558 results match your criteria Skull Base Acoustic Neuroma Vestibular Schwannoma


Comparing costs of microsurgical resection and stereotactic radiosurgery for vestibular schwannoma.

Authors:

J Neurosurg 2018 Nov 1:1-10. Epub 2018 Nov 1.

OBJECTIVEGiven rising scrutiny of healthcare expenditures, understanding intervention costs is increasingly important. This study aimed to compare and characterize costs for vestibular schwannoma (VS) management with microsurgery and radiosurgery to inform practice decisions and appraise cost reduction strategies.METHODSIn conjunction with medical records, internal hospital financial data were used to evaluate costs. Read More

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http://dx.doi.org/10.3171/2018.5.JNS18508DOI Listing
November 2018
1 Read

Incidence of Prolonged Systemic Steroid Treatment after Surgery for Acoustic Neuroma and Its Implications.

J Neurol Surg B Skull Base 2018 Dec 13;79(6):559-568. Epub 2018 Apr 13.

Department of Otolaryngology - Head and Neck Surgery, Weill Cornell Medical College, New York, United States.

 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.  Retrospective chart review.  Retrospective chart review of patients undergoing resection of acoustic neuroma between 2010 and 2017 at two tertiary care medical centers. Read More

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http://dx.doi.org/10.1055/s-0038-1641752DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6239872PMC
December 2018
3 Reads

Revision Surgery for Vestibular Schwannomas.

J Neurol Surg B Skull Base 2018 Dec 9;79(6):528-532. Epub 2018 Apr 9.

House Clinic, Los Angeles, California, United States.

 To describe clinical outcomes of patients undergoing revision surgery for vestibular schwannomas.  Retrospective case series.  Tertiary private neurotologic practice. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1635256
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http://dx.doi.org/10.1055/s-0038-1635256DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6239869PMC
December 2018
6 Reads

Role of Endoscopy in Resection of Intracanalicular Vestibular Schwannoma via Middle Fossa Approach: Technical Nuances.

World Neurosurg 2018 Dec 7;120:395-399. Epub 2018 Sep 7.

Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. Electronic address:

Background: Surgical resection of vestibular schwannomas (VS) located within the internal auditory canal (IAC) is challenging, especially those located very laterally in the IAC. Various transcranial approaches have been described for resection of intracanalicular VS including retrosigmoid, translabyrinthine, and middle fossa approaches. Each approach has its indications, advantages, and limitations. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.08.215DOI Listing
December 2018
1 Read

Factors That Affect Length of Hospital Stay After Vestibular Schwannoma Surgery.

Otol Neurotol 2018 Oct;39(9):1203-1209

Southern California Permanente Medical Group, Pasadena.

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. Read More

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http://dx.doi.org/10.1097/MAO.0000000000001960DOI Listing
October 2018

Shared decision making and decisional conflict in the Management of Vestibular Schwannoma: a prospective cohort study.

J Otolaryngol Head Neck Surg 2018 Sep 3;47(1):52. Epub 2018 Sep 3.

Division of Otolaryngology, Head and Neck Surgery, Dalhousie University, Halifax, NS, Canada.

Background: Patients with vestibular schwannomas (VS) are faced with complex management decisions. Watchful waiting, surgical resection, and radiation are all viable options with associated risks and benefits. We sought to determine if patients with VS experience decisional conflict when deciding between surgery or non-surgical management, and factors influencing the degree of decisional conflict. Read More

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http://dx.doi.org/10.1186/s40463-018-0297-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122206PMC
September 2018

Using Three-Dimensional Printing to Create Individualized Cranial Nerve Models for Skull Base Tumor Surgery.

World Neurosurg 2018 Dec 16;120:e142-e152. Epub 2018 Aug 16.

Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing, China. Electronic address:

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. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.07.236DOI Listing
December 2018
12 Reads

Continuous and Dynamic Facial Nerve Mapping During Surgery of Cerebellopontine Angle Tumors: Clinical Pilot Series.

World Neurosurg 2018 Nov 9;119:e855-e863. Epub 2018 Aug 9.

Department of Neurosurgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Düsseldorf, Germany.

