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Bourhila C, Cotrutz C, Daniel RT, George M, Schiappacasse L, Patin D, Levivier M, Tuleasca C. Stereotactic radio-neurosurgery for jugular foramen schwannomas. Acta Neurochir (Wien) 2024; 166:348. [PMID: 39177697 PMCID: PMC11343977 DOI: 10.1007/s00701-024-06211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/18/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Stereotactic radiosurgery (SRS) represents a minimally invasive and valuable alternative for jugular foramen schwannomas (JFS), both as upfront and/or adjuvant treatment (in hybrid approaches). METHODS We conducted a retrospective review of our cases treated at the Lausanne University Hospital (CHUV) from June 2010 to October 2023. Eleven patients underwent SRS, among whom three had prior surgery, two in our center in the frame of a planned combined approach and one in another center. Two patients received "volume-staged" SRS. The mean age at SRS was 60 years (median 68; range 29-83). Cranial nerve (CN) symptoms were present in six patients, while five were asymptomatic. The mean tumor volume at SRS was 2.1 cc (median 1.2; range 0.068-7.3 cc), with a 12 Gy marginal dose prescribed in all cases. RESULTS The mean follow-up period was 3.9 years (median 2, range 1-7). Cranial nerve function improved after SRS in six patients, while five remained stable. At the last follow-up, all tumors showed a decrease in volume, except for one patient, who underwent surgery at 18 months after SRS, for volumetric increase at 6 and 12 months, with further XII-th CN palsy and medulla oblongata compression. Although tumor decreased at 18 months, such patient needed microsurgical resection for symptom persistence and was further controlled. The mean tumor volume at 1 year post-SRS was 1.6 cc (median 0.55; range 0.028-7.77 cc), at 2 years was 1.31 cc (median 0.76; range 0.19-5), and at 3 years was 1.32 cc (median 0.59; range 0.23-4.8). No adverse radiation events were observed. CONCLUSIONS Stereotactic radiosurgery is considered a safe and effective treatment for jugular foramen schwannomas, ensuring high rates of tumor control in all patients over the long term. The cranial nerve function improved after SRS in the 6 patients who had deficits and the other 5 patients who had no deficits remained asymptomatic. For larger tumors, combined/hybrid approaches can be a valuable alternative, to obtain tumor control and to preserve neurological function.
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Affiliation(s)
- Camil Bourhila
- Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland.
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.
| | - Cristian Cotrutz
- Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Roy Thomas Daniel
- Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Mercy George
- ENT Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Luis Schiappacasse
- Radiation Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - David Patin
- Institute of Radiation Physics, Lausanne, Switzerland
| | - Marc Levivier
- Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Constantin Tuleasca
- Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
- Ecole Polytechnique Fédérale de Lausanne (EPFL, LTS-5), Lausanne, Switzerland
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Carlstrom LP, Bauman MMJ, Oushy S, Perry A, Brown PD, Peris-Celda M, Van Gompel JJ, Graffeo CS, Link MJ. Lower Cranial Nerve Schwannomas: Cohort Study and Systematic Review. Neurosurgery 2024; 94:745-755. [PMID: 37874134 DOI: 10.1227/neu.0000000000002735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/10/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Schwannomas originating from the lower cranial nerves (LCNS) are rare and pose a significant surgical challenge. Resection is the mainstay treatment; however, risk of treatment morbidity is considerable, and the available literature regarding differential treatment outcomes in this vulnerable population is sparse. METHODS A single-institution cohort study and systematic literature review of LCNS were performed. RESULTS Fifty-eight patients were included: 34 underwent surgical resection and 24 underwent stereotactic radiosurgery (SRS). The median age at diagnosis was 48 years (range 17-74). Presenting symptoms were dysphagia (63%), dysarthria/hypophonia (47%), imbalance (33%), and hearing loss/tinnitus (30%). Tumor size was associated with surgical resection, as compared with initial SRS (4.1 cm vs 1.5 cm, P = .0001). Gross total resection was obtained in 52%, with tumor remnants predominantly localized to the jugular foramen (62%). Post-treatment worsening of symptoms occurred in 68% of surgical and 29% of SRS patients ( P = .003). Postoperative symptoms were mostly commonly hypophonia/hoarseness (63%) and dysphagia (59%). Seven patients (29%) had new neurological issues after SRS treatment, but symptoms were overall milder. The median follow-up was 60 months (range 12-252); 98% demonstrated meaningful clinical improvement. Eighteen surgical patients (53%) underwent adjuvant radiation at a median of 5 months after resection (range 2-32). At follow-up, tumor control was 97% in the surgical cohort and 96% among SRS patients. CONCLUSION Although LCNS resection is potentially morbid, most postoperative deficits are transient, and patients achieve excellent tumor control-particularly when paired with adjuvant SRS. For minimally symptomatic patients undergoing surgical intervention, we advise maximally safe resection with intracapsular dissection to preserve nerve integrity where possible. For residual or as a primary treatment modality, SRS is associated with low morbidity and high rates of long-term tumor control.
