Skip to main content
Erschienen in: Journal of Neuro-Oncology 1/2009

Open Access 01.05.2009 | Topic Review

Facial nerve preservation after vestibular schwannoma Gamma Knife radiosurgery

verfasst von: Isaac Yang, Michael E. Sughrue, Seunggu J. Han, Shanna Fang, Derick Aranda, Steven W. Cheung, Lawrence H. Pitts, Andrew T. Parsa

Erschienen in: Journal of Neuro-Oncology | Ausgabe 1/2009

Abstract

Objective Facial nerve preservation is a critical measure of clinical outcome after vestibular schwannoma treatment. Gamma Knife radiosurgery has evolved into a practical treatment modality for vestibular schwannoma patients, with several reported series from a variety of centers. In this study, we report the results of an objective analysis of reported facial nerve outcomes after the treatment of vestibular schwannomas with Gamma Knife radiosurgery. Materials and methods A Boolean Pub Med search of the English language literature revealed a total of 23 published studies reporting assessable and quantifiable outcome data regarding facial nerve function in 2,204 patients who were treated with Gamma Knife radiosurgery for vestibular schwannoma. Inclusion criteria for articles were: (1) Facial nerve preservation rates were reported specifically for vestibular schwannoma, (2) Facial nerve functional outcome was reported using the House–Brackmann classification (HBC) for facial nerve function, (3) Tumor size was documented, and (4) Gamma Knife radiosurgery was the only radiosurgical modality used in the report. The data were then aggregated and analyzed based on radiation doses delivered, tumor volume, and patient age. Results An overall facial nerve preservation rate of 96.2% was found after Gamma Knife radiosurgery for vestibular schwannoma in our analysis. Patients receiving less than or equal to 13 Gy of radiation at the marginal dose had a better facial nerve preservation rate than those who received higher doses (≤13 Gy = 98.5% vs. >13 Gy = 94.7%, P < 0.0001). Patients with a tumor volume less than or equal to 1.5 cm3 also had a greater facial nerve preservation rate than patients with tumors greater than 1.5 cm3 (≤1.5 cm3 99.5% vs. >1.5 cm3 95.5%, P < 0.0001). Superior facial nerve preservation was also noted in patients younger than or equal to 60 years of age (96.8 vs. 89.4%, P < 0.0001). The average reported follow up duration in this systematic review was 54.1 ± 31.3 months. Conclusion Our analysis of case series data aggregated from multiple centers suggests that a facial nerve preservation rate of 96.2% can be expected after Gamma knife radiosurgery for vestibular schwannoma. Younger patients with smaller tumors less than 1.5 cm3 and treated with lower doses of radiation less than 13 Gy will likely have better facial nerve preservation rates after Gamma Knife radiosurgery for vestibular schwannoma.

Introduction

Gamma Knife radiosurgery (GKRS) has evolved into a practical alternative treatment to open microsurgical resection of vestibular schwannoma (VS) [130]. GKRS as a treatment modality for VS typically does not require inpatient hospitalization, however acute and chronic complications can occur [3133]. In particular, radiation toxicity of neuro-anatomic structures adjacent to the tumor may develop and manifest as impaired function of the facial nerve, hearing loss, or loss of equilibrium and balance. [14, 16, 17, 23, 27, 30, 3441]. Hydrocephalus, cerebral edema, and other cranial neuropathies have also been documented after GKRS, and in some reported cases required shunting as a treatment for hydrocephalus [4, 23, 37, 4249].
Despite the available data on facial nerve outcome in VS patients treated with GKRS, there is no consensus as to what reported clinical parameters relate to facial nerve function. Most reported studies to date have been small to modest in size, frequently from a single institution, and lacking the statistical power and freedom from potential practitioner bias to draw concrete conclusions. Our review of the literature revealed widely varying results with reported facial nerve preservation between 55 and 100% after GKRS for VS (Table 1). Due to these factors and the multitude of methods to assess facial nerve preservation in the reported literature, facial nerve preservation after GKRS has not yet been fully characterized.
Table 1
Data summary from papers listed by Pub Med ID and institution
PubMed ID
 
Total sample
CN VII intact
Avg age
Avg dose (Gy)
Avg tumor volume (cm3)
Tumor ctrl rate (%)
Avg follow up (mo.)
CN VII preservation (%)
17379451
University of Pittsburgh
216
215
56.5
13.0
1.300
98.30
68.4
100.0
16741754
Ludwig Maximilians University
123
121
59
13.0
1.600
96.70
98.4
100.0
16094154
Komaki City Hospital
317
291
54
13.2
5.600
92.00
93.6
96.4
15854240
Haukeland University Hospital, Norway
103
102
59.7
12.2
 
89.20
70.8
94.8
15662791
Inst of Neural Org, Japan
18
9
15.200
93.33
72.0
100.0
15662787
Taipei Veterans Gen Hosp and Natl Yang Ming University
195
135
51
13.0
4.100
95.00
36.0
100.0
15354007
Medical College of Wisconsin
29
25
13.5
 
96.55
100.0
15337560
University of Pittsburgh
313
313
56
13.0
1.100
98.60
24.0
100.0
14617712
Royal Hallamshire Hospital, UK
232
179
56
14.6
3.350
92.00
35.0
99.1
14609174
Gunma Univ Sch of Med, Japan
1
1
63
12.0
0.520
0.00
27.0
0.0
14571654
Hospital Academique Erasme, Belgium
48
42
54.8
12.3
1.440
97.92
12.0
97.9
14519213
University of Pittsburgh
157
124
60
16.7
96.90
109.2
95.0
12520350
Addenbrooke’s Hospital, England
5
5
29
0.00
80.0
12459364
Baylor memorial Hermann Hospital
72
58
61.6
14.5
 
91.00
48.0
97.4
12379008
Karl-Franzens University, Graz, Austria
60
52
58
13.0
3.400
96.00
76.0
85.0
11483338
Thomas Jefferson Univ Hosp, PA
69
57
61
12.0
2.920
98.00
119.0
98.0
11143268
University of Tokyo
1
1
25
14.0
0.180
100.00
60.0
100.0
10821551
Northwestern Hospital
9
9
39
19.6
 
74.00
55.6
10030254
Mayo Clinic and Mayo Foundation [reduced protocol]
40
33
65
16.0
3.700
97.44
27.6
92.0
10030254
Mayo Clinic and Mayo Foundation [standard protocol]
42
35
63
3.000
97.44
27.6
62.0
9833820
Mayo Clinic/University of Pittsburgh
76
35
58
15.0
2.800
94.00
43.0
83.0
9392535
University of Tokyo
46
46
54
16.8
96.00
39.0
80.0
8588625
House Ear Clinic and House Ear Institute
1
1
39
0.00
24.0
100.0
7826279
University of Pittsburgh
31
19
55
0.600
90.00
26.0
95.0
Totals and Avg
 
2,204
1,908
55.3
13.1
3.2
82.5
54.1
96.2
Several potential factors affecting facial nerve preservation after GKRS have been suggested, including the dose of radiation delivered, tumor volume, and patient age. In this study, we performed an extensive review of the English Language literature to objectively analyze and methodically evaluate facial nerve outcomes of patients with VS treated with GKRS. The primary aims were to provide an objective summary of the published literature on facial nerve preservation and to evaluate specific prognostic factors that may influence facial nerve preservation after GKRS for VS.