Objective: To evaluate a new surgical tool combining suction and monopolar neurostimulation (stimulation sucker) for cerebellopontine angle (CPA) tumors. The usefulness for continuous (time) and dynamic (space) facial nerve mapping was studied.

Methods: Patients operated on with the stimulation sucker for a CPA tumor between April 2016 and May 2017 in a tertiary care center were identified. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.07.286DOI Listing
November 2018
11 Reads

Brief Commentary on Gidley et al: "Contemporary Opinions on Intraoperative Facial Nerve Monitoring".

Otolaryngol Head Neck Surg 2018 Oct 7;159(4):601-602. Epub 2018 Aug 7.

2 Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Intraoperative facial nerve monitoring (IOFNM) has evolved from requiring sophisticated electromyography equipment to a self-contained monitor with an auditory signal. Subspecialty ear surgeons currently use IOFNM in most otologic and temporal bone procedures as it improves facial nerve outcomes. Our competency and near-universal adoption of IOFNM notwithstanding, otolaryngologists are rarely reimbursed for this procedure. Read More

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http://dx.doi.org/10.1177/0194599818791800DOI Listing
October 2018

Petroclival Meningiomas: Factors Determining the Choice of Approach.

J Neurol Surg B Skull Base 2018 Aug 11;79(4):367-378. Epub 2017 Dec 11.

Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.

 To review a surgical series of petroclival meningiomas and the factors considered in the choice of approach.  Retrospective review.  The study was conducted in a university hospital in southern Brazil. Read More

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http://dx.doi.org/10.1055/s-0037-1608654DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043175PMC
August 2018
1 Read

Comprehensive review of the extended middle cranial fossa approach.

Curr Opin Otolaryngol Head Neck Surg 2018 Oct;26(5):286-292

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

Purpose Of Review: To review the current literature on the extended middle cranial fossa (xMCF) approach and to provide a comprehensive description of the relevant anatomy, indications, surgical technique, results, and complications.

Recent Findings: The xMCF approach expands the surgical exposure provided by the sMCF approach, allowing access to the internal auditory canal, cerebellopontine angle, prepontine cistern, anterior petrous apex, petrous carotid artery, Meckel's cave, cavernous sinus, mid and upper clivus, and posterior lesions approaching the jugular foramen. Preservation of serviceable hearing is possible with success rates approximating 50% in vestibular schwannoma and meningioma resection, and facial nerve outcome is excellent. Read More

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http://dx.doi.org/10.1097/MOO.0000000000000471DOI Listing
October 2018

Neuroglial ectopia of the vestibular nerve masquerading as a vestibular schwannoma: A case report.

Neuropathology 2018 May 20. Epub 2018 May 20.

Department of Neurosurgery, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, CA, USA.

Neuroglial ectopia is a rare entity of undetermined clinical significance. Here, we report a unique case of neuroglial ectopia of the vestibular nerve. A 27-year-old pharmacy student with a previous radiological diagnosis of vestibular schwannoma presented to our clinic for surgical evaluation. Read More

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http://dx.doi.org/10.1111/neup.12475DOI Listing
May 2018
18 Reads

Long-Term Facial Nerve Outcomes after Microsurgical Resection of Vestibular Schwannomas in Patients with Preoperative Facial Nerve Palsy.

J Neurol Surg B Skull Base 2018 Jun 3;79(3):309-313. Epub 2017 Nov 3.

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

 This study aimed at evaluating facial nerve outcomes in vestibular schwannoma patients presenting with preoperative facial nerve palsy.  A retrospective review.  Single-institution cohort. Read More

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http://dx.doi.org/10.1055/s-0037-1607320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5951693PMC

A Cross-sectional Survey of the North American Skull Base Society: Current Practice Patterns of Vestibular Schwannoma Evaluation and Management in North America.

J Neurol Surg B Skull Base 2018 Jun 3;79(3):289-296. Epub 2017 Nov 3.

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, United States.

 Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America.  This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care. Read More

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http://dx.doi.org/10.1055/s-0037-1607319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5951692PMC
June 2018
1 Read

Are Patients with Spontaneous CSF Otorrhea and Superior Canal Dehiscence Congenitally Predisposed to Their Disorders?

