700 results match your criteria Skull Base Acoustic Neuroma Vestibular Schwannoma

Multi-Disciplinary Skull Base Conference and its Effects on Patient Management.

Ann Otol Rhinol Laryngol 2021 May 28:34894211021251. Epub 2021 May 28.

Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Objective: Examine the effects of a multi-disciplinary skull base conference (MDSBC) on the management of patients seen for skull base pathology in a neurotology clinic.

Methods: Retrospective case review of patients who were seen in a neurotology clinic at a tertiary academic medical center for pathology of the lateral skull base and were discussed at an MDSBC between July 2019 and February 2020. Patient characteristics, nature of the skull base pathology, and pre- and post-MDSBC plan of care was categorized. Read More

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Hemihypoglossal-facial nerve anastomosis: results and electromyographic characterization.

Eur Arch Otorhinolaryngol 2021 May 25. Epub 2021 May 25.

Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Úvalu 84, 150 06, Prague 5, Czech Republic.

Introduction: The facial nerve surgery belongs to the basic procedures during lateral skull base approaches. Its damage has serious medical and psychological consequences, and therefore mastery of reconstruction and correction techniques should belong to the repertoire of skull base surgeons. The goal of this study was to demonstrate usefulness of electromyographic follow-up in facial nerve reconstruction. Read More

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Defining current practice patterns of vestibular schwannoma management in Italy: results of a nationwide survey.

Acta Otorhinolaryngol Ital 2021 Apr;41(2):185-191

Otolaryngology Section, Department of Neuroscience - DNS, Padova University, Padova, Italy.

Objective: Despite the increasing incidence rate of vestibular schwannomas (VS), controversies in their management are still present.

Methods: A 35-item multiple-choice survey investigating the current practice patterns of VS care was sent to the members of the Italian Society of Otolaryngology, Head and Neck Surgery (SIO) and of the Italian Society of Neurosurgery (SINCH).

Results: Among 66 respondents, 37 (56. Read More

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Comparison of Surgical Outcomes and Recurrence Rates of Cystic and Solid Vestibular Schwannomas.

J Neurol Surg B Skull Base 2021 Jun 21;82(3):333-337. Epub 2019 Oct 21.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States.

 Cystic vestibular schwannomas (CVSs) are anecdotally believed to have worse clinical and tumor-control outcomes than solid vestibular schwannomas (SVSs); however, no data have been reported to support this belief. In this study, we characterize the clinical outcomes of patients with CVSs versus those with SVSs.  This is a retrospective review of prospectively collected data. Read More

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Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Retrosigmoid Approach.

J Neurol Surg B Skull Base 2021 Jun 28;82(3):321-332. Epub 2019 Oct 28.

Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.

 Neurosurgical anatomy is traditionally taught via anatomic and operative atlases; however, these resources present the skull base using views that emphasize three-dimensional (3D) relationships rather than operative perspectives, and are frequently written above a typical resident's understanding. Our objective is to describe, step-by-step, a retrosigmoid approach dissection, in a way that is educationally valuable for trainees at numerous levels.  Six sides of three formalin-fixed latex-injected specimens were dissected under microscopic magnification. Read More

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Medical Malpractice and Vestibular Schwannomas: A Nationwide Review.

World Neurosurg 2021 Jun 26;150:e714-e726. Epub 2021 Mar 26.

Department of Neurological Surgery, Montefiore Medical Center, Bronx, New York, USA.

Objective: Most surgeons face litigation related to the care of their patients, with specialties including neurosurgery facing a particularly high risk. Diagnosis and management of vestibular schwannomas can be challenging, potentially giving rise to medicolegal proceedings. Accordingly, a full appreciation of the medicolegal implications of treating these challenging tumors is warranted. Read More

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Intracanalicular Vestibular Schwannoma: A Systematic Review and Meta-analysis of Therapeutics Outcomes.

Otol Neurotol 2021 03;42(3):351-362

Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University.

Objective: To perform a systematic review and meta-analysis summarizing the current evidence on the management of intracanalicular vestibular schwannoma.

Data Sources: Embase (1947-), Medline (1946-), Cochrane library (1947-), Scopus (2010-), and CINAHL (1961-) were searched from 1969 to October 5, 2019 (50 years).

Study Selection: A search strategy was performed to identify patients with vestibular schwannoma confined to the internal auditory canal without extension to the cerebellopontine angle. Read More

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Immunophenotype of Vestibular Schwannomas.

Otol Neurotol 2020 12;41(10):e1290-e1296

Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.