Methodology

Article selection

Articles were identified via Boolean PubMed searches using key words “Gamma knife,” “radiosurgery,” “acoustic neuroma,” “facial nerve,” “vestibular schwannoma,” and “facial nerve preservation,” alone and in combination. This query identified 23 papers describing over 2,204 patients from which all quantifiable and assessable data regarding patients treated with radiosurgery were analyzed. Articles published up to and including the year 2007 were included in this analysis. Inclusion criteria for articles were: (1) Facial nerve preservation rates were reported specifically for VS before and after GKRS, (2) Facial nerve outcome was reported using the House–Brackmann classification (HBC) for facial nerve function [5, 5054], (3) Tumor size was documented, and (4) GKRS was the only radiation modality used to treat the tumor. The data were then aggregated and analyzed based on radiosurgery dose delivered, size of the tumor, and patient age.

Data extraction

Data from individual and aggregated cases were extracted from each paper. Cases with pre-operative facial dysfunction (HBC 3 or higher) were excluded. All recent cases of open microsurgery and radiotherapy other than GKRS were also excluded. “Facial nerve preservation” was defined as having a grade I or II HBC at the last reported follow-up visit. Overall average for facial preservation, patient age, and radiation dose were weighted accordingly to their sample size, so that larger and smaller series had an appropriate impact on the overall data. Data were analyzed as a whole and stratified into three groups. (1) Radiosurgery marginal dose ≤13 versus >13 Gy, (2) Tumor size ≤1.5 versus >1.5 cm3, and (3) Age ≤60 versus >60 years old.

Statistical analysis

The raw data were tabulated using Microsoft Excel (Microsoft Corp., Seattle, WA). All results were analyzed using a Fisher’s exact test or a t-test when appropriate for statistical evaluation of the data. For these statistical investigations, tests for significance were two sided, with a (two tailed) P-value threshold of 0.05 considered statistically significant. Unless otherwise stated, all continuous values presented were mean ± standard deviation or standard error of measurement when appropriate.

Results

Results of comprehensive analysis

A total of 23 articles involving 2,204 patients with 1,908 patients meeting our inclusion criteria, were evaluated [1, 2, 1113, 16, 17, 26, 41, 43, 44, 5577] (Table 1). The overall facial nerve functional preservation rate in patients with VS treated with GKRS reported in the included studies was 96.2%. The mean of the reported average age of the patients in this analysis was 55.3 years (±10.8; SEM ± 2.3) with an average of reported length of follow up duration of 54.1 months (±31.4 months). Median length of follow up time in this analysis was 43.0 months. In this systematic analysis, the average of the published radiation doses used to treat these patients was 13.1 ±2 Gy (SEM ± 0.4).

The effect of radiation dose on facial nerve preservation

A total of 1,038 reported patients were treated using an average marginal dose of ≤13 Gy, and 801 patients treated with an average marginal dose of >13 Gy. In this comparison, the group treated with lower dose radiosurgery (less than or equal to 13 Gy) had superior facial nerve preservation rates [≤13 Gy = 98.5% vs. >13 Gy = 94.7%, P < 0.0001 (Fig. 1)]. Improved facial nerve preservation with low dose Gamma Knife radiosurgery suggests that radiation dose is a significant prognostic factor for facial nerve preservation with Gamma Knife radiosurgery. Patients with improved facial nerve preservation with low dose GKRS maintained good tumor control rates of 96.7%.

The effect of volume on facial nerve preservation

A total of 591 reported patients in our analysis had an average tumor volume of 1.5 cm3 or less, and 947 patients had an average tumor volume of >1.5 cm3. The patients with the smaller tumors (measuring 1.5 cm3 or less) had superior facial nerve preservation rates than those with larger tumors [≤1.5 cm3 99.5% vs.  >1.5 cm3 95.5%, P < 0.0001 (Fig. 2)]. Smaller tumors were significantly associated with better facial nerve preservation after treatment with GKRS. The mean of the reported average radiation dose for smaller tumors was 12.9 ± 0.8 Gy which was less than the 13.7 ± 1.3 Gy that larger (>1.5 cm3) tumors received on average (P < 0.0001).

The effect of age on facial nerve preservation

A total of 1,690 patients were reported to have an average age equal to or younger than 60 years, and 184 patients were reported to be older than 60 years on average at the time of Gamma Knife radiosurgery. Facial nerve preservation was noted to be worse in patients older than 60 years of age [≤60 years = 96.8% vs. >60 years = 89.4%, P < 0.0001 (Fig. 3)]. Younger and older patients had similar tumor sizes (2.31 vs. 2.54 cm3) indicating that younger patient had improved facial nerve preservation despite tumor size. Furthermore older patients (>57 years old), treated with higher levels of radiation (>13 Gy) had significantly worse facial nerve outcomes than younger patient (<57 years old) treated with similarly higher radiation doses of greater than 13 Gy (P < 0.0010). Younger age may be an important prognostic factor for improved facial nerve preservations with GKRS for VS.