Otolaryngol Head Neck Surg 2018 Sep 24;159(3):543-552. Epub 2018 Apr 24.

4 Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA.

Objectives (1) Compare lateral skull base (LSB) height/thickness in patients with spontaneous cerebrospinal fluid otorrhea (CSF), superior canal dehiscence (SCD), acoustic neuromas (AN), and otosclerosis (OTO). (2) Perform correlations between age, body mass index (BMI), sex, and LSB height/thickness. Study Design Case series with chart review. Read More

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http://dx.doi.org/10.1177/0194599818769875DOI Listing
September 2018

Natural History of Sporadic Vestibular Schwannoma: A Volumetric Study of Tumor Growth.

Otolaryngol Head Neck Surg 2018 Sep 24;159(3):535-542. Epub 2018 Apr 24.

1 Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.

Objective (1) Assess 3-dimensional volumetric growth of untreated sporadic vestibular schwannomas (VSs) in a large cohort of patients treated with conservative observation. (2) Compare volumetric and conventional linear diameter measurements for detecting tumor growth. Study Design Case series with chart review. Read More

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http://dx.doi.org/10.1177/0194599818770413DOI Listing
September 2018

Feasibility of real-time intraoperative fluorescence imaging of dural sinus thrombosis.

J Clin Neurosci 2018 Jun 9;52:153-155. Epub 2018 Apr 9.

Division of Neurosurgery, University of Toronto, Toronto, ON, Canada; Division of Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Dural sinus thrombosis is a well-recognized and potentially serious complication following lateral skull base surgery. Methods of diagnosis are limited to post-operative computerized tomography scans or magnetic resonance venography. There are currently no reports of an intraoperative technique used to detect dural sinus thrombosis. Read More

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http://dx.doi.org/10.1016/j.jocn.2018.03.011DOI Listing
June 2018
3 Reads

The Role of Fast Imaging Employing Steady-State Acquisition (FIESTA) Magnetic Resonance Imaging for Assessment of Delayed Enhancement of Fat Graft Packing on Postoperative Imaging After Vestibular Schwannoma Surgery.

World Neurosurg 2018 Jun 30;114:e1066-e1072. Epub 2018 Mar 30.

Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Center for Skull Base and Pituitary Surgery, Rutgers Neurological Institute of New Jersey, Newark, New Jersey, USA. Electronic address:

Objective: To investigate the role and efficacy of fast imaging employing steady-state acquisition (FIESTA) imaging in distinguishing fat graft enhancement from residual or recurrent tumor after vestibular schwannoma (VS) surgery.

Methods: A retrospective study of 33 patients who underwent VS resection via the retrosigmoid or translabyrinthine approach with fat graft reconstruction was performed. Magnetic resonance imaging (MRI) was collected at different time points: preoperative, immediate postoperative (24-48 hours), delayed postoperative (3-6 months after surgery), and yearly postoperative. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.03.147DOI Listing
June 2018
6 Reads

Use of a flexible hollow-core carbon dioxide laser for microsurgical resection of vestibular schwannomas.

Neurosurg Focus 2018 Mar;44(3):E6

Neurosurgery, House Clinic, Los Angeles, California.

OBJECTIVE The CO laser has been used on an intermittent basis in the microsurgical resection of brain tumors for decades. These lasers were typically cumbersome to use due to the need for a large, bulky design since infrared light cannot be transmitted via fiber-optic cables. Development of the OmniGuide cable, which is hollow and lined with an omnidirectional dielectric mirror, has facilitated the reintroduction of the CO laser in surgical use in a number of fields. Read More

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https://thejns.org/view/journals/neurosurg-focus/44/3/articl
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http://dx.doi.org/10.3171/2017.12.FOCUS17592DOI Listing
March 2018
3 Reads

Acute Deafness: A Rare Complication of Shunting.

World Neurosurg 2018 May 30;113:276-279. Epub 2018 Mar 30.

Division of Skull Base and Vascular Neurosurgery, National Institute of Neurosurgery Dr Asenjo, Universidad de Chile, Santiago, Chile.

Background: Mild hearing loss following shunting has been described; however, severe auditory impairment associated with ventriculoperitoneal (VP) shunt is an uncommon, rarely reported phenomenon. Treatment options and pathophysiologic considerations are discussed in this case report.

