrument for acoustic neuroma: the Penn Acoustic Neuroma Quality-of-Life Scale. Laryngoscope; 2010 Aug;120(8):1646-54
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Validation of a disease-specific quality-of-life instrument for acoustic neuroma: the Penn Acoustic Neuroma Quality-of-Life Scale.
  • OBJECTIVES/HYPOTHESIS: To design and validate the first disease-specific quality-of-life instrument for acoustic neuroma, the Penn Acoustic Neuroma Quality-of-Life (PANQOL) scale.
  • METHODS: One hundred forty-three patients with acoustic neuromas completed the 80-question preliminary instrument and the general Short Form-36 Health Survey (SF-36).
  • PANQOL face domain scores showed significant differences across the House-Brackmann grading system scores and correlated inversely with tumor size.
  • The PANQOL scale discriminated acoustic neuroma cases from controls better than the SF-36.
  • CONCLUSIONS: We have developed the first validated disease-specific quality of life instrument for patients with acoustic neuromas.
  • Given the lack of a validated equivalent, this tool has the potential to become a critical outcome measure for studies evaluating treatment of patients with acoustic neuromas.
  • [MeSH-major] Health Status Indicators. Neuroma, Acoustic / diagnosis. Quality of Life

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  • (PMID = 20641085.001).
  • [ISSN] 1531-4995
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article; Validation Studies
  • [Publication-country] United States
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63. Grainger J, Dias PS: Case report: optic disc edema without hydrocephalus in acoustic neuroma. Skull Base; 2005 Feb;15(1):83-6; discussion 86-8

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  • [Title] Case report: optic disc edema without hydrocephalus in acoustic neuroma.
  • Traditionally, visual disturbance and optic disc edema are regarded as late manifestations of acoustic neuromas indicating increased intracranial pressure as a result of obstructive hydrocephalus or a sizeable mass lesion.
  • Magnetic resonance imaging showed a large acoustic neuroma.
  • However, there was no ventriculomegaly and at surgery intracranial pressure was normal.
  • Furthermore, patients with acoustic neuromas and a visual disturbance related to optic disc edema may be inappropriate for treatment with stereotactic radiosurgery and should be offered early surgery to prevent visual deterioration.

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  • [Cites] Am J Ophthalmol. 2002 Jul;134(1):141-2 [12095830.001]
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  • (PMID = 16148986.001).
  • [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/ PMC1151706
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64. Goodden JR, Tranter R, Hardwidge C: Setting the standard--UK neurosurgical acoustic neuroma practice. Ann R Coll Surg Engl; 2006 Sep;88(5):486-9
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  • [Title] Setting the standard--UK neurosurgical acoustic neuroma practice.
  • INTRODUCTION: The aim of this study was to determine how current practice in the UK and Ireland complies with the Clinical Effectiveness Guidelines for the Management of Acoustic Neuromas.
  • RESULTS: Fifty-six neurosurgeons treat acoustic neuromas in 33 out of 34 units.
  • All surgeons use facial nerve monitoring during surgery.
  • [MeSH-major] Guideline Adherence / standards. Neuroma, Acoustic / surgery. Neurosurgical Procedures / standards. Practice Guidelines as Topic / standards. Professional Practice / standards

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  • [Cites] Otolaryngol Head Neck Surg. 2001 Jun;124(6):645-51 [11391255.001]
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  • (PMID = 17002857.001).
  • [ISSN] 1478-7083
  • [Journal-full-title] Annals of the Royal College of Surgeons of England
  • [ISO-abbreviation] Ann R Coll Surg Engl
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1964694
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65. Lin D, Hegarty JL, Fischbein NJ, Jackler RK: The prevalence of "incidental" acoustic neuroma. Arch Otolaryngol Head Neck Surg; 2005 Mar;131(3):241-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The prevalence of "incidental" acoustic neuroma.
  • OBJECTIVE: To estimate the prevalence of "incidental" acoustic neuromas (ANs) in the population at large.
  • DESIGN: An intracranial magnetic resonance imaging (MRI) database of 46 414 patients presenting to the University of California, San Francisco (UCSF), without known audiovestibular complaints was searched retrospectively from July 1995 to February 2003.
  • A medical chart review of 688 patients with acoustic neuromas presenting to UCSF between 1980 and 1999 was searched for sex distribution.
  • Tumor size in this population ranged from 3 to 28 mm.
  • [MeSH-major] Magnetic Resonance Imaging. Neuroma, Acoustic / diagnosis. Neuroma, Acoustic / epidemiology
  • [MeSH-minor] Adult. Age Distribution. Aged. Aged, 80 and over. California / epidemiology. Evoked Potentials, Auditory, Brain Stem / physiology. Female. Humans. Male. Middle Aged. Prevalence. Prognosis. Registries. Retrospective Studies. Risk Assessment. Severity of Illness Index. Sex Distribution. Survival Rate