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Affiliation(s)
- Lucas P Carlstrom
- Department of Neurosurgery, Mayo Clinic, Rochester , Minnesota , USA
| | - Megan M J Bauman
- Department of Neurosurgery, Mayo Clinic, Rochester , Minnesota , USA
| | - Soliman Oushy
- Department of Neurosurgery, Mayo Clinic, Rochester , Minnesota , USA
| | - Avital Perry
- Department of Neurosurgery, Sheba Medical Center, Tel Aviv , Israel
| | - Paul D Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester , Minnesota , USA
| | - Maria Peris-Celda
- Department of Neurosurgery, Mayo Clinic, Rochester , Minnesota , USA
- Department of Otolaryngology, Mayo Clinic, Rochester , Minnesota , USA
| | - Jamie J Van Gompel
- Department of Neurosurgery, Mayo Clinic, Rochester , Minnesota , USA
- Department of Otolaryngology, Mayo Clinic, Rochester , Minnesota , USA
| | | | - Michael J Link
- Department of Neurosurgery, Mayo Clinic, Rochester , Minnesota , USA
- Department of Otolaryngology, Mayo Clinic, Rochester , Minnesota , USA
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Early-onset adverse events after stereotactic radiosurgery for jugular foramen schwannoma: a mid-term follow-up single-center review of 46 cases. Radiat Oncol 2022; 17:89. [PMID: 35525985 PMCID: PMC9077941 DOI: 10.1186/s13014-022-02057-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Recently, stereotacitc radiosurgery (SRS) has been in the spotlight as an alternative therapeutic option for jugular foramen schwannomas (JFS). While most reported studies focus on the long-term efficacy and safety issues of SRS, none describe the early-onset adverse events (eAEs). We aimed to investigate the incidence, clinical characteristics, and mid-term outcomes of eAEs occurring within six months after SRS for JFS. Methods In this retrospective review, patients who underwent at least six months of follow-up were included among all patients with JFS who have performed SRS at our institution between July 2008 and November 2019. And eAEs were defined as a newly developed neurological deficit or aggravation of pre-existing symptoms during the first six months after SRS. Results Forty-six patients were included in the analysis. The median follow-up period was 50 months (range 9–136). The overall tumor control rate was 91.3%, and the actuarial 3-, 5-, and 10-year progression-free survival rates were 97.8%, 93.8%, and 76.9%, respectively. Of the 46 patients, 16 had eAEs, and the median time to onset of eAEs was one month (range 1–6 months), and the predominant symptoms were lower cranial nerve dysfunctions. Thirteen of 16 patients showed improved eAE symptoms during the follow-up period, and the median resolution time was six months (range 1–52). In 11 (68.8%) of 16 patients with eAEs, transient expansions were observed with a mean of 3.6 months after the onset of eAEs, and the mean difference between the initial tumor volume and the transient expansion volume was more prominent in the patients with eAEs (3.2 cm3 vs. 1.0 cm3; p = 0.057). In univariate analysis, dumbbell-shaped tumors (OR 10.56; p = 0.004) and initial tumor volume (OR 1.32; p = 0.033) were significantly associated with the occurrence of eAEs. Conclusions Although acute adverse events after SRS for JFS are not rare, these acute effects were not permanent and mostly improved with the steroid treatment. Dumbell-shaped and large-volume tumors are significant predictive factors for the occurrence of eAEs. And the transient expansion also seems to be closely related to eAEs. Therefore, clinicians need to be more cautious when treating these patients and closely monitor the occurrence of eAEs.