Case Description: A 27-year-old man who was treated for an eighth cranial nerve schwannoma with complete resection and a VP shunt 10 years previously presented to the emergency department with acute severe hearing loss and headache. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.02.089DOI Listing
May 2018
4 Reads

Patient Decision Making in Vestibular Schwannoma: A Survey of the Acoustic Neuroma Association.

Otolaryngol Head Neck Surg 2018 May 13;158(5):912-916. Epub 2018 Feb 13.

1 Division of Neurotology and Skull Base Surgery, University of California, Irvine, Irvine, California, USA.

Objective To assess the decision-making process of patients with vestibular schwannoma (VS). Study Design Patients with VS completed a voluntary survey over a 3-month period. Setting Surveys were distributed online through email, Facebook, and member website. Read More

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http://dx.doi.org/10.1177/0194599818756852DOI Listing
May 2018
7 Reads

Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis.

Cureus 2017 Nov 15;9(11):e1846. Epub 2017 Nov 15.

Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland.

Introduction The objective of this study was to describe the most common clinical features associated with an acoustic neuroma diagnosis and to identify those features associated with larger tumour size at initial diagnosis. Methods The clinical information of 945 consecutive patients diagnosed with acoustic neuroma at a single centre between 1992 and 2015 was analysed. Clinical features were examined and the relationship between these features and tumour size (>2. Read More

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http://dx.doi.org/10.7759/cureus.1846DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768319PMC
November 2017
2 Reads
1 Citation

A comparison of semi-automated volumetric vs linear measurement of small vestibular schwannomas.

Eur Arch Otorhinolaryngol 2018 Apr 15;275(4):867-874. Epub 2018 Jan 15.

Cambridge Skull Base Unit, Department of ENT, Addenbrookes Hospital, Cambridge University Hospitals, Cambridge, CB2 0QQ, UK.

Objective: Accurate and precise measurement of vestibular schwannoma (VS) size is key to clinical management decisions. Linear measurements are used in routine clinical practice but are prone to measurement error. This study aims to compare a semi-automated volume segmentation tool against standard linear method for measuring small VS. Read More

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http://dx.doi.org/10.1007/s00405-018-4865-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838150PMC

The impact of acoustic neuroma on long-term quality-of-life outcomes in the United Kingdom.

Eur Arch Otorhinolaryngol 2018 Mar 12;275(3):709-717. Epub 2018 Jan 12.

The Skull Base Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Aintree, Liverpool, L9 7AL, UK.

Objective: To quantify the impact of acoustic neuroma on the quality-of-life (QOL) patients in the United Kingdom.

Study Design: Online questionnaire survey.

Patients: Members of the British Acoustic Neuroma Association received PANQOL questionnaires. Read More

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http://dx.doi.org/10.1007/s00405-018-4864-0DOI Listing
March 2018
1 Read

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on Otologic and Audiologic Screening for Patients With Vestibular Schwannomas.

Neurosurgery 2018 Feb;82(2):E29-E31

Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia.

Question 1: What is the expected diagnostic yield for vestibular schwannomas when using a magnetic resonance imaging (MRI) to evaluate patients with previously published definitions of asymmetric sensorineural hearing loss?

Target Population: These recommendations apply to adults with an asymmetric sensorineural hearing loss on audiometric testing.

Recommendation: Level 3: On the basis of an audiogram, it is recommended that MRI screening on patients with ≥10 decibels (dB) of interaural difference at 2 or more contiguous frequencies or ≥15 dB at 1 frequency be pursued to minimize the incidence of undiagnosed vestibular schwannomas. However, selectively screening patients with ≥15 dB of interaural difference at 3000 Hz alone may minimize the incidence of MRIs performed that do not diagnose a vestibular schwannoma. Read More

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http://academic.oup.com/neurosurgery/article/82/2/E29/476404
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http://dx.doi.org/10.1093/neuros/nyx509DOI Listing
February 2018
15 Reads

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on Hearing Preservation Outcomes in Patients With Sporadic Vestibular Schwannomas.

Neurosurgery 2018 Feb;82(2):E35-E39

Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia.