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  • (PMID = 15781765.001).
  • [ISSN] 0886-4470
  • [Journal-full-title] Archives of otolaryngology--head & neck surgery
  • [ISO-abbreviation] Arch. Otolaryngol. Head Neck Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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66. Sachdeva R, Rothner DA, Traboulsi EI, Hayden BC, Rychwalski PJ: Astrocytic hamartoma of the optic disc and multiple café-au-lait macules in a child with neurofibromatosis type 2. Ophthalmic Genet; 2010 Dec;31(4):209-14
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  • The characteristic and diagnostic finding of NF2 is bilateral vestibular nerve schwannomas (acoustic neuromas).
  • In addition to other tumors involving the central and peripheral nervous systems, ophthalmic manifestations, including posterior subcapsular and peripheral cortical cataracts, optic nerve meningiomas, epiretinal membrane, and combined pigment epithelial and retinal hamartomas, are common to NF2.
  • Herein we present an 8-year-old girl with NF2 and astrocytic hamartoma of the optic disc.
  • However, neuroimaging revealed bilateral acoustic neuromas, leading to a clinical diagnosis of NF2.
  • [MeSH-major] Astrocytes / pathology. Hamartoma / complications. Neurofibromatosis 2 / complications. Optic Disk / pathology. Optic Nerve Diseases / complications
  • [MeSH-minor] Child. Female. Humans. Magnetic Resonance Imaging. Nerve Fibers / pathology. Neurofibromin 2 / genetics. Retinal Ganglion Cells / pathology. Tomography, Optical Coherence. Visual Acuity

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  • (PMID = 21067482.001).
  • [ISSN] 1744-5094
  • [Journal-full-title] Ophthalmic genetics
  • [ISO-abbreviation] Ophthalmic Genet.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Neurofibromin 2
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67. Yuguang L, Chengyuan W, Meng L, Shugan Z, Wandong S, Gang L, Xingang L: Neuroendoscopic anatomy and surgery of the cerebellopontine angle. J Clin Neurosci; 2005 Apr;12(3):256-60

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  • NEAMN tumour resection was performed in eight acoustic neuromas, one meningioma and 14 cholesteatomas and NEAMN vascular decompression was performed in five patients with trigeminal neuralgia.
  • Complete excision of the tumour with preservation of the facial nerve was achieved in all eight acoustic neuromas.
  • [MeSH-minor] Adult. Anesthesia, General. Cerebellar Diseases / pathology. Cerebellar Diseases / surgery. Cerebellar Neoplasms / pathology. Cerebellar Neoplasms / surgery. Cholesteatoma / surgery. Decompression, Surgical. Endoscopy. Female. Humans. Male. Meningioma / surgery. Microsurgery. Middle Aged. Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Trigeminal Neuralgia / surgery

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  • (PMID = 15851077.001).
  • [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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68. Poetker DM, Jursinic PA, Runge-Samuelson CL, Wackym PA: Distortion of magnetic resonance images used in gamma knife radiosurgery treatment planning: implications for acoustic neuroma outcomes. Otol Neurotol; 2005 Nov;26(6):1220-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Distortion of magnetic resonance images used in gamma knife radiosurgery treatment planning: implications for acoustic neuroma outcomes.
  • OBJECTIVE: To quantify the image distortion of our series of acoustic neuromas treated with gamma knife radiosurgery.
  • PATIENTS: Patients undergoing gamma knife radiosurgery for the treatment of acoustic neuromas.
  • Known clinical measurements of audiometric, vestibular, facial, and trigeminal nerve functions were then compared with current measurements of tumor size.
  • Tumor volumes of the treatment plan that fell outside of the internal auditory canal ranged from 0 to 414 mm, with a mean of 90.5 mm.
  • The mean percentage that fell outside of the internal auditory canal was 16.7% of total tumor volume (range, 2.4-77.6%).
  • We could not draw any consistent correlations between degree of image shift and continued tumor growth or objective examination values.
  • Although the image shift does not seem to affect the growth of the acoustic neuromas or auditory or facial nerve function, longer term follow-up is required to fully appreciate the true impact of this image shift.
  • [MeSH-major] Artifacts. Image Processing, Computer-Assisted / standards. Magnetic Resonance Imaging / standards. Neuroma, Acoustic / surgery. Radiosurgery / standards. Radiotherapy Planning, Computer-Assisted / standards. Surgery, Computer-Assisted / standards

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  • (PMID = 16272946.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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69. Wandong S, Meng L, Xingang L, Yuguang L, Shugan Z, Lei W, Chengyuan W: Cystic acoustic neuroma. J Clin Neurosci; 2005 Apr;12(3):253-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cystic acoustic neuroma.
  • To define the clinical characteristics of cystic acoustic neuroma, we retrospectively analyzed 22 patients with cystic acoustic neuroma and reviewed the literature with regard to clinical manifestation, imaging features, diagnosis, surgical procedures and prognosis.
  • An acoustic neuroma was defined as cystic according to the following criteria: the presence of hypodense/hypointense areas on CT or MRI, the identification of cystic elements at operation and histological verification.
  • At the end of surgery, the facial nerve was anatomically intact in 86.4% of cystic acoustic neuromas.
  • Complete removal of the tumor was achieved in 18 cases (81.8%).
  • We conclude that patients with cystic acoustic neuroma need prompt surgery with special attention paid to the preservation of the facial nerve.
  • [MeSH-major] Neuroma, Acoustic / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Facial Nerve / surgery. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neurosurgical Procedures. Prognosis. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 15851076.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Scotland
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70. Cohen NL: Retrosigmoid approach for acoustic tumor removal. 1992. Neurosurg Clin N Am; 2008 Apr;19(2):239-50, vi
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Retrosigmoid approach for acoustic tumor removal. 1992.
  • This approach may be used for acoustic neuromas of all sizes, from intracanalicular, to more than 4 cm from the porus acusticus.
  • The facial nerve is readily visualized at the lateral end of the IAC and is at no greater risk than in the translabyrinthine operation.
  • The authors use this approach for all hearing preservation surgery as well as for tumors of more than 3 cm, regardless of hearing.
  • [MeSH-major] Craniotomy / history. Neuroma, Acoustic / history

