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Acoustic neuroma surgery

N Sai, W J Han, M M Wang, X Qin, T Zhang, W D Shen, J Liu, P Dai, S M Yang, D Y Han
Objective: To elucidate the clinical behavior, causes of misdiagnosis, surgical management, and outcomes of facial nerve schwannomas (FNS). Methods: A retrospective review in Chinese People's Liberation Army General Hospital from January 1, 2002 to December 31, 2015 was carried out and evaluated 110 patients with FNS, including 50 males and 60 females, aged 16-67 years old. The appropriate surgical strategy was selected based on each patient's clinical manifestations, facial nerve function, and imaging characteristics...
February 7, 2019: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Colin J Przybylowski, Jacob F Baranoski, Gabriella M Paisan, Kristina M Chapple, Andrew J Meeusen, Stephen Sorensen, Kaith K Almefty, Randall W Porter
Fractionated CyberKnife radiosurgery (CKRS) treatment for acoustic neuromas may reduce the risk of long-term radiation toxicity to nearby critical structures compared to that of single-fraction radiosurgery. However, tumor control rates and clinical outcomes after CKRS for acoustic neuromas are not well described. We retrospectively reviewed all acoustic neuroma patients treated with CKRS (2004-2011) in a prospectively maintained clinical and radiographic database. Treatment failure, the need for additional surgical intervention, was evaluated using Kaplan-Meier analysis...
February 12, 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Elisabetta Zanoletti, Antonio Mazzoni, Domenico d'Avella
BACKGROUND: Current imaging modalities enable early diagnosis of a large number of small acoustic neuromas in patients with well-preserved hearing, whose best management is still a debatable matter. METHODS: Comparing the hearing outcome of the various therapeutical approaches, including observation, radiosurgery, or resective surgery, is not easy because of the numerous classifications measuring hearing in different ways. In this review, a literature review was performed and papers selected dealing with small tumors, short- and long-term hearing, tumor control or radical resection, and effect of pre-treatment hearing and size on outcome...
December 8, 2018: Acta Neurochirurgica
Remi A Kessler, Deborah L Benzil, Joshua Loewenstern, Sabrina Chen, Ansh Bhammar, Karan M Kohli, Constantinos G Hadjipanayis, Alan Scarrow, Joshua Bederson, Raj K Shrivastava
BACKGROUND: Medical malpractice litigation is an issue of major concern in neurosurgery, with 19.1% of neurosurgeons facing a claim annually. Neurosurgery possesses the greatest risk of malpractice of any specialty, likely owing to the complex clinical environment and disease severity. In the present study, we have characterized such litigation to determine the common factors that compel plaintiffs to file these claims. METHODS: WestLawNext, a prominent legal database, was used to identify all cases from 1985 to 2016 related to brain tumors...
November 23, 2018: World Neurosurgery
Kenny F Lin, Claire R Stewart, Philip E Steig, Cameron W Brennan, Philip H Gutin, Samuel H Selesnick
Objectives  To determine the incidence of prolonged postoperative systemic corticosteroid therapy after surgery for acoustic neuroma as well as the indications and associated risk factors that could lead to prolonged steroid administration, and the incidence of steroid-related adverse effects. Study Designs  Retrospective chart review. Methods  Retrospective chart review of patients undergoing resection of acoustic neuroma between 2010 and 2017 at two tertiary care medical centers. Patient and tumor characteristics, operative approach, hospital length of stay, initial postoperative taper length, number of discrete postoperative steroid courses, and postoperative complications were analyzed...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
Henrik Smeds, Jeremy Wales, Tiit Mathiesen, Mats Talbäck, Maria Feychting
Purpose: Cochlear implants are widely used for hearing rehabilitation of deaf children with congenital deafness or adults with acquired severe-to-profound hearing loss. The sound processor antenna creates a radio frequency-electromagnetic field transmitting the sound signal to the implant, similar to that in a mobile phone. A recent case report suggested a relationship between cochlear implants and malignant glioma, and some epidemiological studies have suggested an increased glioma and acoustic neuroma risk associated with long hours of mobile phone use...