Background: Vestibular schwannomas exhibit a uniquely variable natural history of growth, stability, or even spontaneous regression. We hypothesized that a transitory population of immune cells, or immunomodulation of tumors cells, may influence the growth pattern of schwannomas. We therefore sought to characterize the impact of the immune microenvironment on schwannoma behavior. Read More

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December 2020

Large and small vestibular schwannomas: same, yet different tumors.

Acta Neurochir (Wien) 2021 Jan 20. Epub 2021 Jan 20.

Department of Neurologic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.

Background: Vestibular schwannomas (VS) present at variable size with heterogeneous symptomatology. Modern treatment paradigms for large VS include gross total resection, subtotal resection (STR) in combination with observation, and/or radiation to achieve optimal function preservation, whereas treatment is felt to be both easier and safer for small VS. The objective is to better characterize the presentation and surgical outcomes of large and small VS. Read More

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January 2021

The role of a virtual telephone clinic in the follow-up management of lateral skull base tumours.

J Laryngol Otol 2020 Dec 17;134(12):1081-1084. Epub 2020 Dec 17.

Neuro-Otology and Skull Base Service, Beaumont Hospital, Dublin, Ireland.

Objective: The purpose of this article was to determine the impact of employing a telephone clinic for follow-up of patients with stable lateral skull-base tumours.

Method: An analysis of 1515 patients in the national lateral skull-base service was performed, and 148 patients enrolled in the telephone clinic to date were identified. The length of time that patients waited for results of their follow-up scans and the travel distance saved by patients not having to attend the hospital for their results was determined. Read More

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December 2020

What determines quality of life in patients with vestibular schwannoma?

Clin Otolaryngol 2021 Mar 28;46(2):412-420. Epub 2020 Dec 28.

Department of Otorhinolaryngology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.

Objectives: Patients with a vestibular schwannoma (VS) experience a reduced quality of life (QoL). The main objective of this study was to determine the strongest predictors reducing physical and mental QoL from the disease-specific Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire in patients with VS.

Design: Observational study. Read More

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ESTRO ACROP guideline for target volume delineation of skull base tumors.

Radiother Oncol 2021 03 10;156:80-94. Epub 2020 Dec 10.

Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy; IRCCS Neuromed, Pozzilli, Italy. Electronic address:

Background And Purpose: For skull base tumors, target definition is the key to safe high-dose treatments because surrounding normal tissues are very sensitive to radiation. In the present work we established a joint ESTRO ACROP guideline for the target volume definition of skull base tumors.

Material And Methods: A comprehensive literature search was conducted in PubMed using various combinations of the following medical subjects headings (MeSH) and free-text words: "radiation therapy" or "stereotactic radiosurgery" or "proton therapy" or "particle beam therapy" and "skull base neoplasms" "pituitary neoplasms", "meningioma", "craniopharyngioma", "chordoma", "chondrosarcoma", "acoustic neuroma/vestibular schwannoma", "organs at risk", "gross tumor volume", "clinical tumor volume", "planning tumor volume", "target volume", "target delineation", "dose constraints". Read More

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Preoperative Radiographic Predictors of Hearing Preservation After Retrosigmoid Resection of Vestibular Schwannomas.

Otolaryngol Head Neck Surg 2020 Dec 8:194599820978246. Epub 2020 Dec 8.

Department of Head and Neck Surgery, Kaiser Permanente Southern California Group, San Diego, California, USA.

Objective: To identify preoperative radiographic predictors of hearing preservation (HP) after retrosigmoid resection of vestibular schwannomas (VSs).

Study Design: Retrospective case series with chart review.

Setting: Tertiary skull base referral center. Read More

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December 2020

Determinants of Vestibular Schwannoma Growth.

Otol Neurotol 2021 06;42(5):746-754

Department of Skull Base Surgery, Cambridge University Hospitals.

Objective: Management of vestibular schwannomas (VS) involves surgery, radiotherapy, or surveillance, based on patient and tumor factors. We recently described conditional probability as a more accurate method for stratifying VS growth risk. Building on this, we now describe determinants of VS growth, allowing clinicians to move toward a more personalized approach to growth-risk profiling. Read More

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Association between socioeconomic indicators and geographic distribution of vestibular schwannomas in West Scotland: a 15-year review.

J Laryngol Otol 2020 Dec 3:1-9. Epub 2020 Dec 3.

Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK.

Objective: Socioeconomic risk factors may contribute to geographic variation in diseases, but studies are limited due to lack of large available cohorts.

Method: A geographic analysis was performed of the association between socioeconomic risk factors and the distribution of vestibular schwannomas in adults diagnosed with sporadic vestibular schwannomas through the National Health Services in the West of Scotland from 2000 to 2015.