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Kawashima M, Hasegawa H, Shin M, Shinya Y, Saito N. Intratumoral hemorrhage in jugular foramen schwannoma after stereotactic radiosurgery: A case report. Surg Neurol Int 2021; 12:479. [PMID: 34754529 PMCID: PMC8571193 DOI: 10.25259/sni_550_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Clinically significant intratumoral hemorrhage is a rare complication of stereotactic radiosurgery (SRS) for benign tumors. Case Description: Here, we present the case of a 64-year-old man who underwent SRS for a relatively large dumbbell-shaped left jugular foramen schwannoma (JFS) and thereafter developed intratumoral hemorrhage. On post-SRS day 3, he developed lower cranial nerve palsies with radiographically evident tumor expansion. His neurological conditions had gradually improved thereafter; however, he suddenly developed headache, dizziness, and mild hearing deterioration at 7 months due to intratumoral hemorrhage. We managed the patient conservatively, and eventually, his symptoms improved except for slight ataxia and hearing deterioration. Follow-up images at 4 years from SRS demonstrated significant tumor shrinkage. This is the first report describing intratumoral hemorrhage after SRS for JFS. Conclusion: Transient expansion of the tumor and subsequent venous stasis around the tumor may have played a role in the hemorrhage. Intratumoral hemorrhage should be considered as a rare, but potential complication of SRS for JFSs.
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Affiliation(s)
- Mariko Kawashima
- Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan
| | - Hirotaka Hasegawa
- Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan
| | - Masahiro Shin
- Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan
| | - Yuki Shinya
- Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan
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Kano H, Meola A, Yang HC, Guo WY, Martínez-Alvarez R, Martínez-Moreno N, Urgosik D, Liscak R, Cohen-Inbar O, Sheehan J, Lee JYK, Abbassy M, Barnett GH, Mathieu D, Kondziolka D, Lunsford LD. Stereotactic radiosurgery for jugular foramen schwannomas: an international multicenter study. J Neurosurg 2018; 129:928-936. [DOI: 10.3171/2017.5.jns162894] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEFor some jugular foramen schwannomas (JFSs), complete resection is possible but may be associated with significant morbidity. Stereotactic radiosurgery (SRS) is a minimally invasive alternative or adjunct to microsurgery for JFSs. The authors reviewed clinical and imaging outcomes of SRS for patients with these tumors.METHODSNine participating centers of the International Gamma Knife Research Foundation identified 92 patients who underwent SRS between 1990 and 2013. Forty-one patients had prior subtotal microsurgical resection. The median interval between previous surgery and SRS was 15 months (range 0.5–144 months). Eighty-four patients had preexisting cranial nerve (CN) symptoms and signs. The median tumor volume was 4.1 cm3 (range 0.8–22.6 cm3), and the median margin dose was 12.5 Gy (range 10–18 Gy). Patients with neurofibromatosis were excluded from this study.RESULTSThe median follow-up was 51 months (range 6–266 months). Tumors regressed in 47 patients, remained stable in 33, and progressed in 12. The progression-free survival (PFS) was 93% at 3 years, 87% at 5 years, and 82% at 10 years. In the entire series, only a dumbbell shape (extension extracranially via the jugular foramen) was significantly associated with worse PFS. In the group of patients without prior microsurgery (n = 51), factors associated with better PFS included tumor volume < 6 cm3 (p = 0.037) and non–dumbbell-shaped tumors (p = 0.015). Preexisting cranial neuropathies improved in 27 patients, remained stable in 51, and worsened in 14. The CN function improved after SRS in 12% of patients at 1 year, 24% at 2 years, 27% at 3 years, and 32% at 5 years. Symptomatic adverse radiation effects occurred in 7 patients at a median of 7 months after SRS (range 5–38 months). Six patients underwent repeat SRS at a median of 64 months (range 44–134 months). Four patients underwent resection at a median of 14 months after SRS (range 8–30 months).CONCLUSIONSStereotactic radiosurgery proved to be a safe and effective primary or adjuvant management approach for JFSs. Long-term tumor control rates and stability or improvement in CN function were confirmed.