2018: Clinical Epidemiology
Koichi Torihashi, Shigeo Sora, Hiroaki Sato, Michihiro Kohno
Preservation of facial nerve (FN) function is the most important goal in acoustic neuroma (AN) surgery. We have been using intraoperative continuous facial nerve monitoring (ICFNm) of evoked electromyography during AN surgery. ICFNm is very useful, and we can identify the real-time functions of the FN. Some surgeons have experienced difficulty with placing the ICFN stimulating electrode (SE). We therefore show how to place the ICFN SE. We mostly perform AN surgery with a retrosigmoid approach (RSA). A craniotomy with four burr holes is performed...
November 15, 2018: Neurologia Medico-chirurgica
Nopawan Vorasubin, Thomas H Alexander, Bill Mastrodimos, Roberto A Cueva
OBJECTIVE: To identify perioperative factors that influence hospital length of stay (LOS) after resection of vestibular schwannoma (VS). STUDY DESIGN: Retrospective case review. SETTING: Tertiary skull base referral center. PATIENTS: Patients who underwent acoustic neuroma resection between January 1, 2007 and January 1, 2014. INTERVENTIONS: Approaches used for VS resection included translabyrinthine and retrosigmoid...
October 2018: Otology & Neurotology
E Zanoletti, D Cazzador, C Faccioli, S Gallo, L Denaro, D D'Avella, A Martini, A Mazzoni
The current treatment options for acoustic neuromas (AN) - observation, microsurgery and radiotherapy - should assure no additional morbidity on cranial nerves VII and VIII. Outcomes in terms of disease control and facial function are similar, while the main difference lies in hearing. From 2012 to 2016, 91 of 169 patients (54%) met inclusion criteria for the present study, being diagnosed with unilateral, sporadic, intrameatal or extrameatal AN up to 1 cm in the cerebello-pontine angle; the remaining 78 patients (46%) had larger AN and were all addressed to surgery...
August 2018: Acta Otorhinolaryngologica Italica
Jiye Lin, Zhenjun Zhou, Jianwei Guan, Yubo Zhu, Yang Liu, Zhilin Yang, Bomiao Lin, Yongyan Jiang, Xianyue Quan, Yiquan Ke, Tao Xu
OBJECTIVE: Using three-dimensional (3D) printing to create individualized patient models of the skull base, the optic chiasm and facial nerve can be previsualized to help identify and protect these structures during tumor removal surgery. METHODS: Preoperative imaging data for 2 cases of sellar tumor and 1 case of acoustic neuroma were obtained. Based on these data, the cranial nerves were visualized using 3D T1-weighted turbo field echo sequence and diffusion tensor imaging-based fiber tracking...
December 2018: World Neurosurgery
Dilok Puanhvuan, Sorayouth Chumnanvej, Yodchanan Wongsawat
INTRODUCTION: Cranial nerve (CN) VII localization is a critical step during acoustic neuroma surgery because the nerve is generally hidden due to the tumor mass. The patient can suffer from Bell's palsy if the nerve is accidentally damaged during tumor removal. Surgeons localize CN VII by exploring the target area with a stimulus probe. Compound muscle action potentials (CMAPs) are elicited when the probe locates the nerve. However, false positives and false negatives are possible due to unpredictable tissue impedance in the operative area...
June 2018: Brain and Behavior
Kevin A Peng, Gregory P Lekovic, Eric P Wilkinson
PURPOSE OF REVIEW: To discuss the use of the middle fossa craniotomy for resection of vestibular schwannomas; to present pearls of and modifications to the approach. RECENT FINDINGS: The middle fossa craniotomy allows for hearing preservation in the resection of intracanalicular vestibular schwannomas. Over recent years, the approach has been modified to address larger tumors with a limited cerebellopontine angle component. Positive identification of the superior semicircular canal allows for rapid exposure of the internal auditory canal (IAC)...
October 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Kaley Woods, Percy Lee, Tania Kaprealian, Isaac Yang, Ke Sheng
Purpose: This study investigates whether 4π noncoplanar radiation therapy can spare the cochleae and consequently potentially improve hearing preservation in patients with acoustic neuroma who are treated with radiation therapy. Methods and materials: Clinical radiation therapy plans for 30 patients with acoustic neuroma were included (14 stereotactic radiation surgery [SRS], 6 stereotactic radiation therapy [SRT], and 10 intensity modulated radiation therapy [IMRT])...
