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KMID : 0942820100090020097
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Journal of Korean Brain Tumor Society
2010 Volume.9 No. 2 p.97 ~ p.102
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Intended Subtotal Resection Followed by Radiosurgery for Large Vestibular Schwannoma： Single Institute Observational Study
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Choi Doo-Yong
Kang Seok-Gu
Jeun Sin-Soo
Hong Yong-Kil
Kim Moon-Chan
Park Chun-Kun
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Abstract
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Objective: Although there have been many reports about the management options for vestibular schwannoma (VS), the lack of high evidence prospective clinical trials made us choose proper management based on clinician’s personal priorities. In terms of functional outcome(hearing and facial nerve preservation), the surgical results for large VS may be worse compared to small VS. The aim of this study was to report our treatment strategy for large VS. We have performed a prospective observational study to evaluate this treatment strategy.
Methods: Between March 2005 and December 2008, we treated 16 large VSs with maximal diameter of 3.0 cm or greater using intended subtotal removal followed by radiosurgery. Median observation time was 42(26-62) months. The selected surgical approach was retrosigmoid suboccipital approach. Radiosurgery was performed 3 month after surgery. We evaluated tumor control, symptomatic relief, facial nerve preservation, hearing preservation, other cranial nerve preservation, and complications.
Results: Our treatment strategy showed 93.8%(15/16) tumor control rate, excellent facial nerve preservation(93.8%, 15/16), retaining preoperative serviceable hearing(75%, 3/4) and low treatment morbidity.
Conclusion: Although there was a limitation of the follow-up period, case numbers, and single institute results, in the case of large VS, intended subtotal removal followed by radiosurgery might be an excellent option for maintaining facial, auditory, and other cranial nerve function and tumor control.
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KEYWORD
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Facial nerve preservation, Observational study, Radiosurgery, Subtotal resection, Vestibular schwannoma
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