Question 1: What is the overall probability of maintaining serviceable hearing following stereotactic radiosurgery utilizing modern dose planning, at 2, 5, and 10 yr following treatment?

Recommendation: Level 3: Individuals who meet these criteria and are considering stereotactic radiosurgery should be counseled that there is moderately high probability (>50%-75%) of hearing preservation at 2 yr, moderately high probability (>50%-75%) of hearing preservation at 5 yr, and moderately low probability (>25%-50%) of hearing preservation at 10 yr.

Question 2: Among patients with AAO-HNS (American Academy of Otolaryngology-Head and Neck Surgery hearing classification) class A or GR (Gardner-Robertson hearing classification) grade I hearing at baseline, what is the overall probability of maintaining serviceable hearing following stereotactic radiosurgery, utilizing modern dose planning, at 2, 5, and 10 yr following treatment?

Recommendation: Level 3: Individuals who meet these criteria and are considering stereotactic radiosurgery should be counseled that there is a high probability (>75%-100%) of hearing preservation at 2 yr, moderately high probability (>50%-75%) of hearing preservation at 5 yr, and moderately low probability (>25%-50%) of hearing preservation at 10 yr.

Question 3: What patient- and tumor-related factors influence progression to nonserviceable hearing following stereotactic radiosurgery using ≤13 Gy to the tumor margin?

Recommendation: Level 3: Individuals who meet these criteria and are considering stereotactic radiosurgery should be counseled regarding the probability of successful hearing preservation based on the following prognostic data: the most consistent prognostic features associated with maintenance of serviceable hearing are good preoperative word recognition and/or pure tone thresholds with variable cut-points reported, smaller tumor size, marginal tumor dose ≤12 Gy, and cochlear dose ≤4 Gy. Read More

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http://dx.doi.org/10.1093/neuros/nyx511DOI Listing
February 2018
9 Reads

Immediate and Long-term Hearing Outcomes With the Middle Cranial Fossa Approach for Vestibular Schwannoma Resection.

Otol Neurotol 2018 01;39(1):92-98

Division of Otology-Neurotology, Department of Otolaryngology-Head and Neck Surgery.

Objective: To analyze the immediate postoperative and long-term hearing outcome data in patients who have undergone hearing preservation attempts with the middle cranial fossa (MCF) approach for the resection of sporadic vestibular schwannoma.

Study Design: Retrospective review of a surgical patient cohort.

Setting: Tertiary academic referral center. Read More

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http://dx.doi.org/10.1097/MAO.0000000000001623DOI Listing
January 2018
1 Read

Endoscopic Transcanal Transpromontorial Approach for Vestibular Schwannoma Resection: A Case Series.

Otol Neurotol 2017 12;38(10):e490-e494

*Department of Otolaryngology-Head and Neck Surgery †Department of Neurosurgery, University of Texas, Southwestern Medical Center, Dallas, Texas ‡Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee.

Objective: To demonstrate successful surgical management of vestibular schwannomas via an exclusively endoscopic transcanal transpromontorial approach (EETTA).

Patients: Four patients with vestibular schwannomas.

Interventions: Surgical excision via EETTA. Read More

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http://dx.doi.org/10.1097/MAO.0000000000001588DOI Listing
December 2017
6 Reads

Anterior Extension of Tumor is as Important as Tumor Size to Facial Nerve Outcome and Extent of Resection for Vestibular Schwannomas.

J Neurol Surg B Skull Base 2017 Dec 25;78(6):473-480. Epub 2017 Jul 25.

Department of Neurologic Surgery, University of South Florida, Tampa, Florida, United States.

 We examined vestibular schwannoma tumor dimension and direction of growth to determine whether these correlate with facial nerve outcome as well as extent of resection (EOR).  Retrospective review of prospectively maintained databases.  206 patients were a part of this study. Read More

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http://dx.doi.org/10.1055/s-0037-1604331DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680033PMC
December 2017
13 Reads

Prognostic Indices for Predicting Facial Nerve Outcome following the Resection of Large Acoustic Neuromas.

J Neurol Surg B Skull Base 2017 Dec 19;78(6):454-460. Epub 2017 Jul 19.