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Affiliation(s)
- Hideyuki Kano
- 1Department of Neurological Surgery, Center for Image-guided Neurosurgery, University of Pittsburgh, Pennsylvania
| | - Antonio Meola
- 1Department of Neurological Surgery, Center for Image-guided Neurosurgery, University of Pittsburgh, Pennsylvania
| | - Huai-che Yang
- 2Departments of Radiation Oncology and Neurological Surgery, Taipei Veterans Hospital, Taipei, Taiwan
| | - Wan-Yuo Guo
- 2Departments of Radiation Oncology and Neurological Surgery, Taipei Veterans Hospital, Taipei, Taiwan
| | | | | | - Dusan Urgosik
- 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
| | - Roman Liscak
- 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
| | - Or Cohen-Inbar
- 5Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia
| | - Jason Sheehan
- 5Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia
| | - John Y. K. Lee
- 6Department of Neurological Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mahmoud Abbassy
- 7Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Gene H. Barnett
- 7Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio
| | - David Mathieu
- 8Université de Sherbrooke, Centre de Recherche Clinique Étienne-LeBel, Sherbrooke, Quebec, Canada; and
| | | | - L. Dade Lunsford
- 1Department of Neurological Surgery, Center for Image-guided Neurosurgery, University of Pittsburgh, Pennsylvania
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Langlois AM, Iorio-Morin C, Masson-Côté L, Mathieu D. Gamma Knife Stereotactic Radiosurgery for Nonvestibular Cranial Nerve Schwannomas. World Neurosurg 2017; 110:e1031-e1039. [PMID: 29223524 DOI: 10.1016/j.wneu.2017.11.163] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 11/26/2017] [Accepted: 11/28/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nonvestibular cranial schwannomas represent a rare type of benign intracranial tumor. Few studies have evaluated the use of stereotactic radiosurgery (SRS) as a primary management option for these lesions. We performed a retrospective review of our institution's experience focusing on efficacy with regard to tumor control and clinical symptom stabilization as well as treatment safety. METHODS Patients were included if they underwent at least 1 SRS procedure for a nonvestibular schwannoma and had at least 6 months of available imaging follow-up. Demographic, SRS dose planning, clinical, and imaging data were collected from chart reviews of treated patients. χ2 and Kaplan-Meier analyses were performed. RESULTS Between 2004 and 2016, 35 schwannomas were treated in 34 patients. Median follow-up was 48 months. Median age at time of treatment was 51 years. Three patients had neurofibromatosis 2. Schwannoma location was trigeminal (57%), facial (20%), jugular foramen (14%), abducens (6%), and trochlear (3%). Median margin dose delivered was 13 Gy. The 5-year and 10-year tumor control rates were 94.4% and 88.5%, respectively. Presenting clinical symptoms stabilized or improved in 79% of cases after radiosurgery, and new or worsening symptoms were seen in 21%. CONCLUSIONS SRS is a safe and effective modality for treatment of nonvestibular cranial nerve schwannomas.
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Affiliation(s)
- Anne-Marie Langlois
- Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christian Iorio-Morin
- Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Laurence Masson-Côté
- Department of Radiation-Oncology, Université de Sherbrooke, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - David Mathieu
- Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.
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Zeng XJ, Li D, Hao SY, Wang L, Tang J, Xiao XR, Meng GL, Jia GJ, Zhang LW, Wu Z, Zhang JT. Long-Term Functional and Recurrence Outcomes of Surgically Treated Jugular Foramen Schwannomas: A 20-Year Experience. World Neurosurg 2016; 86:134-46. [DOI: 10.1016/j.wneu.2015.09.104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/26/2015] [Accepted: 09/28/2015] [Indexed: 11/30/2022]
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Hasegawa T, Kato T, Kida Y, Sasaki A, Iwai Y, Kondoh T, Tsugawa T, Sato M, Sato M, Nagano O, Nakaya K, Nakazaki K, Kano T, Hasui K, Nagatomo Y, Yasuda S, Moriki A, Serizawa T, Osano S, Inoue A. Gamma Knife surgery for patients with jugular foramen schwannomas: a multiinstitutional retrospective study in Japan. J Neurosurg 2016; 125:822-831. [PMID: 26799304 DOI: 10.3171/2015.8.jns151156] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to explore the efficacy and safety of stereotactic radiosurgery in patients with jugular foramen schwannomas (JFSs). METHODS This study was a multiinstitutional retrospective analysis of 117 patients with JFSs who were treated with Gamma Knife surgery (GKS) at 18 medical centers of the Japan Leksell Gamma Knife Society. The