Discussion

Facial nerve preservation continues to be a primary concern of patients undergoing Gamma Knife radiosurgery for vestibular schwannomas. Despite the currently available data there have been few efforts to combine this research into accurate estimates of facial nerve preservation with GKRS for VS. In this study we performed a comprehensive analysis of facial nerve functional preservation in a large aggregated population of patients who underwent GKRS for vestibular schwannomas.
Our methodical analysis revealed that patients treated with a marginal dose of less than 13 Gy were more likely to preserve facial nerve function after GKRS treatment than studies that delivered higher doses of radiation. Higher doses of radiation are associated with higher rates of cranial nerve toxicity [67, 7881]. One possible reason for this is the significant amount of fibrosis within and around the vestibular schwannoma, involving the adjacent cochlear and facial nerves. This finding has been noted in surgical salvage after failed irradiation [82, 83]. Several recent studies have demonstrated that low dose radiosurgery has a favorable efficacy/toxicity ratio as compared to higher doses [4, 23, 40, 44, 48, 57, 61, 84]. In our analysis patients treated with lower dose Gamma Knife radiosurgery (<13 Gy) had superior facial nerve preservation rates [<13 Gy = 98.5% vs. >13 Gy = 94.7%, P < 0.0001 (Fig. 1)] with good tumor control rates of 96.7% at a reported average length of follow up duration of 54.1 months (Median 43.0 months).
In our objective analysis, patients with an average tumor volume of 1.5 cm3 or less had a better facial nerve preservation rate compared to studies with tumors of larger volumes [<1.5 cm3 99.5% vs. >1.5 cm3 95.5%, P < 0.0001 (Fig. 2)]. Smaller tumors had improved facial preservation rates and lower average radiation doses for smaller tumors (12.9 ± 0.8 Gy vs. 13.7 ± 1.3 Gy, P < 0.0001). This data suggests that both smaller tumor size and lower radiosurgery dose are important risk factors for facial nerve preservation with Gamma knife radiosurgery treatment. Although it appears that radiation dose is an important associated factor with facial nerve preservation, our data does not permit the discrimination between size or radiation dose as the more significant parameter for facial nerve preservation as both smaller tumors and lower radiation doses both had improved outcomes. Our data does not clarify this ambiguity about whether size or radiation dose has a more significant impact on facial nerve preservation.
Older patients commonly have medically related comorbidities which can preclude them from open brain surgery. Our analysis indicates that older patients with age >60 years had inferior facial nerve preservation rates than younger patients [<60 years = 96.8% vs. >60 years = 89.4%, P < 0.0001 (Fig. 3)]. Age may be an important prognostic factor for facial nerve preservation despite tumor size or radiation dose. Older patients had similar tumor sizes as younger patients (2.31 vs. 2.54 cm3). Advanced age does appear to be a negative prognostic factor in facial nerve preservation outcomes in patients treated with GKRS for VS. Furthermore older patients (>57 years old), treated with high levels of radiation (>13 Gy) had significantly worse facial nerve outcomes than younger patient (<57 years old) treated with similarly high radiation doses of greater than 13 Gy (P < 0.0010). Our data suggests that older age may be significantly associated with worse facial nerve preservation independent of radiation dose because older patients did worse with high radiation doses than their younger counterparts who also received high radiation doses (>13 Gy).
The various methods of data presentation reported in the papers for our systematic analysis precluded us from further investigation to stratify other statistically significant data points. Unfortunately actuarial time dependant data was not possible in our retrospective, systematic analysis as this is an inherent limitation in the methodology of our study. Similarly, multi-variable analysis and a logistic regression analysis are also problematic across multiple studies which adhere to differing formats of data presentation.
Prospective studies could further elucidate the actuarial nature of facial nerve preservation over time after GKRS and may also provide further insight into the exact relationship between the prognostic variables we investigated here and facial nerve preservation. Our systematic analysis is the first reported attempt to comprehensively evaluate the overall impact of GKRS for VS on facial nerve function as described in the published literature.
There are some inherent limitations with systematic reviews and analysis [85]. One obvious limitation is that any aggregation of data is only as good as its composite studies. The quality of the data reported in the literature, the effect of failure to detect, or unwillingness to report complications, and other such omissions would inevitably change and skew the result reported in our aggregated analysis. Furthermore, small sample size reports that met our inclusion criteria were also included in our analysis. Although their contribution is small, we mitigated the effect of case reports and small samples by analyzing an aggregated database and by weighting the appropriate contribution of each paper by the number of patients with facial nerve intact before GKRS accordingly. Hence in our analysis, smaller sample sizes and case reports had a proportionate effect on our overall aggregated facial nerve preservation data. However, the large nature of our systematic review minimizes the biases and dilutes the inherent error of any individual study in our comprehensive report and also has the advantage of expansive results from multiple international centers.
In conclusion, we report the results from a large aggregated analysis of facial nerve outcomes in patients with vestibular schwannoma treated specifically with Gamma Knife radiosurgery. Utilizing this systematic data set from the available published literature, minimizes the effect of bias and dilutes the inherent error from individual institutions, increases the statistical power of our analysis, and aggregates expansive results to determine an accurate and overall facial nerve preservation for patients treated with Gamma Knife radiosurgery for vestibular schwannomas. This systematic analysis suggests that radiation dose is an important and critical prognostic factor for facial nerve outcomes in VS patients treated with GKRS. Our data also confirms that patients treated with 13 Gy or less of radiation, with tumors less than 1.5 cm3 in size, and younger patients have improved facial nerve outcomes.

Acknowledgments

IY the first author was partially supported by a UCSF Clinical and Translational Scientist Training Research Award in performing this investigation. ATP senior author is partially funded by the Reza and Georgianna Khatib Endowed Chair in Skull Base Tumor Surgery.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
Open AccessThis is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License (https://​creativecommons.​org/​licenses/​by-nc/​2.​0), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Unsere Produktempfehlungen

e.Med Interdisziplinär

Kombi-Abonnement

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

© Springer Medizin

Bis 11. April 2024 bestellen und im ersten Jahr 50 % sparen!

e.Med Neurologie & Psychiatrie

Kombi-Abonnement

Mit e.Med Neurologie & Psychiatrie erhalten Sie Zugang zu CME-Fortbildungen der Fachgebiete, den Premium-Inhalten der dazugehörigen Fachzeitschriften, inklusive einer gedruckten Zeitschrift Ihrer Wahl.

© Springer Medizin

Bis 11. April 2024 bestellen und im ersten Jahr 50 % sparen!

e.Med Neurologie

Kombi-Abonnement

Mit e.Med Neurologie erhalten Sie Zugang zu CME-Fortbildungen des Fachgebietes, den Premium-Inhalten der neurologischen Fachzeitschriften, inklusive einer gedruckten Neurologie-Zeitschrift Ihrer Wahl.

© Springer Medizin

Bis 11. April 2024 bestellen und im ersten Jahr 50 % sparen!