Department of Neurological Surgery and Otolaryngology, Head and Neck Surgery, Loyola University Chicago, Maywood, Illinois, United States.

This study analyzes the simple ratio of anterior-to-posterior extension of large (>2.5 cm) acoustic neuromas relative to the internal auditory canal (ICA; anterior-posterior [A/P] index) as a tool for predicting risk of facial nerve (FN) injury. In total, 105 patients who underwent microsurgical resection for large acoustic neuromas were analyzed retrospectively. Read More

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http://dx.doi.org/10.1055/s-0037-1604077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680026PMC
December 2017
13 Reads

Retrosigmoid Intradural Suprameatal-Inframeatal Approach for Complete Surgical Removal of a Giant Recurrent Vestibular Schwannoma with Severe Petrous Bone Involvement: Technical Case Report.

World Neurosurg 2018 02 10;110:93-98. Epub 2017 Nov 10.

Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany.

Background: Surgical removal of giant vestibular schwannomas with severe petrous bone involvement remains challenging due to the high risk of complications. The retrosigmoid intradural suprameatal-inframeatal approach (RISIA) allows for safe exposure extending from Meckel's cave to the petrous internal carotid artery (ICA).

Case Description: A 27-year-old man presented with recurrence of a giant vestibular schwannoma (4. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.10.176DOI Listing
February 2018
20 Reads

Vertigo in Vestibular Schwannoma Patients Due to Other Pathologies.

Otol Neurotol 2017 12;38(10):e457-e459

*Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery †Department of Biomedical Engineering, University of California, Irvine, Irvine, California.

Objective: To report findings from a cohort of vestibular schwannoma (VS) patients presenting with vertigo from a secondary comorbid vestibular disorder; and to discuss management strategies for this subset of patients presenting with both episodic vertigo and VS.

Patients: All VS patients who presented with vertigo as the primary symptom from 2012 to 2015 and endorsing no other major complaints were examined.

Intervention: Treatment with migraine lifestyle and prophylactic therapy, or Epley maneuver. Read More

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http://dx.doi.org/10.1097/MAO.0000000000001567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082136PMC
December 2017
17 Reads

Complications of the Middle Cranial Fossa Approach for Acoustic Neuroma Removal.

J Int Adv Otol 2017 Aug;13(2):186-190

Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Wuerzburg, Wuerzburg, Germany.

Objective: To analyze postoperative complications after microsurgery for acoustic neuroma (AN) via the middle fossa approach (MFA).

Materials And Methods: In total, 203 consecutive patients of a tertiary skull base referral center at a university hospital were included in this retrospective chart and database analysis. All patients had undergone primary microsurgery at the Otorhinolaryngology department via MFA between December 2005 and October 2014. Read More

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http://dx.doi.org/10.5152/iao.2017.3585DOI Listing
August 2017
6 Reads

Probabilistic Tractography of the Cranial Nerves in Vestibular Schwannoma.

World Neurosurg 2017 Nov 25;107:47-53. Epub 2017 Jul 25.

Department of Neurosurgery and Outpatient Clinic, Carl Gustav Carus Medical Faculty, University of Technology, Dresden, Germany.

Objective: Multiple recent studies have reported on diffusion tensor-based fiber tracking of cranial nerves in vestibular schwannoma, with conflicting results as to the accuracy of the method and the occurrence of cochlear nerve depiction. Probabilistic nontensor-based tractography might offer advantages in terms of better extraction of directional information from the underlying data in cranial nerves, which are of subvoxel size.

Methods: Twenty-one patients with large vestibular schwannomas were recruited. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.07.102DOI Listing
November 2017
16 Reads

How I Do It: The Role of Flexible Hand-held 2μ-Thulium Laser Fiber in Microsurgical Removal of Acoustic Neuromas.

J Neurol Surg B Skull Base 2017 Aug 8;78(4):301-307. Epub 2017 Feb 8.

Division of Neurosurgery, Department of Neurological Sciences, San Filippo Neri Hospital, Roma, Italy.