Results: A total of 511 sporadic vestibular schwannomas were identified in a population of over 3. Read More

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December 2020

Imaging Post Stereotactic Radiosurgery for Vestibular Schwannomas-When Should We Scan?

Otol Neurotol 2021 02;42(2):e216-e221

Department of Otolaryngology, Skull Base Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom.

Objective: To identify the optimal time for imaging following stereotactic radiosurgery (SRS) in patients with vestibular schwannomas (VS).

Study Design: Retrospective case series.

Setting: Tertiary, university center. Read More

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February 2021

Endoscopic Assisted Lateral Skull Base Surgery.

Otolaryngol Clin North Am 2021 Feb;54(1):163-173

ENT Department, University Hospital of Verona, Piazzale Aristide Stefani, 1, Verona 37126, Italy.

Pathology of the lateral skull base poses a unique challenge for the surgeon. An intimate knowledge of the anatomy and the various approaches used for accessing pathology of the lateral skull base is critical. Three novel, minimally invasive, transcanal approaches for the management of lateral skull base pathology are described herein along with their respective indications, advantages, and disadvantages. Read More

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February 2021

Incidental Findings of a Vestibular Schwannoma on 18F-Choline PET/CT.

Clin Nucl Med 2021 Feb;46(2):e75-e77

Radiotherapy, University Hospital of Brest.

Abstract: We report an increased uptake of 18F-choline in the right cerebellopontine angle area in a 73-year-old man with biochemical failure prostate cancer after radical prostatectomy, potentially suggestive of bone metastasis in the base of the skull. A brain MRI was also performed showing an intense gadolinium enhancement focus in the same area, concordant with a right vestibular schwannoma, subsequently histologically proven. This case underlines that schwannoma is a diagnostic pitfall in 18F-choline PET/CT, suggesting this radiolabeled tracer as a promising tool for brain tumors characterization due to its higher signal-to-background ratio than 18F-FDG. Read More

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February 2021

Prospective Study of Disease-Specific Quality-of-Life in Sporadic Vestibular Schwannoma Comparing Observation, Radiosurgery, and Microsurgery.

Otol Neurotol 2021 02;42(2):e199-e208

Department of Otolaryngology-Head and Neck Surgery.

Background: Previous cross-sectional studies analyzing quality of life (QOL) outcomes in patients with sporadic vestibular schwannoma (VS) have shown surprisingly little difference among treatment modalities. To date, there is limited prospective QOL outcome data available comparing baseline to posttreatment scores.

Study Design: Prospective longitudinal study using the disease-specific Penn Acoustic Neuroma Quality of Life (PANQOL) scale. Read More

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February 2021

Facial nerve management in patients with malignant skull base tumors.

J Neurooncol 2020 Dec 28;150(3):493-500. Epub 2020 Oct 28.

Facial Paralysis Institute, Center for Advanced Facial Plastic Surgery, Beverly Hills, CA, USA.

Introduction: The course of the facial nerve through the cerebellopontine angle, temporal bone, and parotid gland puts the nerve at risk in cases of malignancy. In contrast to Bell's palsy, which presents with acute facial paralysis, malignancies cause gradual or fluctuating weakness.

Methods: We review malignancies affecting the facial nerve, including those involving the temporal bone, parotid gland, and cerebellopontine angle, in addition to metastatic disease. Read More

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December 2020

Tracking Spontaneous Vestibular Schwannoma Regression with Volumetric Measurements.

Laryngoscope 2021 05 26;131(5):E1647-E1652. Epub 2020 Oct 26.

Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, U.S.A.

Objective: To characterize a series of patients with MRI evidence of spontaneous vestibular schwannoma (VS) regression.

Study Design: Retrospective case series.

Methods: Retrospective review between 2012 and 2020 from a single, tertiary-care center of all patients with an untreated, sporadic VS and spontaneous regression in volumetric tumor size over the course of observation. Read More

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Hypercoagulability in Vestibular Schwannoma Surgery.

Otol Neurotol 2021 02;42(2):e222-e226

Division of Neurotology, House Ear Institute.

Objective: Patients with vestibular schwannoma who harbor a genetic predisposition for venous thromboembolism require special consideration when determining optimal therapeutic management. The primary objective of the current study was to provide recommendations on treatment of hypercoagulable patients with vestibular schwannoma through a case series and review of the literature.

Patients: Two patients who underwent resection of vestibular schwannomas. Read More

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February 2021

The Association of Vestibular Schwannoma Volume With Facial Nerve Outcomes After Surgical Resection.

Laryngoscope 2021 04 2;131(4):E1328-E1334. Epub 2020 Oct 2.

Department of Otolaryngology - Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.

