Subtotal resection of vestibular schwannoma with subsequent Gamma Knife irradiation – tumor growth control, facial and cochlear nerve outcome – preliminary results-Reference-Cited by-同舟云学术

Subtotal resection of vestibular schwannoma with subsequent Gamma Knife irradiation – tumor growth control, facial and cochlear nerve outcome – preliminary results

Published:2024-07-21 Issue:4 Volume:78 Page:7-15
ISSN:0030-6657
Container-title:Otolaryngologia Polska
language:
Short-container-title:Otolaryngol Pol

Author:

Turek Grzegorz¹^ORCID,Drożdż Adrian²,Dzierzęcki Sebastian³^ORCID,Dżaman Karolina⁴^ORCID,Gruda Mariusz³,Zielińska-Turek Justyna⁵,Gajewski Jan⁶,Bodzak Dominika³,Ząbek Mirosław⁷^ORCID

Affiliation:

1. Department of Neurosurgery, Brodno Masovian Hospital, Warsaw, Poland

2. Department of Neurosurgery, Brodno Masovian Hospital, Warsaw, Poland, Department of Descriptive and Clinical Anatomy, Centre for Biostructure Research, Medical University of Warsaw, Poland

3. Gamma Knife Centre, Warsaw, Poland

4. Department of Otolaryngology, Centre of Postgraduate Medical Education, Warsaw, Poland

5. Department of Neurology, The National Institute of Medicine of the Ministry of Interior and Administration, Warsaw, Poland

6. Faculty of Physical Education, Józef Piłsudski University of Physical Education, Warsaw, Poland

7. Department of Neurosurgery, Postgraduate Medical Centre, Warsaw, Poland, Department of Neurosurgery, Brodno Masovian Hospital, Warsaw, Poland, Gamma Knife Centre, Warsaw, Poland

Abstract

Introduction: The choice of treatment of vestibular schwannoma (VS) depends on several factors, including the tumor size, the patient’s age and overall health, and the presence and severity of symptoms.Aim: The aim of the study was to assess the effectiveness of intentional subtotal resection (STR) of tumor followed by Gamma Knife surgery (GKS) in patients with larger VS (Koos 3 and 4).Materials and methods: The retrospective analysis was performed on 18 patients. Data of VS volumes measured in MRI, the facial nerve function assessed in the House-Brackmann scoring system (HB), and the results of audiological examination expressed on the Gardner-Robertson scale (GR) were collected preoperatively, postoperatively, and post-GKS.Results: Preoperatively, the main symptom was hearing loss observed in 13 out of 18 patients. The facial nerve function was assessed as HB 1 in 16, whereas HB 2 in 2 patients. The mean volume of the tumor in the initial MRI amounted to 16.81 cm3 . Postoperatively, the facial nerve was assessed as HB 1 or 2 in 16, whereas HB 3 in 2 patients. Serviceable hearing was presented by only 4 persons. The Mean diameter of the tumor after subtotal surgery amounted to 3.16 cm3 , 1.83 cm3 after GKS, and 1.58 cm3 at the last follow-up. The facial nerve function and hearing level remained the same as before GKS in all patients.Conclusions: STR followed by GKS can be a safe and effective method of treatment of large VS concerning the functional outcome of the facial nerve and the tumor volume growth control.

Publisher

Index Copernicus

Link

https://otolaryngologypl.com/gicid/pdf/01.3001.0054.5437

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