median age of the patients was 53 years. Fifty-six patients underwent GKS as their initial treatment, while 61 patients had previously undergone resection. At the time of GKS, 46 patients (39%) had hoarseness, 45 (38%) had hearing disturbances, and 43 (36%) had swallowing disturbances. Eighty-five tumors (73%) were solid, and 32 (27%) had cystic components. The median tumor volume was 4.9 cm3, and the median prescription dose administered to the tumor margin was 12 Gy. Five patients were treated with fractionated GKS and maximum and marginal doses of 42 and 21 Gy, respectively, using a 3-fraction schedule. RESULTS The median follow-up period was 52 months. The last follow-up images showed partial remission in 62 patients (53%), stable tumors in 42 patients (36%), and tumor progression in 13 patients (11%). The actuarial 3- and 5-year progression-free survival (PFS) rates were 91% and 89%, respectively. The multivariate analysis showed that pre-GKS brainstem edema and dumbbell-shaped tumors significantly affected PFS. During the follow-up period, 20 patients (17%) developed some degree of symptomatic deterioration. This condition was transient in 12 (10%) of these patients and persistent in 8 patients (7%). The cause of the persistent deterioration was tumor progression in 4 patients (3%) and adverse radiation effects in 4 patients (3%), including 2 patients with hearing deterioration, 1 patient with swallowing disturbance, and 1 patient with hearing deterioration and hypoglossal nerve palsy. However, the preexisting hoarseness and swallowing disturbances improved in 66% and 63% of the patients, respectively. CONCLUSIONS GKS resulted in good tumor control in patients with either primary or residual JFSs. Although some patients experienced some degree of symptomatic deterioration after treatment, persistent adverse radiation effects were seen in only 3% of the entire series at the last follow-up. Lower cranial nerve deficits were extremely rare adverse radiation effects, and preexisting hoarseness and swallowing disturbances improved in two-thirds of patients. These results indicated that GKS was a safe and reasonable alternative to surgical resection in selected patients with JFSs.
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Affiliation(s)
| | - Takenori Kato
- Department of Neurosurgery, Komaki City Hospital, Komaki
| | - Yoshihisa Kida
- Department of Neurosurgery, Kamiiida Daiichi General Hospital, Nagoya
| | - Ayaka Sasaki
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka
| | | | | | - Manabu Sato
- Department of Neurosurgery, Rakusai Shimizu Hospital, Kyoto
| | - Mitsuya Sato
- Department of Neurosurgery, Kitanihon Neurosurgical Hospital, Gosen
| | - Osamu Nagano
- Department of Neurosurgery, Chiba Cerebral and Cardiovascular Center, Ichihara
| | - Kotaro Nakaya
- Department of Neurosurgery, Atami Tokoro Memorial Hospital, Atami
| | - Kiyoshi Nakazaki
- Department of Neurosurgery, Brain Attack Center, Ota Memorial Hospital, Fukuyama
| | - Tadashige Kano
- Department of Neurosurgery, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Isesaki
| | - Koichi Hasui
- Department of Neurosurgery, Okamura Isshindow Hospital, Okayama
| | | | | | | | - Toru Serizawa
- Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo
| | - Seiki Osano
- Department of Neurosurgery, Shonan Fujisawa Tokushukai Hospital, Fujisawa; and
| | - Akira Inoue
- Department of Neurosurgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
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Wang Z, Chen H, Huang Q, Zhang Z, Yang J, Wu H. Facial and lower cranial nerve function preservation in lateral approach for craniocervical schwannomas. Eur Arch Otorhinolaryngol 2014; 272:2207-12. [DOI: 10.1007/s00405-014-3127-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 05/23/2014] [Indexed: 11/28/2022]
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Abstract
This article summarizes tumor control and functional outcomes of stereotactic radiosurgery (SRS) for patients with nonvestibular schwannomas, in comparison with those treated with microsurgical resection. To date, surgical resection has been a common treatment for nonvestibular schwannomas. Because these tumors are generally benign, complete tumor resection is a desirable curative treatment. However, it is almost infeasible to completely remove these tumors without any complications, even for experienced neurosurgeons, because of adherence to surrounding critical structures such as cranial nerves, brainstem, or vessels. SRS provides a good tumor control rate with much less morbidity than microsurgical resection.
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Affiliation(s)
- Toshinori Hasegawa
- Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, 1-20 Jobushi, Komaki, Aichi Prefecture 485-8520, Japan.
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