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Abstract

Acoustic schwannomas are benign tumors of the 8 cranial nerve sheath that can affect function of the fifth, seventh, and eighth cranial nerves as well as compress the brainstem. Careful detailed assessment with long observations times is needed with these slow-growing tumors to detect recurrence/progression or complications whenever observation, surgery, or radiation treatment is used for management. Management choices for these tumors have evolved and been refined considerably since the introduction of radiosurgery. This chapter reviews the use of radiosurgery in the management of acoustic schwannomas and covers background information necessary for understanding the optimal management of patients with these tumors.

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References

  1. Tator CH, Duncan EG, Charles D. Comparisons of the clinical and radiological features and surgical management of posterior fossa meningiomas and acoustic neuromas. Can J Neurol Sci. 1990;17:170–6.

    CAS  PubMed  Google Scholar 

  2. Asthagiri AR, Parry DM, Butman JA, Kim HJ, Tsilou ET, Zhuang Z, Lonser RR. Neurofibromatosis type 2. Lancet. 2009;373:1974–86.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Roche PH, Bouvier C, Chinot O, Figarella-Branger D. Genesis and biology of vestibular schwannomas. Prog Neurol Surg. 2008;21:24–31. doi:10.1159/000156556.

    Article  PubMed  Google Scholar 

  4. Gardner G, Robertson JH. Hearing preservation in unilateral acoustic neuroma surgery. Ann Otol Rhinol Laryngol. 1988;97:55–66.

    Article  CAS  PubMed  Google Scholar 

  5. House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93:146–7.

    CAS  PubMed  Google Scholar 

  6. Chang CS, Chuang CC, Wu MF, Liu WS, Tu HT, Huang CF. Gamma Knife surgery for hemifacial spasm related to cerebellopontine angle tumors. J Neurosurg. 2012;117(Suppl):170–4.

    PubMed  Google Scholar 

  7. Kondziolka D, Mousavi SH, Kano H, Flickinger JC, Lunsford LD. The newly diagnosed vestibular schwannoma: radiosurgery, resection, or observation? Neurosurg Focus. 2012;33:E8. doi:10.3171/2012.6.FOCUS12192.

    Article  PubMed  Google Scholar 

  8. Wallner KE, Sheline GE, Pitts LH, Wara WM, Davis RL, Boldrey EB. Efficacy of irradiation for incompletely excised acoustic neurilemomas. J Neurosurg. 1987;67:858–63. doi:10.3171/jns.1987.67.6.0858.

    Article  CAS  PubMed  Google Scholar 

  9. 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;86:486–98. doi:10.3109/09553001003667982.

    Article  CAS  PubMed  Google Scholar 

  10. Flickinger JC, Kondziolka D, Lunsford LD. Dose and diameter relationships for facial trigeminal and acoustic neuropathies following acoustic neuroma radiosurgery. Radiother Oncol. 1996;41(3):215–9. S0167814096018312 [pii].

    Article  CAS  PubMed  Google Scholar 

  11. Flickinger JC, Kondziolka D, Pollock BE, Maitz AH, Lunsford LD. Complications from arteriovenous malformation radiosurgery: multivariate analysis and risk modeling. Int J Radiat Oncol Biol Phys. 1997;38:485–90. S0360301697894813 [pii].

    Article  CAS  PubMed  Google Scholar 

  12. Nakaya K, Niranjan A, Kondziolka D, Kano H, Khan AA, Nettel B, Koebbe C, Pirris S, Flickinger JC, Lunsford LD. Gamma knife radiosurgery for benign tumors with symptoms from brainstem compression. Int J Radiat Oncol Biol Phys. 2010;77:988–95.

    Article  PubMed  Google Scholar 

  13. Adams G, Martin OA, Roos DE, Lobachevsky PN, Potter AE, Zacest AC, Bezak E, Bonner WM, Martin RF, Leong T. Enhanced intrinsic radiosensitivity after treatment with stereotactic radiosurgery for an acoustic neuroma. Radiother Oncol. 2012;103:410–4.

    Article  PubMed  Google Scholar 

  14. Kano H, Kondziolka D, Khan A, Flickinger JC, Lunsford LD. Predictors of hearing preservation after stereotactic radiosurgery for acoustic neuroma. J Neurosurg. 2009;111:863–73.

    Article  PubMed  Google Scholar 

  15. Zuur CL, Simis YJ, Lamers EA, Hart AA, Dreschler WA, Balm AJ, Rasch CR. Risk factors for hearing loss in patients treated with intensity-modulated radiotherapy for head-and-neck tumors. Int J Radiat Oncol Biol Phys. 2009;74:490–6.

    Article  PubMed  Google Scholar 

  16. Yomo S, Carron R, Thomassin JM, Roche PH, Regis J. Longitudinal analysis of hearing before and after radiosurgery for vestibular schwannoma. J Neurosurg. 2012;117:877–85.