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  • (PMID = 18534337.001).
  • [ISSN] 1558-1349
  • [Journal-full-title] Neurosurgery clinics of North America
  • [ISO-abbreviation] Neurosurg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Biography; Classical Article; Historical Article; Journal Article
  • [Publication-country] United States
  • [Personal-name-as-subject] Cohen NL
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71. Lin VY, Stewart C, Grebenyuk J, Tsao M, Rowed D, Chen J, Nedzelski J: Unilateral acoustic neuromas: long-term hearing results in patients managed with fractionated stereotactic radiotherapy, hearing preservation surgery, and expectantly. Laryngoscope; 2005 Feb;115(2):292-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Unilateral acoustic neuromas: long-term hearing results in patients managed with fractionated stereotactic radiotherapy, hearing preservation surgery, and expectantly.
  • INTRODUCTION: Hearing preservation is invariably a consideration when exploring treatment options for acoustic neuromas.
  • We reviewed the long-term hearing results of patients who were treated using 1) hyperfractionated stereotactic radiotherapy (HSR), 2) hearing preservation tumor excision surgery (HPTES), and 3) expectantly (no treatment).
  • [MeSH-major] Neuroma, Acoustic / therapy

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  • (PMID = 15689753.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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72. Mazzoni A, Dubey SP, Poletti AM, Colombo G: Sporadic acoustic neuroma in pediatric patients. Int J Pediatr Otorhinolaryngol; 2007 Oct;71(10):1569-72
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  • [Title] Sporadic acoustic neuroma in pediatric patients.
  • OBJECTIVE: Sporadic acoustic neuroma, usually occur between the ages of 40 and 70 years, are very rare in children.
  • We review the experiences of 10 cases of sporadic (non-NF2) acoustic neuromas in pediatric patients.
  • Among these almost 900 cases were acoustic neuromas.
  • The diameter of the tumors varied widely with minimum of 10 mm to maximum up to 60 mm.
  • Five patients each underwent resection of the tumor by translabyrinthine and retrosigmoid approach, respectively.
  • Postoperatively seven cases the facial nerve recovered to grade I, and one each to grade II and grade VI of House-Brackmann classification.
  • The youngest patient with largest tumor diameter of 60 mm developed transient hemiparesis in the immediate postoperative period and he recovered fully in due course.
  • CONCLUSION: We found preservation of facial nerve function is more easier than hearing in this group of patients.
  • [MeSH-major] Neuroma, Acoustic / epidemiology

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  • (PMID = 17643497.001).
  • [ISSN] 0165-5876
  • [Journal-full-title] International journal of pediatric otorhinolaryngology
  • [ISO-abbreviation] Int. J. Pediatr. Otorhinolaryngol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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73. Nikolopoulos TP, Fortnum H, O'Donoghue G, Baguley D: Acoustic neuroma growth: a systematic review of the evidence. Otol Neurotol; 2010 Apr;31(3):478-85
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Acoustic neuroma growth: a systematic review of the evidence.
  • AIM: To undertake a systematic review of the literature on acoustic neuroma growth.
  • RESULTS: The percentage of acoustic neuromas exhibiting growth ranges widely from 18 to 73%.
  • The percentage of tumors reported not to grow for some years after diagnosis ranges from 9 to 75%.
  • The mean growth rate for all tumors varies between 1 and 2 mm/yr, and for only those that grow, between 2 and 4 mm/yr.
  • There are various patterns of growth, and a tumor that shows growth may stop doing so and vice versa.
  • Finally, some tumors that have been stable for many years can exhibit tumor growth.
  • CONCLUSION: The growth pattern of acoustic neuromas is variable and incompletely understood.
  • As much as 75% of tumors have been reported to show no growth, supporting a "wait and rescan" policy in many patients, although there are no reliable predictors of tumor behavior, and some tumors may grow rapidly.
  • [MeSH-major] Neuroma, Acoustic / pathology

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  • (PMID = 20147867.001).
  • [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; Review
  • [Publication-country] United States
  • [Number-of-references] 52
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74. 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

  • [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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75. Benson VS, Pirie K, Green J, Bull D, Casabonne D, Reeves GK, Beral V, Million Women Study Collaborators: Hormone replacement therapy and incidence of central nervous system tumours in the Million Women Study. Int J Cancer; 2010 Oct 01;127(7):1692-8
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  • During a mean follow-up of 5.3 years per woman, 1,266 CNS tumours were diagnosed, including 557 gliomas, 311 meningiomas and 117 acoustic neuromas.
  • Compared with never users of HRT, the relative risks (RRs) for all incident CNS tumours, gliomas, meningiomas and acoustic neuromas in current users of HRT were 1.20 (95% CI: 1.05-1.36), 1.09 (95% CI: 0.89-1.32), 1.34 (95% CI: 1.03-1.75) and 1.58 (95% CI: 1.02-2.45), respectively, and there was no significant difference in the relative risks by tumour type (heterogeneity p = 0.2).
  • [MeSH-minor] Female. Glioma / epidemiology. Humans. Incidence. Male. Meningioma / epidemiology. Middle Aged. Neuroma, Acoustic / epidemiology. Perimenopause. Postmenopause. Pregnancy. Premenopause. Risk Factors. Sex Characteristics