April 2018: Advances in Radiation Oncology
Marcel Fabian Glaas, Ralf Schäfer, Philipp Jansen, Matthias Franz, Igor Stenin, Thomas Klenzner, Jörg Schipper, Katrin Eysel-Gosepath, Julia Kristin
OBJECTIVE: To quantify the postoperative quality of life (QOL) of patients after translabyrinthine surgery for vestibular schwannoma (VS) using the German version of the Penn acoustic neuroma quality-of-life questionnaire (PANQOL) in a university hospital. METHODS: The PANQOL questionnaire was administered to 72 patients who were treated in our department with translabyrinthine surgery for VS between January 2007 and January 2017. Descriptive evaluations of results were performed in addition to analyses of the reliability and convergent validity of the results and a subgroup analysis...
July 2018: Otology & Neurotology
Robin Babadjouni, Timothy Wen, Daniel A Donoho, Ian A Buchanan, Steven Y Cen, Rick A Friedman, Arun Amar, Jonathan J Russin, Steven L Giannotta, William J Mack, Frank J Attenello
BACKGROUND: Hospital readmissions are commonly linked to elevated health care costs, with significant financial incentive introduced by the Affordable Care Act to reduce readmissions. OBJECTIVE: To study the association between patient, hospital, and payer factors with national rate of readmission in acoustic neuroma surgery. METHODS: All adult inpatients undergoing surgery for acoustic neuroma in the newly introduced Nationwide Readmissions Database from 2013 to 2014 were included...
June 8, 2018: Neurosurgery
Ronny Kalash, Scott M Glaser, John C Flickinger, Steven Burton, Dwight E Heron, Peter C Gerszten, Johnathan A Engh, Nduka M Amankulor, John A Vargo
OBJECTIVE Akin to the nonoperative management of benign intracranial tumors, stereotactic body radiation therapy (SBRT) has emerged as a nonoperative treatment option for noninfiltrative primary spine tumors such as meningioma and schwannoma. The majority of initial series used higher doses of 16-24 Gy in 1-3 fractions. The authors hypothesized that lower doses (such as 12-13 Gy in 1 fraction) might provide an efficacy similar to that found with the dose de-escalation commonly used for intracranial radiosurgery to treat acoustic neuroma or meningioma and with a lower risk of toxicity...
August 2018: Journal of Neurosurgery. Spine
Ahad Sabab, Jaspreet Sandhu, Stephen Bacchi, Alistair Jukes, Andrew Zacest
Vestibular schwannoma (VS) is a brain tumour arising from Schwann cells that is typically closely associated with the vestibulocochlear nerve. Post-operative headaches (POH) are a potentially common complication of surgery for VS. Greatly differing rates of POH have previously been reported, particularly with different surgical approaches. The aim of this review is to identify and summarise the available peer-reviewed evidence on rates of POH following operative (or radiosurgery) treatment for VS, in addition to information about the treatment and prognosis of POH in these patients...
June 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Baohui Hou
The medium and long-term effects of electrophysiologic monitoring on the facial nerve function in minimally invasive surgery treating acoustic neuroma were studied. Sixty-two patients with acoustic neuroma taking minimally invasive surgeries in Dezhou Hospital from August 2014 to September 2015 were selected and randomly divided into 29 cases of the control group and 33 cases of the observation group. Intraoperative electrophysiologic monitoring was applied to the observation group, but not to the control group...
March 2018: Experimental and Therapeutic Medicine
Michael J Link, Morten Lund-Johansen, Christine M Lohse, Colin L W Driscoll, Ehrling Myrseth, Oystein Vesterli Tveiten, Matthew L Carlson
BACKGROUND: The goal of microsurgical removal of a vestibular schwannoma is to completely remove the tumor, to provide long-term durable cure. In many cases, less than gross total resection (GTR) is performed to preserve neurological, and especially facial nerve function. OBJECTIVE: To analyze long-term quality of life (QoL) in a cohort of patients who received either GTR or less than GTR. METHODS: Patients operated for vestibular schwannoma less than 3...
April 1, 2018: Neurosurgery
Evg A Kasparova, O I Sobkova, E A Kasparova, A A Kasparov
OBJECTIVE: The study objective was to develop a method for surgical treatment of advanced purulent corneal ulcer in the setting of neuroparalytic keratitis developed after acoustic neuroma removal and strokes. MATERIAL AND METHODS: The study included 12 patients (13 eyes). All patients underwent single-step keratoplasty, conjunctival autografting, and partial permanent tarsorrhaphy. RESULTS: The eye as an organ was spared in 100% of cases; vision was spared in 50% of cases and improved, from 0...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
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