Literatur
1.
Zurück zum Zitat Delbrouck C, Hassid S, Massager N, Choufani G, David P, Devriendt D, Levivier M (2003) Preservation of hearing in vestibular schwannomas treated by radiosurgery using Leksell Gamma Knife: preliminary report of a prospective Belgian clinical study. Acta Otorhinolaryngol Belg 57:197–204PubMed Delbrouck C, Hassid S, Massager N, Choufani G, David P, Devriendt D, Levivier M (2003) Preservation of hearing in vestibular schwannomas treated by radiosurgery using Leksell Gamma Knife: preliminary report of a prospective Belgian clinical study. Acta Otorhinolaryngol Belg 57:197–204PubMed
2.
Zurück zum Zitat Karpinos M, Teh BS, Zeck O, Carpenter LS, Phan C, Mai WY, Lu HH, Chiu JK, Butler EB, Gormley WB, Woo SY (2002) Treatment of acoustic neuroma: stereotactic radiosurgery vs. microsurgery. Int J Radiat Oncol Biol Phys 54:1410–1421. doi:10.1016/S0360-3016(02)03651-9 PubMed Karpinos M, Teh BS, Zeck O, Carpenter LS, Phan C, Mai WY, Lu HH, Chiu JK, Butler EB, Gormley WB, Woo SY (2002) Treatment of acoustic neuroma: stereotactic radiosurgery vs. microsurgery. Int J Radiat Oncol Biol Phys 54:1410–1421. doi:10.​1016/​S0360-3016(02)03651-9 PubMed
5.
Zurück zum Zitat Flickinger JC, Kondziolka D, Lunsford LD (1998) Clinical applications of stereotactic radiosurgery. Cancer Treat Res 93:283–297PubMed Flickinger JC, Kondziolka D, Lunsford LD (1998) Clinical applications of stereotactic radiosurgery. Cancer Treat Res 93:283–297PubMed
6.
Zurück zum Zitat Noren G (1998) Long-term complications following gamma knife radiosurgery of vestibular schwannomas. Stereotact Funct Neurosurg 70(Suppl 1):65–73. doi:10.1159/000056408 PubMed Noren G (1998) Long-term complications following gamma knife radiosurgery of vestibular schwannomas. Stereotact Funct Neurosurg 70(Suppl 1):65–73. doi:10.​1159/​000056408 PubMed
7.
Zurück zum Zitat Pellet W, Regis J, Roche PH, Delsanti C (2003) Relative indications for radiosurgery and microsurgery for acoustic schwannoma. Adv Tech Stand Neurosurg 28:227–282; discussion 282–284 Pellet W, Regis J, Roche PH, Delsanti C (2003) Relative indications for radiosurgery and microsurgery for acoustic schwannoma. Adv Tech Stand Neurosurg 28:227–282; discussion 282–284
9.
Zurück zum Zitat Regis J, Delsanti C, Roche P, Soumare O, Dufour H, Porcheron D, Peragut JC, Thomassin JM, Pellet W (2002) Preservation of hearing function in the radiosurgical treatment of unilateral vestibular schwannomas. Preliminary results. Neurochirurgie 48:471–478PubMed Regis J, Delsanti C, Roche P, Soumare O, Dufour H, Porcheron D, Peragut JC, Thomassin JM, Pellet W (2002) Preservation of hearing function in the radiosurgical treatment of unilateral vestibular schwannomas. Preliminary results. Neurochirurgie 48:471–478PubMed
10.
Zurück zum Zitat Regis J, Pellet W, Delsanti C, Dufour H, Roche PH, Thomassin JM, Zanaret M, Peragut JC (2002) Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas. J Neurosurg 97:1091–1100PubMed Regis J, Pellet W, Delsanti C, Dufour H, Roche PH, Thomassin JM, Zanaret M, Peragut JC (2002) Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas. J Neurosurg 97:1091–1100PubMed
11.
Zurück zum Zitat Unger F, Walch C, Papaefthymiou G, Feichtinger K, Trummer M, Pendl G (2002) Radiosurgery of residual and recurrent vestibular schwannomas. Acta Neurochir (Wien) 144:671–676; discussion 676–677 Unger F, Walch C, Papaefthymiou G, Feichtinger K, Trummer M, Pendl G (2002) Radiosurgery of residual and recurrent vestibular schwannomas. Acta Neurochir (Wien) 144:671–676; discussion 676–677
12.
Zurück zum Zitat Unger F, Walch C, Schrottner O, Eustacchio S, Sutter B, Pendl G (2002) Cranial nerve preservation after radiosurgery of vestibular schwannomas. Acta Neurochir Suppl (Wien) 84:77–83 Unger F, Walch C, Schrottner O, Eustacchio S, Sutter B, Pendl G (2002) Cranial nerve preservation after radiosurgery of vestibular schwannomas. Acta Neurochir Suppl (Wien) 84:77–83
13.
Zurück zum Zitat Unger F, Walch C, Haselsberger K, Papaefthymiou G, Trummer M, Eustacchio S, Pendl G (1999) Radiosurgery of vestibular schwannomas: a minimally invasive alternative to microsurgery. Acta Neurochir (Wien) 141:1281–1285; discussion 1285–1286 Unger F, Walch C, Haselsberger K, Papaefthymiou G, Trummer M, Eustacchio S, Pendl G (1999) Radiosurgery of vestibular schwannomas: a minimally invasive alternative to microsurgery. Acta Neurochir (Wien) 141:1281–1285; discussion 1285–1286
14.
Zurück zum Zitat Friedman WA, Foote KD (2003) Linear accelerator-based radiosurgery for vestibular schwannoma. Neurosurg Focus 14:e2PubMed Friedman WA, Foote KD (2003) Linear accelerator-based radiosurgery for vestibular schwannoma. Neurosurg Focus 14:e2PubMed
15.
Zurück zum Zitat Shoshan Y, Wygoda M, Umansky F (2005) Stereotactic radiosurgery and fractionated stereotactic radiotherapy: background, definitions, applications. Isr Med Assoc J 7:597–599PubMed Shoshan Y, Wygoda M, Umansky F (2005) Stereotactic radiosurgery and fractionated stereotactic radiotherapy: background, definitions, applications. Isr Med Assoc J 7:597–599PubMed
17.
Zurück zum Zitat Pollock BE, Lunsford LD, Kondziolka D, Flickinger JC, Bissonette DJ, Kelsey SF, Jannetta PJ (1995) Outcome analysis of acoustic neuroma management: a comparison of microsurgery and stereotactic radiosurgery. Neurosurgery 36:215–224; discussion 224–229 Pollock BE, Lunsford LD, Kondziolka D, Flickinger JC, Bissonette DJ, Kelsey SF, Jannetta PJ (1995) Outcome analysis of acoustic neuroma management: a comparison of microsurgery and stereotactic radiosurgery. Neurosurgery 36:215–224; discussion 224–229
18.