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  • (PMID = 20091865.001).
  • [ISSN] 1097-0215
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Grant] United Kingdom / Medical Research Council / / G0700474; United Kingdom / Medical Research Council / / G9900923; United Kingdom / Cancer Research UK / / ; United Kingdom / Medical Research Council / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Investigator] Austoker J; Banks E; Beral V; Church J; English R; Green J; Patnick J; Peto R; Reeves G; Vessey M; Wallis M; Abbott S; Armstrong M; Baker K; Balkwill A; Benson V; Beral V; Black J; Brown A; Bull D; Cairns B; Chivenga J; Crossley B; Ewart D; Ewart S; Fletcher L; Gerrard L; Goodill A; Green I; Green J; Hilton E; Hooley J; Kan SW; Keene C; Kirichek O; Langston N; Liu B; Luque MJ; MacGregor M; Pank L; Pirie K; Reeves G; Sherman E; Sherry-Starmer E; Simmonds M; Spencer E; Strange H; Sweetland S; Timadjer A; Tipper S; Travis R; Wang X; Watson J; Williams S; Wright L; Yang T; Young H
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76. Jombík P, Bahyl V: Short latency disconjugate vestibulo-ocular responses to transient stimuli in the audio frequency range. J Neurol Neurosurg Psychiatry; 2005 Oct;76(10):1398-402

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: To determine whether unilateral activation of the vestibular labyrinth by brief air conducted tones can elicit disconjugate reflex eye movements in healthy subjects.
  • METHODS: 40 normal volunteers, one patient with bilateral congenital sensorineural deafness, and four patients with an acoustic neuromas were subjected to monoaural air conducted tones (125 to 6000 Hz; 132 dB SPL; 3-4 ms).
  • In patients with acoustic neuromas the responses were induced only by stimuli to the healthy ear.
  • (1) Disconjugate eye movements in response to brief mechanical stimuli in this audio frequency range always indicated the side of the activated vestibular labyrinth. (2) In contrast to longer stimuli used by conventional vestibular activation methods, brief stimuli may activate only the direct monocular vestibulo-ocular pathway.
  • [MeSH-minor] Adult. Aged. Ear, Inner / physiopathology. Electrooculography. Evoked Potentials, Auditory, Brain Stem / physiology. Female. Hearing Loss, Bilateral / diagnosis. Hearing Loss, Sensorineural / diagnosis. Hearing Loss, Sensorineural / physiopathology. Humans. Male. Middle Aged. Nystagmus, Physiologic / physiology. Time Factors

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  • (PMID = 16170084.001).
  • [ISSN] 0022-3050
  • [Journal-full-title] Journal of neurology, neurosurgery, and psychiatry
  • [ISO-abbreviation] J. Neurol. Neurosurg. Psychiatr.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1739361
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77. Deb P, Sharma MC, Gaikwad S, Gupta A, Mehta VS, Sarkar C: Cerebellopontine angle paraganglioma - report of a case and review of literature. J Neurooncol; 2005 Aug;74(1):65-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Majority of the cerebellopontine angle (CPA) tumors are acoustic neuromas, while bulk of the non-acoustic tumors are formed by meningiomas and epidermoid cysts.
  • Primary paraganglioma is a rare tumor in this location, with only two such cases having been reported in the literature, till date.
  • We report another case of an intracranial paraganglioma of the CPA in a 40-year-old female, which did not have any vascular attachment but had focal cerebellar extension.

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  • (PMID = 16078110.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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78. Muscat JE, Hinsvark M, Malkin M: Mobile telephones and rates of brain cancer. Neuroepidemiology; 2006;27(1):55-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mobile telephones and rates of brain cancer.
  • The risk of most primary brain cancers including gliomas and acoustic neuromas is unrelated to the use of mobile telephones in several studies.
  • An increased risk caused by short-term mobile phone use was reported for neuroepithelial tumors, a rare histologic subgroup of brain cancers that are characterized by neuronal features.
  • [MeSH-major] Brain Neoplasms / epidemiology. Cell Phones / utilization. Ganglioglioma / epidemiology

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  • (PMID = 16825795.001).
  • [ISSN] 0251-5350
  • [Journal-full-title] Neuroepidemiology
  • [ISO-abbreviation] Neuroepidemiology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Switzerland
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79. Morrison D: Management of patients with acoustic neuromas: a Markov decision analysis. Laryngoscope; 2010 Apr;120(4):783-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of patients with acoustic neuromas: a Markov decision analysis.
  • OBJECTIVES/HYPOTHESIS: The management of patients with small (<1.5 cm) acoustic neuromas is controversial.
  • A period of observation is sometimes advised followed by microsurgery or radiosurgery for tumors that demonstrate growth during the observation period.
  • RESULTS: The benefit of a period of observation followed by radiosurgery, if needed, for significant tumor growth is greater then all other strategies for all age groups and both sexes.
  • CONCLUSIONS: For patients of all ages, a period of observation during which tumor growth and hearing thresholds are closely monitored is the superior strategy.
  • For tumors that grow substantially or when hearing deteriorates, definitive management via radiosurgery is recommended.
  • [MeSH-major] Decision Support Techniques. Markov Chains. Microsurgery / methods. Neuroma, Acoustic / surgery. Otologic Surgical Procedures / methods. Quality-Adjusted Life Years. Radiosurgery / methods

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  • (PMID = 20213657.001).
  • [ISSN] 1531-4995
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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80. de Paula Vernetta C, Orts Alborch MH, García Callejo FJ, Ramírez Sabio JB, Morant Ventura A, Marco Algarra J: [Radiosurgery treatment of acoustic neuromas. Our experience]. Acta Otorrinolaringol Esp; 2007 Mar;58(3):75-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Radiosurgery treatment of acoustic neuromas. Our experience].
  • [Transliterated title] Tratamiento del neurinoma del acústico con radiocirugía. Nuestra experiencia.
  • OBJECTIVE: To evaluate the results and side effects obtained using radiosurgery to treat acoustic neuromas.
  • MATERIAL AND METHOD: Between 1999 and 2004 we treated 30 patients with unilateral acoustic neuromas with a mean age of 54 years old (31-76), a mean follow-up of 34 months (12-54), and tumour size between 4 and 38 millimetres (mean, 16.5).
  • CONCLUSIONS: Although microsurgery is the treatment of choice for acoustic neuromas, we consider radiosurgical treatment a valid alternative for selected patients (the elderly, co-morbid conditions, small size, contralateral hearing loss...).
  • [MeSH-major] Neuroma, Acoustic / surgery. Radiosurgery / instrumentation

