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Relative Indications for Radiosurgery and Microsurgery for Acoustic Schwannoma

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Advances and Technical Standards in Neurosurgery

Part of the book series: Advances and Technical Standards in Neurosurgery ((NEUROSURGERY,volume 28))

Abstract

The physical and biological principles underlying the use of radiosurgery for the treatment of vestibular schwannomas of up to 2.5 cm in diameter are reviewed together with the historical controversies that have surrounded its introduction. The results in terms of mortality, quality of life, preservation of facial movement and hearing, incidence of shunt-dependent hydrocephalus cancer neogenesis and brain stem damage are compared in the Marseilles series of 600 microsurgical procedures and 830 Gamma knife procedures and with the peer-reviewed literature. The key principles of a steep profile to radiation exposure at the tumour margin, careful topographical planning of the radiation against the tumour shape to minimise the radiation dose to the cranial nerves and brain stem, early tumour swel1ing, tumour texture and national history of the tumour are analysed. Protocols for the management of unilateral schwannoma, Type II neurofibromatosis (both the Wishart and the Gardner types) and residual/ recurrent tumours are presented. In summary, the growth of nearly 97% of vestibular schwannomas (up to 2.5 cm) is arrested by the Gamma knife, the facial nerve is preserved in almost all cases and hearing may be preserved at its pre-operative level in nearly 70% of cases without the complications of microsurgery.

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Authors and Affiliations

  1. Department of Otoneurosurgery, Hôpital Sainte Marguerite, Marseille, France

    W. Pellet, J. Regis, P.-H. Roche & C. Delsanti

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  1. W. Pellet
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  2. J. Regis
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  3. P.-H. Roche
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  4. C. Delsanti
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Editor information

Editors and Affiliations

  1. Cambrigde

    J. D. Pickard

  2. Ljubljana

    V. V. Dolenc

  3. Lisbon

    J. Lobo Antunes

  4. Munich

    JH.-J. Reulen

  5. Lyon

    M. Sindou

  6. London

    A. J. Strong

  7. Lausanne

    N. de Tribolet

  8. Utrecht

    C. A. F. Tulleken

  9. Kuopio

    M. Vapalahti

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© 2003 Springer-Verlag Wien

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Pellet, W., Regis, J., Roche, PH., Delsanti, C. (2003). Relative Indications for Radiosurgery and Microsurgery for Acoustic Schwannoma. In: Pickard, J.D., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 28. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0641-9_4

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  • DOI: https://doi.org/10.1007/978-3-7091-0641-9_4

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7217-9

  • Online ISBN: 978-3-7091-0641-9

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