    Article  PubMed  Google Scholar 

  17. Hasegawa T, Kida Y, Kato T, Iizuka H, Yamamoto T. Factors associated with hearing preservation after Gamma Knife surgery for vestibular schwannomas in patients who retain serviceable hearing. J Neurosurg. 2011;115:1078–86.

    Article  PubMed  Google Scholar 

  18. Kim YH, Kim DG, Han JH, Chung HT, Kim IK, Song SW, Park JH, Kim JW, Park CK, Kim CY, Paek SH, Jung HW. Hearing outcomes after stereotactic radiosurgery for unilateral intracanalicular vestibular schwannomas: implication of transient volume expansion. Int J Radiat Oncol Biol Phys. 2013;85:61–7.

    Article  PubMed  Google Scholar 

  19. Carlson ML, Jacob JT, Pollock BE, Neff BA, Tombers NM, Driscoll CL, Link MJ. Long-term hearing outcomes following stereotactic radiosurgery for vestibular schwannoma: patterns of hearing loss and variables influencing audiometric decline. J Neurosurg. 2013;118(3):579–87.

    Article  PubMed  Google Scholar 

  20. Roos DE, Potter AE, Zacest AC. Hearing preservation after low dose linac radiosurgery for acoustic neuroma depends on initial hearing and time. Radiother Oncol. 2011;101(3):420–4.

    Article  PubMed  Google Scholar 

  21. Lunsford LD, Niranjan A, Flickinger JC, Maitz A, Kondziolka D. Radiosurgery of vestibular schwannomas: summary of experience in 829 cases. J Neurosurg. 2005;102(Suppl):195–9.

    Article  PubMed  Google Scholar 

  22. Hasegawa T, Kida Y, Kato T, Iizuka H, Kuramitsu S, Yamamoto T. Long-term safety and efficacy of stereotactic radiosurgery for vestibular schwannomas: evaluation of 440 patients more than 10 years after treatment with Gamma Knife surgery. J Neurosurg. 2013;118:557–65.

    Article  PubMed  Google Scholar 

  23. Regis J, Roche PH, Delsanti C, Thomassin JM, Ouaknine M, Gabert K, Pellet W. Modern management of vestibular schwannomas. Prog Neurol Surg. 2007;20:129–41.

    Article  PubMed  Google Scholar 

  24. Hayhurst C, Monsalves E, Bernstein M, Gentili F, Heydarian M, Tsao M, Schwartz M, van Prooijen M, Millar BA, Menard C, Kulkarni AV, Laperriere N, Zadeh G. Predicting nonauditory adverse radiation effects following radiosurgery for vestibular schwannoma: a volume and dosimetric analysis. Int J Radiat Oncol Biol Phys. 2012;82:2041–6. doi:10.1016/j.ijrobp.2011.02.017.

    Article  PubMed  Google Scholar 

  25. Han JH, Kim DG, Chung HT, Paek SH, Park CK, Kim CY, Hwang SS, Park JH, Kim YH, Kim JW, Song SW, Kim IK, Jung HW. The risk factors of symptomatic communicating hydrocephalus after stereotactic radiosurgery for unilateral vestibular schwannoma: the implication of brain atrophy. Int J Radiat Oncol Biol Phys. 2012;84:937–42. doi:10.1016/j.ijrobp.2012.01.048.

    Article  PubMed  Google Scholar 

  26. Lee SH, Seol HJ, Kong DS, Nam DH, Park K, Kim JH, Lee JI. Risk factors and tumor response associated with hydrocephalus after gamma knife radiosurgery for vestibular schwannoma. Acta Neurochir (Wien). 2012;154:1679–84. doi:10.1007/s00701-012-1350-0.

    Article  Google Scholar 

  27. Milligan BD, Pollock BE, Foote RL, Link MJ. Long-term tumor control and cranial nerve outcomes following γ knife surgery for larger-volume vestibular schwannomas. J Neurosurg. 2012;116(3):598–604.

    Article  PubMed  Google Scholar 

  28. 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;76(2):520–7.

    Article  PubMed  Google Scholar 

  29. Yomo S, Arkha Y, Delsanti C, Roche PH, Thomassin JM, Régis J. Repeat gamma knife surgery for regrowth of vestibular schwannomas. Neurosurgery. 2009;64(1):48–54. discussion 54–5.

    Article  PubMed  Google Scholar 

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Correspondence to John C. Flickinger M.D. .

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Flickinger, J.C., Kano, H., Lunsford, L.D. (2015). Radiosurgery of Acoustic Schwannomas. In: Chin, L., Regine, W. (eds) Principles and Practice of Stereotactic Radiosurgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8363-2_23

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  • DOI: https://doi.org/10.1007/978-1-4614-8363-2_23

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8362-5

  • Online ISBN: 978-1-4614-8363-2

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