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  • (PMID = 17371688.001).
  • [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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81. Wang WH, Wu H: [Progress in hearing preservation of acoustic neuromas surgery]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2006 May;41(5):392-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Progress in hearing preservation of acoustic neuromas surgery].
  • [MeSH-major] Hearing. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods

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  • (PMID = 16848304.001).
  • [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] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] China
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82. Smouha EE, Yoo M, Mohr K, Davis RP: Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm. Laryngoscope; 2005 Mar;115(3):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] Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm.
  • OBJECTIVES/HYPOTHESES: Conservative management is a viable treatment alternative for acoustic neuroma.
  • METHODS: Published studies on conservative management of acoustic neuroma were found using a key word search through PubMed in addition to the bibliographies of these selected studies.
  • A spreadsheet was made to tabulate the selection criteria for conservative management, duration and frequency of follow-up, patient demographics, initial tumor size and rate of growth, change in hearing status, and the need for definitive treatment.
  • The average initial tumor size was 11.8 mm (n = 900); 43% of 1,244 acoustic neuromas showed growth, whereas 57% showed either no growth or tumor regression.
  • CONCLUSIONS: Our meta-analysis supports the role of conservative management of acoustic neuromas in properly selected patients on the basis of a slow overall rate of growth and a substantial incidence of no growth.
  • An algorithm for acoustic neuroma management is proposed based on initial tumor size, patient age, and hearing status.
  • [MeSH-major] Algorithms. Neuroma, Acoustic / therapy

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  • [CommentIn] Laryngoscope. 2005 Sep;115(9):1704; author reply 1704 [16148723.001]
  • (PMID = 15744156.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis
  • [Publication-country] United States
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83. Omeis I, Hillard VH, Braun A, Benzil DL, Murali R, Harter DH: Meningioangiomatosis associated with neurofibromatosis: report of 2 cases in a single family and review of the literature. Surg Neurol; 2006 Jun;65(6):595-603
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  • BACKGROUND: Meningioangiomatosis (MA) is a rare benign disorder.
  • Magnetic resonance imaging (MRI) scans of the brain revealed bilateral acoustic neuromas and multiple calcified intracranial lesions.
  • MRI scans of the brain revealed bilateral acoustic neuromas and a right parietal mass.
  • Patient 1 underwent a suboccipital craniotomy to resect the right-sided acoustic neuroma.
  • [MeSH-minor] Adolescent. Adult. Craniotomy / methods. Diagnosis, Differential. Female. Frontal Lobe. Humans. Magnetic Resonance Imaging. Neuroma, Acoustic / complications. Neuroma, Acoustic / surgery. Neurosurgical Procedures / methods. Parietal Lobe

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  • (PMID = 16720184.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 75
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84. Chang SD, Gibbs IC, Sakamoto GT, Lee E, Oyelese A, Adler JR Jr: Staged stereotactic irradiation for acoustic neuroma. Neurosurgery; 2005 Jun;56(6):1254-61; discussion 1261-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Staged stereotactic irradiation for acoustic neuroma.
  • OBJECTIVE: Stereotactic radiosurgery has proven effective in the treatment of acoustic neuromas.
  • Prior reports using single-stage radiosurgery consistently have shown excellent tumor control, but only up to a 50 to 73% likelihood of maintaining hearing at pretreatment levels.
  • Staged, frame-based radiosurgery using 12-hour interfraction intervals previously has been shown by our group to achieve excellent tumor control while increasing the rate of hearing preservation at 2 years to 77%.
  • The arrival of CyberKnife (Accuray, Inc., Sunnyvale, CA) image-guided radiosurgery now makes it more practical to treat acoustic neuroma with a staged approach.
  • In this retrospective study, we report our experience with staged radiosurgery for managing acoustic neuromas.
  • METHODS: Since 1999, the CyberKnife has been used to treat more than 270 patients with acoustic neuroma at Stanford University.
  • Among the treated patients, the mean transverse tumor diameter was 18.5 mm, whereas the total marginal dose was either 18 or 21 Gy using three 6- or 7-Gy fractions.
  • Only one treated tumor (2%) progressed after radiosurgery; 29 (48%) of 61 decreased in size and 31 (50%) of the 61 tumors were stable.
  • In no patients did new trigeminal dysfunction develop, nor did any patient experience permanent injury to their facial nerve; two patients experienced transient facial twitching that resolved in 3 to 5 months.
  • CONCLUSION: Although still preliminary, these results indicate that improved tumor dose homogeneity and a staged treatment regimen may improve hearing preservation in acoustic neuroma patients undergoing stereotactic radiosurgery.
  • [MeSH-major] Cranial Nerve Neoplasms / surgery. Neuroma, Acoustic / surgery. Radiosurgery / methods