 We performed a retrospective nonrandomized study to analyze the results of microsurgery of acoustic neuromas (AN) using 2μ-thulium flexible hand-held laser fiber (Revolix jr).  From September 2010 to September 2015, 89 patients suffering from AN have been operated on with microsurgical technique via retrosigmoid approach. In 37 cases, tumor resection was performed with the assistance of 2μ-thulium flexible hand-held laser fiber (L-group). Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1598202
Publisher Site
http://dx.doi.org/10.1055/s-0037-1598202DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515659PMC
August 2017
3 Reads

Management of Residual Tumor After Limited Subtotal Resection of Large Vestibular Schwannomas: Lessons Learned and Rationale for Specialized Care.

World Neurosurg 2017 Sep 21;105:737-744. Epub 2017 Jun 21.

Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA; Department of Otorhinolaryngology, Mayo Clinic School of Medicine, Rochester, Minnesota, USA. Electronic address:

Background: In an era where subtotal resection (STR) is increasingly used, we have encountered a growing number of patients referred to our institution with limited resection of large vestibular schwannomas (VSs), sometimes associated with grave complications. Our aim was to highlight lessons learned in the management of large VSs and provide a rationale for specialized care.

Methods: A prospectively maintained database of >2000 patients with VSs evaluated at our institution between 2000 and 2016 was reviewed. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.06.108DOI Listing
September 2017
6 Reads

Transcanal surgery for vestibular schwannomas: a pictorial review of radiological findings, surgical anatomy and comparison to the traditional translabyrinthine approach.

Eur Arch Otorhinolaryngol 2017 Sep 9;274(9):3295-3302. Epub 2017 Jun 9.

Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Ludovico Antonio Scuro, 10, 37100, Verona, Italy.

The most popular approaches for vestibular schwannoma (VS) removal are retrosigmoid, middle cranial fossa and translabyrinthine (TL). All require a certain degree of invasivity, bone removal, or brain manipulation. Recently, the authors described the transcanal transpromontorial approaches (TTA), which allow the inner ear to be accessed directly through the external auditory canal (EAC), either with a microscopic (Expanded TTA, or ExpTTA) or even an exclusive endoscopic technique (Endoscopic TTA, or EndoTTA). Read More

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http://dx.doi.org/10.1007/s00405-017-4630-8DOI Listing
September 2017
17 Reads

Long-term risk of recurrence and regrowth after gross-total and subtotal resection of sporadic vestibular schwannoma.

J Neurosurg 2017 May 19:1-7. Epub 2017 May 19.

Departments of 1 Neurologic Surgery.

OBJECTIVE The management of vestibular schwannoma (VS) remains controversial. One commonly cited advantage of microsurgery over other treatment modalities is that tumor removal provides the greatest chance of long-term cure. However, there are very few publications with long-term follow-up to support this assertion. Read More

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http://dx.doi.org/10.3171/2016.11.JNS16498DOI Listing
May 2017
16 Reads

CyberKnife for Treatment of Vestibular Schwannoma: A Meta-analysis.

Otolaryngol Head Neck Surg 2017 07 25;157(1):7-15. Epub 2017 Apr 25.

1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA.

Objectives (1) Perform a meta-analysis of the available data on the outcomes of CyberKnife radiosurgery for treatment of vestibular schwannomas (VSs) in the published English-language literature and (2) evaluate the collective outcomes of CyberKnife treatment with respect to tumor control and hearing preservation. Data Sources A thorough literature search of published English-language articles was performed in the PubMed, Ovid, and Cochrane databases. Review Methods A database search was conducted with the keywords "CyberKnife" and "vestibular schwannoma" or "acoustic neuroma. Read More

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http://dx.doi.org/10.1177/0194599817695805DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075676PMC
July 2017
18 Reads

Middle fossa approach for resection of vestibular schwannoma.

Acta Neurochir (Wien) 2017 06 11;159(6):1023-1026. Epub 2017 Apr 11.

Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA.

Background: Surgical approaches for removal of vestibular schwannoma are done through retrosigmoid, translabyrinthine, or middle fossa approaches, depending on the tumor size, preoperative hearing status, surgical team experience, and patient preference. The middle fossa approach (MFA) for the vestibular schwannoma (VS) route preserves hearing and can be done with minimal morbidity and mortality.