Zurück zum Zitat Sekhar LN, Gormley WB, Wright DC (1996) The best treatment for vestibular schwannoma (acoustic neuroma): microsurgery or radiosurgery? Am J Otol 17:676–682; discussion 683–689 Sekhar LN, Gormley WB, Wright DC (1996) The best treatment for vestibular schwannoma (acoustic neuroma): microsurgery or radiosurgery? Am J Otol 17:676–682; discussion 683–689
19.
Zurück zum Zitat Kamerer DB, Lunsford LD, Moller M (1988) Gamma knife: an alternative treatment for acoustic neurinomas. Ann Otol Rhinol Laryngol 97:631–635PubMed Kamerer DB, Lunsford LD, Moller M (1988) Gamma knife: an alternative treatment for acoustic neurinomas. Ann Otol Rhinol Laryngol 97:631–635PubMed
20.
Zurück zum Zitat Lunsford LD, Kamerer DB, Flickinger JC (1990) Stereotactic radiosurgery for acoustic neuromas. Arch Otolaryngol Head Neck Surg 116:907–909PubMed Lunsford LD, Kamerer DB, Flickinger JC (1990) Stereotactic radiosurgery for acoustic neuromas. Arch Otolaryngol Head Neck Surg 116:907–909PubMed
21.
Zurück zum Zitat Wiet RJ, Micco AG, Bauer GP (1996) Complications of the gamma knife. Arch Otolaryngol Head Neck Surg 122:414–416PubMed Wiet RJ, Micco AG, Bauer GP (1996) Complications of the gamma knife. Arch Otolaryngol Head Neck Surg 122:414–416PubMed
23.
Zurück zum Zitat Mendenhall WM, Friedman WA, Buatti JM, Bova FJ (1996) Preliminary results of linear accelerator radiosurgery for acoustic schwannomas. J Neurosurg 85:1013–1019PubMed Mendenhall WM, Friedman WA, Buatti JM, Bova FJ (1996) Preliminary results of linear accelerator radiosurgery for acoustic schwannomas. J Neurosurg 85:1013–1019PubMed
24.
Zurück zum Zitat Linskey ME (2000) Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular schwannoma: a Leksell Gamma Knife Society 2000 debate. J Neurosurg 93(Suppl 3):90–95PubMed Linskey ME (2000) Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular schwannoma: a Leksell Gamma Knife Society 2000 debate. J Neurosurg 93(Suppl 3):90–95PubMed
25.
Zurück zum Zitat Yamamoto M, Hagiwara S, Ide M, Jimbo M, Hirai T, Nakamura Y (1996) Radiosurgery for acoustic neurinoma with rapid growth and relatively high staining indexes for proliferating cell nuclear antigen and MIB-1. Neurol Med Chir (Tokyo) 36:241–245. doi:10.2176/nmc.36.241 CrossRef Yamamoto M, Hagiwara S, Ide M, Jimbo M, Hirai T, Nakamura Y (1996) Radiosurgery for acoustic neurinoma with rapid growth and relatively high staining indexes for proliferating cell nuclear antigen and MIB-1. Neurol Med Chir (Tokyo) 36:241–245. doi:10.​2176/​nmc.​36.​241 CrossRef
27.
Zurück zum Zitat Lunsford LD, Linskey ME (1992) Stereotactic radiosurgery in the treatment of patients with acoustic tumors. Otolaryngol Clin N Am 25:471–491 Lunsford LD, Linskey ME (1992) Stereotactic radiosurgery in the treatment of patients with acoustic tumors. Otolaryngol Clin N Am 25:471–491
28.
Zurück zum Zitat Spiegelmann R, Gofman J, Alezra D, Pfeffer R (1999) Radiosurgery for acoustic neurinomas (vestibular schwannomas). Isr Med Assoc J 1:8–13PubMed Spiegelmann R, Gofman J, Alezra D, Pfeffer R (1999) Radiosurgery for acoustic neurinomas (vestibular schwannomas). Isr Med Assoc J 1:8–13PubMed
29.
Zurück zum Zitat Ottaviani F, Neglia CB, Ventrella L, Giugni E, Motti E (2002) Hearing loss and changes in transient evoked otoacoustic emissions after gamma knife radiosurgery for acoustic neurinomas. Arch Otolaryngol Head Neck Surg 128:1308–1312PubMed Ottaviani F, Neglia CB, Ventrella L, Giugni E, Motti E (2002) Hearing loss and changes in transient evoked otoacoustic emissions after gamma knife radiosurgery for acoustic neurinomas. Arch Otolaryngol Head Neck Surg 128:1308–1312PubMed
30.
Zurück zum Zitat Ito K, Shin M, Matsuzaki M, Sugasawa K, Sasaki T (2000) Risk factors for neurological complications after acoustic neurinoma radiosurgery: refinement from further experiences. Int J Radiat Oncol Biol Phys 48:75–80. doi:10.1016/S0360-3016(00)00570-8 PubMedCrossRef Ito K, Shin M, Matsuzaki M, Sugasawa K, Sasaki T (2000) Risk factors for neurological complications after acoustic neurinoma radiosurgery: refinement from further experiences. Int J Radiat Oncol Biol Phys 48:75–80. doi:10.​1016/​S0360-3016(00)00570-8 PubMedCrossRef
31.
Zurück zum Zitat Yang I, Barbaro NM (2007) Advances in the radiosurgical treatment of epilepsy. Epilepsy Curr/Am Epilepsy Soc 7:31–35 Yang I, Barbaro NM (2007) Advances in the radiosurgical treatment of epilepsy. Epilepsy Curr/Am Epilepsy Soc 7:31–35
32.
Zurück zum Zitat Chin LS, Lazio BE, Biggins T, Amin P (2000) Acute complications following gamma knife radiosurgery are rare. Surg Neurol 53:498–502; discussion 502 Chin LS, Lazio BE, Biggins T, Amin P (2000) Acute complications following gamma knife radiosurgery are rare. Surg Neurol 53:498–502; discussion 502
33.
Zurück zum Zitat de Ipolyi AR, Yang I, Buckley A, Barbaro NM, Cheung SW, Parsa AT (2008) Fluctuating response of a cystic vestibular schwannoma to radiosurgery: case report. Neurosurgery 62: E1164–E1165, E:1165 discussion de Ipolyi AR, Yang I, Buckley A, Barbaro NM, Cheung SW, Parsa AT (2008) Fluctuating response of a cystic vestibular schwannoma to radiosurgery: case report. Neurosurgery 62: E1164–E1165, E:1165 discussion
35.
Zurück zum Zitat Linskey ME, Lunsford LD, Flickinger JC (1990) Radiosurgery for acoustic neurinomas: early experience. Neurosurgery 26:736–744; discussion 744–745 Linskey ME, Lunsford LD, Flickinger JC (1990) Radiosurgery for acoustic neurinomas: early experience. Neurosurgery 26:736–744; discussion 744–745
36.
Zurück zum Zitat Linskey ME, Johnstone PA, O’Leary M, Goetsch S (2003) Radiation exposure of normal temporal bone structures during stereotactically guided gamma knife surgery for vestibular schwannomas. J Neurosurg 98:800–806PubMed Linskey ME, Johnstone PA, O’Leary M, Goetsch S (2003) Radiation exposure of normal temporal bone structures during stereotactically guided gamma knife surgery for vestibular schwannomas. J Neurosurg 98:800–806PubMed