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  • (PMID = 15918941.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] United States
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85. Marshall AH, Owen VM, Nikolopoulos TP, O'Donoghue GM: Acoustic schwannomas: awareness of radiologic error will reduce unnecessary treatment. Otol Neurotol; 2005 May;26(3):512-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Acoustic schwannomas: awareness of radiologic error will reduce unnecessary treatment.
  • OBJECTIVE: To measure the intra- and interobserver error in size estimation of acoustic schwannomas from magnetic resonance imaging (MRI) scans by experienced radiologists to determine whether small amounts of tumor growth that may affect management (2 mm) could be reliably measured in clinical practice.
  • DESIGN: Duplicated, blinded size estimation of acoustic neuromas (according to American Academy of Otolaryngology-Head and Neck Surgery guidelines, 1995) from MRI scans of patients with acoustic neuromas.
  • PARTICIPANTS: Four radiologists (including 2 dedicated neuroradiologists) measuring positive MRI scans of 26 patients with an acoustic neuroma.
  • MAIN OUTCOME MEASURE: Intraradiologist and inter-radiologist repeatability coefficients in millimeters for the maximal tumor diameter in the anteroposterior (AP) axis, medial-longitudinal (ML) axis, and the square-root of the product of these two measurements.
  • CONCLUSION: The study indicates that, in routine clinical practice, differences in tumor size of the order of 2 mm cannot be reliably measured, even by the same radiologist.
  • Thus, reported growth of acoustic tumors should be interpreted with caution, especially if this is the criterion for recommending treatment.
  • [MeSH-major] Magnetic Resonance Imaging. Neuroma, Acoustic / diagnosis

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  • (PMID = 15891658.001).
  • [ISSN] 1531-7129
  • [Journal-full-title] Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • [ISO-abbreviation] Otol. Neurotol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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86. Newton JR, Shakeel M, Flatman S, Beattie C, Ram B: Magnetic resonance imaging screening in acoustic neuroma. Am J Otolaryngol; 2010 Jul-Aug;31(4):217-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Magnetic resonance imaging screening in acoustic neuroma.
  • OBJECTIVES: Magnetic resonance imaging (MRI) is the definitive investigation for detection of an acoustic neuroma.
  • It is however an expensive resource, and pick-up rate of a tumor can be as low as 1% of all patients scanned.
  • In addition, MRI scans and case records were reviewed for the last 30 patients diagnosed with acoustic neuromas.
  • RESULTS: Two acoustic neuromas were picked up out of 132 scans performed.
  • Of the 30 positive scans for a tumor, the patients/audiograms revealed that 10% did not fit the published criteria despite the patients having no other audiovestibular symptoms.
  • Applying protocols may reduce the amount of scans performed, but up to 10% of tumors may be missed by this approach.
  • [MeSH-major] Hearing Loss, Sensorineural / diagnosis. Magnetic Resonance Imaging / methods. Neuroma, Acoustic / diagnosis

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20015748.001).
  • [ISSN] 1532-818X
  • [Journal-full-title] American journal of otolaryngology
  • [ISO-abbreviation] Am J Otolaryngol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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87. Yu LM, Yang SM, Han DY, Huang DL, Yang WY: [Management of operative complications in acoustic neuroma surgery]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2006 Jan;41(1):26-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Management of operative complications in acoustic neuroma surgery].
  • OBJECTIVE: To explore the common complications related to acoustic neuromas and to search methods for preventing from them.
  • METHODS: One hundred and five patients with acoustic neuromas underwent 110 operations with the retrosigmoid approach, middle cranial fossa approach and labyrinth approach.
  • Other complications were cerebrospinal fluid fistulas (CSF, 12.7%, 14/110) , intracranial hematoma (5.5%, 6/110), cranial nerve palsies (4.5%, 5/110), meningitis (3.6%, 4/110), tetraparesis (3.6%, 4/110), balance disturbance (1.8%, 2/110), hemiparalysis and anepia (0.9%, 1/110).
  • Effective stopping bleeding during operation and controlling blood pressure after operation, as well as keeping effective sedation in 24 hours after operation were the important ways to prevent from intracranial hematoma The haemorrhage often accrued in 48 hours post-operation.
  • CSF in this series was another common complication in acoustic neuroma surgery.
  • CONCLUSIONS: The key factors to avoid the complications include mastering the anatomy of different surgical approach, how much of the tumor size, surgical experience and preoperative evaluation of patients' imaging information and other clinical data.
  • [MeSH-major] Neuroma, Acoustic / surgery. Postoperative Complications / prevention & control

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  • (PMID = 16646239.001).
  • [ISSN] 1673-0860
  • [Journal-full-title] Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
  • [ISO-abbreviation] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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88. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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89. Orabi AA, D'Souza AR, Walsh RR, Irving RM: The influence of the Internet on decision making in acoustic neuroma. J Laryngol Otol; 2005 Oct;119(10):806-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The influence of the Internet on decision making in acoustic neuroma.
  • OBJECTIVE: To determine the access to and the use of the Internet by acoustic neuroma patients as a medical information source, and the influence of the Internet on decision-making, as well as the patients' views on the quality of particular sites.
  • MATERIALS AND METHODS: A retrospective 27-item questionnaire was sent to 138 consecutive acoustic neuroma patients diagnosed between 1997 and 2002.
  • Twenty-four per cent accessed the Internet to obtain information about acoustic neuromas.
  • Acoustic neuroma specialists and ENT surgeons in general should familiarize themselves with related websites so that patients can then be directed to high-quality sites.
  • [MeSH-major] Decision Making. Information Services / utilization. Internet / utilization. Neuroma, Acoustic / therapy