Objective: To explore the relationship between tumor size and facial nerve outcomes following vestibular schwannoma (VS) resection.

Study Design: Single institutional retrospective chart review of all adult patients with untreated sporadic VS who underwent surgical resection from 2008 to 2018 with preoperative magnetic resonance imaging (MRI) and 1 year of follow-up. The primary outcome measure was facial nerve outcome as assessed by the House-Brackmann facial nerve grading system. Read More

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Aberrant AICA Injury During Translabyrinthine Approach.

Otol Neurotol 2020 12;41(10):1423-1426

Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.

Objective: To define a complication of the translabyrinthine surgical approach to the posterior fossa related to a rare variant of the anterior inferior cerebellar artery (AICA) that penetrated into the petrous temporal bone.

Patient: A healthy 59-year-old male with a unilateral sporadic vestibular schwannoma.

Intervention: The patient elected to undergo a translabyrinthine approach for resection of a vestibular schwannoma. Read More

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December 2020

Neurofibromatosis type 2: A nationwide population-based study focused on survival after meningioma surgery.

Clin Neurol Neurosurg 2020 11 23;198:106236. Epub 2020 Sep 23.

INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA Team, Université de Paris, France.

Background: There is no dedicated study on outcome after meningioma surgery in neurofibromatosis type 2 (NF2) patients.

Methods: We processed the French Système National des Données de Santé (SNDS) database using an algorithm combining the type of surgical procedure and the International Classification of Diseases to retrieve cases of meningioma operated in NF2 patients between 2007 and 2017. Descriptive and survival analyses were performed. Read More

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November 2020

Middle Cranial Fossa Approach to Vestibular Schwannoma Resection in the Older Patient Population.

Otol Neurotol 2021 01;42(1):e75-e81

Department of Otolaryngology-Head and Neck Surgery.

Objective: Compare outcomes of middle cranial fossa approach (MCF) to vestibular schwannoma (VS) resection in patients 60 years of age and older to patients under 60.

Study Design: Retrospective case series.

Setting: Tertiary referral center. Read More

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January 2021

Effect of Vestibular Schwannoma Size and Nerve of Origin on Posterior External Auditory Canal Sensation: A Prospective Observational Study.

Otol Neurotol 2020 10;41(9):e1145-e1148

Division of Neurotology, House Institute Foundation, Los Angeles, California.

Objective: Posterior external auditory canal (EAC) hypesthesia (Hitselberger's sign) has been previously described to occur in all vestibular schwannomas (1966) but has not been studied since. We hypothesized that sensory loss may be related to tumor size and sought to determine if this clinical sign could predict preoperative characteristics of vestibular schwannomas, intraoperative findings, and/or surgical outcomes.

Study Design: Prospective observational study. Read More

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October 2020

Staged Cranial Surgery for Intracranial Lesions: Historical Perspective.

World Neurosurg 2020 12 22;144:28-33. Epub 2020 Aug 22.

Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA.

We follow the development of staged resection from its first description by Walter E. Dandy, one of the founding fathers of neurosurgery, in 1925 in which he removed a large vestibular schwannoma.This historical vignette cites neurosurgical case reports and literature to demonstrate the evolution of staged resection of intracranial lesions, from Dandy's initial use to its becoming a more viable and safe option for the treatment of meningiomas, vestibular schwannomas, and skull base lesions (among numerous other intracranial pathologies). Read More

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December 2020

Meningiomas of the Internal Auditory Canal.

Laryngoscope 2021 02 18;131(2):E413-E419. Epub 2020 Aug 18.

Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza-Rome, Italy.

Objective: Identify and define specific preoperative and postoperative characteristics of intracanalicular meningiomas (ICMs) in order to improve their diagnosis and management, and to differentiate them from intrameatal vestibular schwannomas (IMVSs).

Methods: Preoperative symptomatology, magnetic resonance imaging (MRI), and postoperative outcomes of 28 ICMs were analyzed. The results were compared to the literature and IMVSs treated by our group. Read More

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February 2021

Surgical management for large vestibular schwannomas: a systematic review, meta-analysis, and consensus statement on behalf of the EANS skull base section.

Acta Neurochir (Wien) 2020 11 29;162(11):2595-2617. Epub 2020 Jul 29.

Department of Neurosurgery Service and Gamma Knife Center, University hospital of Lausanne and Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.

Background And Objective: The optimal management of large vestibular schwannomas continues to be debated. We constituted a task force comprising the members of the EANS skull base committee along with international experts to derive recommendations for the management of this problem from a European perspective.

Material And Methods: A systematic review of MEDLINE database, in compliance with the PRISMA guidelines, was performed. Read More

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November 2020