38.
Zurück zum Zitat Mendenhall WM, Friedman WA, Bova FJ (1994) Linear accelerator-based stereotactic radiosurgery for acoustic schwannomas. Int J Radiat Oncol Biol Phys 28:803–810PubMed Mendenhall WM, Friedman WA, Bova FJ (1994) Linear accelerator-based stereotactic radiosurgery for acoustic schwannomas. Int J Radiat Oncol Biol Phys 28:803–810PubMed
39.
Zurück zum Zitat Spiegelmann R, Lidar Z, Gofman J, Alezra D, Hadani M, Pfeffer R (2001) Linear accelerator radiosurgery for vestibular schwannoma. J Neurosurg 94:7–13PubMed Spiegelmann R, Lidar Z, Gofman J, Alezra D, Hadani M, Pfeffer R (2001) Linear accelerator radiosurgery for vestibular schwannoma. J Neurosurg 94:7–13PubMed
40.
Zurück zum Zitat Foote KD, Friedman WA, Buatti JM, Meeks SL, Bova FJ, Kubilis PS (2001) Analysis of risk factors associated with radiosurgery for vestibular schwannoma. J Neurosurg 95:440–449PubMed Foote KD, Friedman WA, Buatti JM, Meeks SL, Bova FJ, Kubilis PS (2001) Analysis of risk factors associated with radiosurgery for vestibular schwannoma. J Neurosurg 95:440–449PubMed
41.
Zurück zum Zitat Myrseth E, Moller P, Pedersen PH, Vassbotn FS, Wentzel-Larsen T, Lund-Johansen M (2005) Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery. Neurosurgery 56: 927–935; discussion 927–935 Myrseth E, Moller P, Pedersen PH, Vassbotn FS, Wentzel-Larsen T, Lund-Johansen M (2005) Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery. Neurosurgery 56: 927–935; discussion 927–935
42.
Zurück zum Zitat Shin YJ, Lapeyre-Mestre M, Gafsi I, Cognard C, Deguine O, Tremoulet M, Fraysse B (2003) Neurotological complications after radiosurgery versus conservative management in acoustic neuromas: a systematic review-based study. Acta Otolaryngol 123:59–64. doi:10.1081/0036554021000028084 PubMedCrossRef Shin YJ, Lapeyre-Mestre M, Gafsi I, Cognard C, Deguine O, Tremoulet M, Fraysse B (2003) Neurotological complications after radiosurgery versus conservative management in acoustic neuromas: a systematic review-based study. Acta Otolaryngol 123:59–64. doi:10.​1081/​0036554021000028​084 PubMedCrossRef
43.
Zurück zum Zitat Chung WY, Liu KD, Shiau CY, Wu HM, Wang LW, Guo WY, Ho DM, Pan DH (2005) Gamma knife surgery for vestibular schwannoma: 10-year experience of 195 cases. J Neurosurg 102(Suppl):87–96PubMed Chung WY, Liu KD, Shiau CY, Wu HM, Wang LW, Guo WY, Ho DM, Pan DH (2005) Gamma knife surgery for vestibular schwannoma: 10-year experience of 195 cases. J Neurosurg 102(Suppl):87–96PubMed
44.
Zurück zum Zitat Andrews DW, Suarez O, Goldman HW, Downes MB, Bednarz G, Corn BW, Werner-Wasik M, Rosenstock J, Curran WJ Jr (2001) Stereotactic radiosurgery and fractionated stereotactic radiotherapy for the treatment of acoustic schwannomas: comparative observations of 125 patients treated at one institution. Int J Radiat Oncol Biol Phys 50:1265–1278. doi:10.1016/S0360-3016(01)01559-0 PubMed Andrews DW, Suarez O, Goldman HW, Downes MB, Bednarz G, Corn BW, Werner-Wasik M, Rosenstock J, Curran WJ Jr (2001) Stereotactic radiosurgery and fractionated stereotactic radiotherapy for the treatment of acoustic schwannomas: comparative observations of 125 patients treated at one institution. Int J Radiat Oncol Biol Phys 50:1265–1278. doi:10.​1016/​S0360-3016(01)01559-0 PubMed
45.
Zurück zum Zitat Meijer OW, Vandertop WP, Baayen JC, Slotman BJ (2003) Single-fraction vs. fractionated linac-based stereotactic radiosurgery for vestibular schwannoma: a single-institution study. Int J Radiat Oncol Biol Phys 56:1390–1396. doi:10.1016/S0360-3016(03)00444-9 PubMedCrossRef Meijer OW, Vandertop WP, Baayen JC, Slotman BJ (2003) Single-fraction vs. fractionated linac-based stereotactic radiosurgery for vestibular schwannoma: a single-institution study. Int J Radiat Oncol Biol Phys 56:1390–1396. doi:10.​1016/​S0360-3016(03)00444-9 PubMedCrossRef
46.
Zurück zum Zitat Meijer OW, Wolbers JG, Baayen JC, Slotman BJ (2000) Fractionated stereotactic radiation therapy and single high-dose radiosurgery for acoustic neuroma: early results of a prospective clinical study. Int J Radiat Oncol Biol Phys 46:45–49. doi:10.1016/S0360-3016(99)00363-6 PubMedCrossRef Meijer OW, Wolbers JG, Baayen JC, Slotman BJ (2000) Fractionated stereotactic radiation therapy and single high-dose radiosurgery for acoustic neuroma: early results of a prospective clinical study. Int J Radiat Oncol Biol Phys 46:45–49. doi:10.​1016/​S0360-3016(99)00363-6 PubMedCrossRef
47.
Zurück zum Zitat Thomsen J, Tos M, Borgesen SE (1990) Gamma knife: hydrocephalus as a complication of stereotactic radiosurgical treatment of an acoustic neuroma. Am J Otol 11:330–333PubMed Thomsen J, Tos M, Borgesen SE (1990) Gamma knife: hydrocephalus as a complication of stereotactic radiosurgical treatment of an acoustic neuroma. Am J Otol 11:330–333PubMed
49.
Zurück zum Zitat Hudgins WR (1994) Patients’ attitude about outcomes and the role of gamma knife radiosurgery in the treatment of vestibular schwannomas. Neurosurgery 34:459–463; discussion 463–465 Hudgins WR (1994) Patients’ attitude about outcomes and the role of gamma knife radiosurgery in the treatment of vestibular schwannomas. Neurosurgery 34:459–463; discussion 463–465
50.
Zurück zum Zitat House JW, Brackmann DE (1985) Facial nerve grading system. Otolaryngol Head Neck Surg 93:146–147PubMed House JW, Brackmann DE (1985) Facial nerve grading system. Otolaryngol Head Neck Surg 93:146–147PubMed
55.