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  • (PMID = 16259658.001).
  • [ISSN] 0022-2151
  • [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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90. Kalogeridi MA, Georgolopoulou P, Kouloulias V, Kouvaris J, Pissakas G: Long-term follow-up confirms the efficacy of linac radiosurgery for acoustic neuroma and meningioma patients. A single institution's experience. J BUON; 2010 Jan-Mar;15(1):68-73
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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 confirms the efficacy of linac radiosurgery for acoustic neuroma and meningioma patients. A single institution's experience.
  • PURPOSE: To investigate the long-term efficacy and toxicity in a group of consecutive patients treated with linear accelerator (linac) radiosurgery for acoustic neuromas and meningiomas.
  • METHODS: Between 2000 and 2004, 34 patients (median age 65.5 years, range 50-84) with acoustic neuroma or meningioma were treated with linac-based stereotactic radiosurgery with a surface dose of 11-15.5 Gy.
  • Median tumor volume was 5.95cm(3).
  • Nineteen (59%) tumors decreased in size and 13 (41%) remained stable.
  • None of the tumors increased in size in the long-term follow-up, resulting in an overall growth control of 100% for the small number of patients of our study.
  • CONCLUSION: Long-term follow-up confirms the efficacy and low toxicity of linac radiosurgery for neuroma and meningioma patients.
  • [MeSH-major] Meningeal Neoplasms / surgery. Meningioma / surgery. Neuroma, Acoustic / surgery. Particle Accelerators. Radiosurgery / instrumentation
  • [MeSH-minor] Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Radiation Dosage. Time Factors. Tomography, X-Ray Computed. Treatment Outcome. Tumor Burden

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  • (PMID = 20414930.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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91. Kalavagunta S, Karkanevatos A, Swift AC: Giant vertebro-basilar aneurysm: an unusual cerebello-pontine angle lesion. J Laryngol Otol; 2006 Feb;120(2):e8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Acoustic neuromas (vestibular schwannomas) comprise more than 90 per cent of all cerebello-pontine angle (CPA) lesions.
  • [MeSH-major] Cerebellar Neoplasms / pathology. Cerebellopontine Angle / blood supply. Intracranial Aneurysm / pathology. Neuroma, Acoustic / pathology
  • [MeSH-minor] Aged. Female. Humans. Magnetic Resonance Imaging / methods. Pulmonary Disease, Chronic Obstructive / complications. Pulmonary Disease, Chronic Obstructive / radiography. Tomography, X-Ray Computed / methods

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  • (PMID = 16917985.001).
  • [ISSN] 0022-2151
  • [Journal-full-title] The Journal of laryngology and otology
  • [ISO-abbreviation] J Laryngol Otol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 18
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92. Schwager K, Baier G, Helms J, Hagen R: [Results in otosurgically treated patients with acoustic neuroma. Part 2: Hearing results after middle fossa approach]. Laryngorhinootologie; 2008 Sep;87(9):629-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Results in otosurgically treated patients with acoustic neuroma. Part 2: Hearing results after middle fossa approach].
  • [Transliterated title] Ergebnisse otochirurgisch operierter Patienten mit Akustikusneurinom. Teil 2: Hörergebnisse nach transtemporaler Resektion.
  • BACKGROUND: The surgical therapy of acoustic neuromas has been seen critically lately.
  • There was no difference between tumors confined to the inner ear canal and tumors extending into the cerebello pontine angle.
  • There was also no difference between tumors up to a volume of 100 mm3 and tumors between 100 mm3 and 500 mm3.
  • CONCLUSION: Acoustic neuroma confined to the internal meatus or with little extend into the cerebello pontine angle (i. e. no contact to structures of the brain stem or vessels of the posterior fossa) are feasible for resection via the middle fossa approach.
  • The possibility of hearing preservation and low morbidity makes it the treatment of choice for this group of tumors.
  • [MeSH-major] Hearing / physiology. Neuroma, Acoustic / surgery

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  • (PMID = 18421644.001).
  • [ISSN] 0935-8943
  • [Journal-full-title] Laryngo- rhino- otologie
  • [ISO-abbreviation] Laryngorhinootologie
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Germany
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93. Hamann C, Rudolf J, von Specht H, Freigang B: [Vestibular evoked muscle potentials dependency on neural origin and the location of an acoustic neuroma]. HNO; 2005 Aug;53(8):690-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Vestibular evoked muscle potentials dependency on neural origin and the location of an acoustic neuroma].
  • INTRODUCTION: Most acoustic neuromas (AN) originate from the inferior vestibular nerve (IVN).
  • Vestibular evoked myogenic potentials (VEMP) are accepted as the only unilateral test for the function of the sacculus and the IVN.
  • METHODS: The influence of the origin from the IVN and superior vestibular nerve (SVN), and the position of the AN in relation to the internal auditory canal on VEMPs was investigated.
  • [MeSH-major] Acoustic Stimulation / methods. Evoked Potentials, Auditory. Neuroma, Acoustic / diagnosis. Vestibular Function Tests / methods. Vestibulocochlear Nerve Diseases / diagnosis

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  • [Cites] HNO. 2003 Apr;51(4):284-95 [12682730.001]
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  • (PMID = 15558221.001).
  • [ISSN] 0017-6192
  • [Journal-full-title] HNO
  • [ISO-abbreviation] HNO
  • [Language] ger
  • [Publication-type] Clinical Trial; English Abstract; Journal Article
  • [Publication-country] Germany
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94. Kurowska-Mroczek E, Zabek M, Osuch B, Stelmachów J: Therapeutic management of acoustic neurinoma during twin pregnancy: a case report. J Reprod Med; 2009 Jun;54(6):393-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Therapeutic management of acoustic neurinoma during twin pregnancy: a case report.
  • BACKGROUND: Acoustic neuromas belong to relatively rare illnesses in pregnant women.
  • Magnetic resonance imaging showed a vestibular acoustic neuroma of cranial nerve VII on the right side.
  • On the 14th postoperative day a team of neurosurgeons performed a right suboccipital craniectomy and completely removed the tumor.
  • CONCLUSION: The treatment of acoustic neuroma depends on the general health of a patient and the length of pregnancy.
  • If symptoms of intracranial compression quickly worsen, an immediate intervention is often required regardless of the pregnancy stage.
  • [MeSH-major] Neuroma, Acoustic / diagnosis. Neuroma, Acoustic / surgery. Pregnancy Complications, Neoplastic / diagnosis. Pregnancy Complications, Neoplastic / surgery. Pregnancy, Multiple