Zurück zum Zitat Chopra R, Kondziolka D, Niranjan A, Lunsford LD, Flickinger JC (2007) Long-term follow-up of acoustic schwannoma radiosurgery with marginal tumor doses of 12 to 13 Gy. Int J Radiat Oncol Biol Phys 68:845–851. doi:10.1016/j.ijrobp.2007.01.001 PubMed Chopra R, Kondziolka D, Niranjan A, Lunsford LD, Flickinger JC (2007) Long-term follow-up of acoustic schwannoma radiosurgery with marginal tumor doses of 12 to 13 Gy. Int J Radiat Oncol Biol Phys 68:845–851. doi:10.​1016/​j.​ijrobp.​2007.​01.​001 PubMed
57.
Zurück zum Zitat Hasegawa T, Kida Y, Kobayashi T, Yoshimoto M, Mori Y, Yoshida J (2005) Long-term outcomes in patients with vestibular schwannomas treated using gamma knife surgery: 10-year follow up. J Neurosurg 102:10–16PubMed Hasegawa T, Kida Y, Kobayashi T, Yoshimoto M, Mori Y, Yoshida J (2005) Long-term outcomes in patients with vestibular schwannomas treated using gamma knife surgery: 10-year follow up. J Neurosurg 102:10–16PubMed
58.
Zurück zum Zitat Lunsford LD, Niranjan A, Flickinger JC, Maitz A, Kondziolka D (2005) Radiosurgery of vestibular schwannomas: summary of experience in 829 cases. J Neurosurg 102(Suppl):195–199PubMed Lunsford LD, Niranjan A, Flickinger JC, Maitz A, Kondziolka D (2005) Radiosurgery of vestibular schwannomas: summary of experience in 829 cases. J Neurosurg 102(Suppl):195–199PubMed
59.
Zurück zum Zitat Inoue HK (2005) Low-dose radiosurgery for large vestibular schwannomas: long-term results of functional preservation. J Neurosurg 102(Suppl):111–113PubMed Inoue HK (2005) Low-dose radiosurgery for large vestibular schwannomas: long-term results of functional preservation. J Neurosurg 102(Suppl):111–113PubMed
60.
62.
Zurück zum Zitat Rowe JG, Radatz MW, Walton L, Soanes T, Rodgers J, Kemeny AA (2003) Clinical experience with gamma knife stereotactic radiosurgery in the management of vestibular schwannomas secondary to type 2 neurofibromatosis. J Neurol Neurosurg Psychiatry 74:1288–1293. doi:10.1136/jnnp.74.9.1288 PubMedCrossRef Rowe JG, Radatz MW, Walton L, Soanes T, Rodgers J, Kemeny AA (2003) Clinical experience with gamma knife stereotactic radiosurgery in the management of vestibular schwannomas secondary to type 2 neurofibromatosis. J Neurol Neurosurg Psychiatry 74:1288–1293. doi:10.​1136/​jnnp.​74.​9.​1288 PubMedCrossRef
63.
Zurück zum Zitat Watanabe T, Saito N, Hirato J, Shimaguchi H, Fujimaki H, Sasaki T (2003) Facial neuropathy due to axonal degeneration and microvasculitis following gamma knife surgery for vestibular schwannoma: a histological analysis. Case report. J Neurosurg 99:916–920PubMed Watanabe T, Saito N, Hirato J, Shimaguchi H, Fujimaki H, Sasaki T (2003) Facial neuropathy due to axonal degeneration and microvasculitis following gamma knife surgery for vestibular schwannoma: a histological analysis. Case report. J Neurosurg 99:916–920PubMed
64.
Zurück zum Zitat Kondziolka D, Nathoo N, Flickinger JC, Niranjan A, Maitz AH, Lunsford LD (2003) Long-term results after radiosurgery for benign intracranial tumors. Neurosurgery 53:815–821; discussion 821–822 Kondziolka D, Nathoo N, Flickinger JC, Niranjan A, Maitz AH, Lunsford LD (2003) Long-term results after radiosurgery for benign intracranial tumors. Neurosurgery 53:815–821; discussion 821–822
65.
Zurück zum Zitat Moffat DA, Quaranta N, Baguley DM, Hardy DG, Chang P (2003) Management strategies in neurofibromatosis type 2. Eur Arch Otorhinolaryngol 260:12–18PubMed Moffat DA, Quaranta N, Baguley DM, Hardy DG, Chang P (2003) Management strategies in neurofibromatosis type 2. Eur Arch Otorhinolaryngol 260:12–18PubMed
66.
Zurück zum Zitat Tago M, Terahara A, Nakagawa K, Aoki Y, Ohtomo K, Shin M, Kurita H (2000) Immediate neurological deterioration after gamma knife radiosurgery for acoustic neuroma. Case report. J Neurosurg 93(Suppl 3):78–81PubMed Tago M, Terahara A, Nakagawa K, Aoki Y, Ohtomo K, Shin M, Kurita H (2000) Immediate neurological deterioration after gamma knife radiosurgery for acoustic neuroma. Case report. J Neurosurg 93(Suppl 3):78–81PubMed
67.
Zurück zum Zitat Niranjan A, Lunsford LD, Flickinger JC, Maitz A, Kondziolka D (1999) Dose reduction improves hearing preservation rates after intracanalicular acoustic tumor radiosurgery. Neurosurgery 45:753–762; discussion 762–765 Niranjan A, Lunsford LD, Flickinger JC, Maitz A, Kondziolka D (1999) Dose reduction improves hearing preservation rates after intracanalicular acoustic tumor radiosurgery. Neurosurgery 45:753–762; discussion 762–765
68.
Zurück zum Zitat Subach BR, Kondziolka D, Lunsford LD, Bissonette DJ, Flickinger JC, Maitz AH (1999) Stereotactic radiosurgery in the management of acoustic neuromas associated with neurofibromatosis type 2. J Neurosurg 90:815–822PubMed Subach BR, Kondziolka D, Lunsford LD, Bissonette DJ, Flickinger JC, Maitz AH (1999) Stereotactic radiosurgery in the management of acoustic neuromas associated with neurofibromatosis type 2. J Neurosurg 90:815–822PubMed
69.
Zurück zum Zitat Miller RC, Foote RL, Coffey RJ, Sargent DJ, Gorman DA, Schomberg PJ, Kline RW (1999) Decrease in cranial nerve complications after radiosurgery for acoustic neuromas: a prospective study of dose and volume. Int J Radiat Oncol Biol Phys 43:305–311. doi:10.1016/S0360-3016(98)00397-6 PubMed Miller RC, Foote RL, Coffey RJ, Sargent DJ, Gorman DA, Schomberg PJ, Kline RW (1999) Decrease in cranial nerve complications after radiosurgery for acoustic neuromas: a prospective study of dose and volume. Int J Radiat Oncol Biol Phys 43:305–311. doi:10.​1016/​S0360-3016(98)00397-6 PubMed
70.
Zurück zum Zitat Pollock BE, Lunsford LD, Flickinger JC, Clyde BL, Kondziolka D (1998) Vestibular schwannoma management. Part I. Failed microsurgery and the role of delayed stereotactic radiosurgery. J Neurosurg 89:944–948PubMedCrossRef Pollock BE, Lunsford LD, Flickinger JC, Clyde BL, Kondziolka D (1998) Vestibular schwannoma management. Part I. Failed microsurgery and the role of delayed stereotactic radiosurgery. J Neurosurg 89:944–948PubMedCrossRef