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  • (PMID = 19639930.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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95. 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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  • [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: 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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96. Kolagi S, Herur A, Ugale M, Manjula R, Mutalik A: Suboccipital retrosigmoid surgical approach for internal auditory canal--a morphometric anatomical study on dry human temporal bones. Indian J Otolaryngol Head Neck Surg; 2010 Oct;62(4):372-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Suboccipital retrosigmoid craniotomy with removal of posterior wall of internal auditory canal is preferred by many surgeons operating on acoustic neuromas, as it is a simple and safe approach.
  • The maximum distance found between bony orifice of vestibular aqueduct and IAC was 14 mm and the minimum distance was 6 mm.The vertical diameter of IAC ranged between 3 and 7 mm.

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  • (PMID = 22319695.001).
  • [ISSN] 0973-7707
  • [Journal-full-title] Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India
  • [ISO-abbreviation] Indian J Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Other-IDs] NLM/ PMC3266090
  • [Keywords] NOTNLM ; Acoustic neuroma / Human temporal bones / Internal auditory canal / Retrosigmoid approach
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97. Benech F, Perez R, Fontanella MM, Morra B, Albera R, Ducati A: Cystic versus solid vestibular schwannomas: a series of 80 grade III-IV patients. Neurosurg Rev; 2005 Jul;28(3):209-13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cystic versus solid vestibular schwannomas: a series of 80 grade III-IV patients.
  • Cystic acoustic neuromas are less frequent than solid ones and present different clinical and radiological features.
  • Cystic schwannomas are larger, show a shorter clinical history and a different risk of postoperative complications.
  • This study was designed to compare surgical results and complications of solid and cystic vestibular schwannomas of matching size operated upon via either a retrosygmoid or a translabyrinthine approach.
  • The study included 80 patients presenting with grade III and IV acoustic vestibular schwannomas referred to the Neurosurgical and ENT team in the Department of Neuroscience of Torino, Italy.
  • In cystic tumors, rapid clinical worsening is common, due to sudden expansion of cystic elements.
  • Tighter adherences are found between cystic tumours and nervous elements (particularly brainstem and possibly facial nerve), once compared to solid ones.
  • Careful technique, possibly sharp dissection, to divide the tumour adherences from the nervous tissue must be employed, in order to avoid lesions on brainstem veins and traction on a thin facial nerve.
  • [MeSH-minor] Adult. Aged. Connective Tissue / pathology. Connective Tissue / surgery. Female. Humans. Immunohistochemistry. Male. Microsurgery. Middle Aged. Neoplasm Recurrence, Local. Pituitary Hormones / deficiency

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  • (PMID = 15739069.001).
  • [ISSN] 0344-5607
  • [Journal-full-title] Neurosurgical review
  • [ISO-abbreviation] Neurosurg Rev
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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98. Savage J, Cook S, Wadell A: Tinnitus. BMJ Clin Evid; 2007;2007
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Tinnitus can be associated with hearing loss, acoustic neuromas, drug toxicity, ear diseases, and depression.

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  • (PMID = 19454115.001).
  • [ISSN] 1752-8526
  • [Journal-full-title] BMJ clinical evidence
  • [ISO-abbreviation] BMJ Clin Evid
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
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99. Mostafa BE, El Sharnoubi M, Youssef AM: The keyhole retrosigmoid approach to the cerebello-pontine angle: indications, technical modifications, and results. Skull Base; 2008 Nov;18(6):371-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The pathologies included were 60 acoustic neuromas, 28 vestibular neurectomies, nine meningiomas, and four arachnoid cysts.
  • For nonmass lesions, no additional facial nerve injury or deterioration of hearing occurred.
  • Facial nerve integrity was preserved in 92.3% of cases with mass lesions and permanent facial paralysis occurred in 8.3%.

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  • (PMID = 19412406.001).
  • [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/ PMC2637069
  • [Keywords] NOTNLM ; Retrosigmoid approach / acoustic neuromas / microvascular decompression / vestibular neurectomy
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100. Schwartz MS, Otto SR, Shannon RV, Hitselberger WE, Brackmann DE: Auditory brainstem implants. Neurotherapeutics; 2008 Jan;5(1):128-36
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The hallmark of this genetic disorder is the development of bilateral acoustic neuromas, the growth or removal of which causes deafness in most patients.
  • We describe the development, use, and results of the auditory brainstem implant (ABI), which is typically implanted via craniotomy at the time of tumor removal.
  • [MeSH-major] Auditory Brain Stem Implants. Brain Stem / physiopathology. Brain Stem / surgery. Neurofibromatosis 2 / therapy
  • [MeSH-minor] Acoustic Stimulation. Electric Stimulation / instrumentation. Electric Stimulation / methods. Humans. Speech Perception / physiology

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  • (PMID = 18164492.001).
  • [ISSN] 1933-7213
  • [Journal-full-title] Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics
  • [ISO-abbreviation] Neurotherapeutics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 26
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