71.
Zurück zum Zitat Ito K, Kurita H, Sugasawa K, Mizuno M, Sasaki T (1997) Analyses of neuro-otological complications after radiosurgery for acoustic neurinomas. Int J Radiat Oncol Biol Phys 39:983–988. doi:10.1016/S0360-3016(97)00507-5 PubMed Ito K, Kurita H, Sugasawa K, Mizuno M, Sasaki T (1997) Analyses of neuro-otological complications after radiosurgery for acoustic neurinomas. Int J Radiat Oncol Biol Phys 39:983–988. doi:10.​1016/​S0360-3016(97)00507-5 PubMed
73.
Zurück zum Zitat Flickinger JC, Kondziolka D, Pollock BE, Lunsford LD (1996) Evolution in technique for vestibular schwannoma radiosurgery and effect on outcome. Int J Radiat Oncol Biol Phys 36:275–280. doi:10.1016/S0360-3016(96)00335-5 PubMed Flickinger JC, Kondziolka D, Pollock BE, Lunsford LD (1996) Evolution in technique for vestibular schwannoma radiosurgery and effect on outcome. Int J Radiat Oncol Biol Phys 36:275–280. doi:10.​1016/​S0360-3016(96)00335-5 PubMed
74.
Zurück zum Zitat Slattery WH III, Brackmann DE (1995) Results of surgery following stereotactic irradiation for acoustic neuromas. Am J Otol 16:315–319; discussion 319–321 Slattery WH III, Brackmann DE (1995) Results of surgery following stereotactic irradiation for acoustic neuromas. Am J Otol 16:315–319; discussion 319–321
75.
Zurück zum Zitat Ogunrinde OK, Lunsford LD, Flickinger JC, Kondziolka DS (1995) Cranial nerve preservation after stereotactic radiosurgery for small acoustic tumors. Arch Neurol 52:73–79PubMed Ogunrinde OK, Lunsford LD, Flickinger JC, Kondziolka DS (1995) Cranial nerve preservation after stereotactic radiosurgery for small acoustic tumors. Arch Neurol 52:73–79PubMed
76.
Zurück zum Zitat Ogunrinde OK, Lunsford DL, Kondziolka DS, Bissonette DJ, Flickinger JC (1995) Cranial nerve preservation after stereotactic radiosurgery of intracanalicular acoustic tumors. Stereotact Funct Neurosurg 64(Suppl 1):87–97PubMed Ogunrinde OK, Lunsford DL, Kondziolka DS, Bissonette DJ, Flickinger JC (1995) Cranial nerve preservation after stereotactic radiosurgery of intracanalicular acoustic tumors. Stereotact Funct Neurosurg 64(Suppl 1):87–97PubMed
77.
Zurück zum Zitat Linskey ME, Lunsford LD, Flickinger JC (1992) Tumor control after stereotactic radiosurgery in neurofibromatosis patients with bilateral acoustic tumors. Neurosurgery 31:838–839; discussion 838–839 Linskey ME, Lunsford LD, Flickinger JC (1992) Tumor control after stereotactic radiosurgery in neurofibromatosis patients with bilateral acoustic tumors. Neurosurgery 31:838–839; discussion 838–839
78.
Zurück zum Zitat Hirato M, Inoue H, Zama A, Ohye C, Shibazaki T, Andou Y (1996) Gamma knife radiosurgery for acoustic schwannoma: effects of low radiation dose and functional prognosis. Stereotact Funct Neurosurg 66(Suppl 1):134–141. doi:10.1159/000099803 PubMedCrossRef Hirato M, Inoue H, Zama A, Ohye C, Shibazaki T, Andou Y (1996) Gamma knife radiosurgery for acoustic schwannoma: effects of low radiation dose and functional prognosis. Stereotact Funct Neurosurg 66(Suppl 1):134–141. doi:10.​1159/​000099803 PubMedCrossRef
79.
Zurück zum Zitat Niranjan A, Lunsford LD, Flickinger JC, Maitz A, Kondziolka D (1999) Can hearing improve after acoustic tumor radiosurgery? Neurosurg Clin N Am 10:305–315PubMed Niranjan A, Lunsford LD, Flickinger JC, Maitz A, Kondziolka D (1999) Can hearing improve after acoustic tumor radiosurgery? Neurosurg Clin N Am 10:305–315PubMed
80.
Zurück zum Zitat Petit JH, Hudes RS, Chen TT, Eisenberg HM, Simard JM, Chin LS (2001) Reduced-dose radiosurgery for vestibular schwannomas. Neurosurgery 49:1299–1306; discussion 1306–1307 Petit JH, Hudes RS, Chen TT, Eisenberg HM, Simard JM, Chin LS (2001) Reduced-dose radiosurgery for vestibular schwannomas. Neurosurgery 49:1299–1306; discussion 1306–1307
81.
Zurück zum Zitat Rutten I, Baumert BG, Seidel L, Kotolenko S, Collignon J, Kaschten B, Albert A, Martin D, Deneufbourg JM, Demanez JP, Stevenaert A (2007) Long-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma. Radiother Oncol 82:83–89. doi:10.1016/j.radonc.2006.11.019 PubMedCrossRef Rutten I, Baumert BG, Seidel L, Kotolenko S, Collignon J, Kaschten B, Albert A, Martin D, Deneufbourg JM, Demanez JP, Stevenaert A (2007) Long-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma. Radiother Oncol 82:83–89. doi:10.​1016/​j.​radonc.​2006.​11.​019 PubMedCrossRef
83.
Zurück zum Zitat Limb CJ, Long DM, Niparko JK (2005) Acoustic neuromas after failed radiation therapy: challenges of surgical salvage. Laryngoscope 115:93–98PubMedCrossRef Limb CJ, Long DM, Niparko JK (2005) Acoustic neuromas after failed radiation therapy: challenges of surgical salvage. Laryngoscope 115:93–98PubMedCrossRef
84.
Zurück zum Zitat Hasegawa T, Fujitani S, Katsumata S, Kida Y, Yoshimoto M, Koike J (2005) Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years. Neurosurgery 57:257–265; discussion 257–265 Hasegawa T, Fujitani S, Katsumata S, Kida Y, Yoshimoto M, Koike J (2005) Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years. Neurosurgery 57:257–265; discussion 257–265
Metadaten
Titel
Facial nerve preservation after vestibular schwannoma Gamma Knife radiosurgery
verfasst von
Isaac Yang
Michael E. Sughrue
Seunggu J. Han
Shanna Fang
Derick Aranda
Steven W. Cheung
Lawrence H. Pitts
Andrew T. Parsa
Publikationsdatum
01.05.2009
Verlag
Springer US
Erschienen in
Journal of Neuro-Oncology / Ausgabe 1/2009
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-009-9842-3

Weitere Artikel der Ausgabe 1/2009

Journal of Neuro-Oncology 1/2009 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Neu im Fachgebiet Neurologie

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.