Method: The authors discuss the surgical anatomy of the middle fossa, internal auditory canal localization techniques, MFA indications and the procedure for VS removal, and outcome. Read More

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http://link.springer.com/10.1007/s00701-017-3169-1
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http://dx.doi.org/10.1007/s00701-017-3169-1DOI Listing
June 2017
19 Reads

Validation of the facial dysfunction domain of the Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale.

Eur Arch Otorhinolaryngol 2017 Jun 8;274(6):2437-2442. Epub 2017 Apr 8.

The Skull Base Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Aintree, Liverpool, L9 7AL, UK.

The objective of this study is to evaluate the strength of content validity within the facial dysfunction domain of the Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale and to compare how it correlates with a facial dysfunction-specific QOL instrument (Facial Clinimetric Evaluation, FaCE). The study design is online questionnaire survey. Members of the British Acoustic Neuroma Association received both PANQOL questionnaires and the FaCE scale. Read More

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http://dx.doi.org/10.1007/s00405-017-4561-4DOI Listing
June 2017
2 Reads

Baha implant as a hearing solution for single-sided deafness after retrosigmoid approach for the vestibular schwannoma: surgical results.

Eur Arch Otorhinolaryngol 2017 Jun 14;274(6):2429-2436. Epub 2017 Mar 14.

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

Skull base tumors and, in particular, vestibular schwannoma (VS) are among the etiological reasons for single-sided deafness (SSD). Patients with SSD have problems in understanding speech in a noisy environment and cannot localize the direction of sounds. Baha is one of the most frequently used systems for SSD compensation. Read More

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http://dx.doi.org/10.1007/s00405-017-4505-zDOI Listing
June 2017
10 Reads

Multivariate Analysis of Factors Influencing Facial Nerve Outcome following Microsurgical Resection of Vestibular Schwannoma.

Otolaryngol Head Neck Surg 2017 03 16;156(3):525-533. Epub 2016 Nov 16.

1 Unit of Otology, Auditory Implants and Skull Base Surgery, Otorhinolaryngology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.

Objective To assess through multivariate analysis the clinical pre- and intraoperative factors of facial nerve outcomes at day 8 and 1-year recovery of facial palsy, as compared with day 8 status among patients who underwent total resection of unilateral vestibular schwannoma. Study Design Case series with chart review. Setting Tertiary referral center. Read More

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http://dx.doi.org/10.1177/0194599816677711DOI Listing
March 2017
8 Reads

[A combination use of endoscope and microscope in cerebral pontine angle surgery].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Feb;52(2):85-88

Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Jiaotong University Ear Institute, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China.

To evaluate the application of combination use of microscope and endoscope in cerebral pontine angle (CPA) surgery. A total of 72 patients undergone lateral skull base surgeries via endoscope under microscopic control from January 2006 to January 2015 was reviewed respectively. The patients including 35 males and 37 females were composed of 22 cases of vestibular swannnomas, 45 cases of cranial neuropathy and 5 cases of CPA chelesteatoma. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1673-0860.2017.02.002DOI Listing
February 2017
6 Reads

Bilateral otoneurological pathology: To operate or not?

Cochlear Implants Int 2017 03 20;18(2):121-124. Epub 2017 Feb 20.

a Department of Otolaryngology , Cambridge University Hospitals Trust , Cambridge , UK.

Objective: To illustrate our experience when managing a complex patient with potentially life-threatening bilateral otological disease facing multisensory compromise including complete loss of audiovestibular function and visual disturbance Clinical presentation: A 67 year old lady, presented with a large left vestibular schwannoma and extensive right cholesteatoma encircling the otic capsule. She underwent translabyrinthine resection of the vestibular schwannoma, resulting in profound sensorineural hearing loss, vestibular hypofunction and corneal scarring following an initial temporary facial palsy. Due to the extent of the disease and good right-sided bone conduction thresholds, the cholesteatoma was managed conservatively utilising a bone-anchored-hearing-aid with regular review by the Skull-Base team. Read More

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http://dx.doi.org/10.1080/14670100.2017.1289605DOI Listing
March 2017
14 Reads

Dosimetric Analysis of Neural and Vascular Structures in Skull Base Tumors Treated with Stereotactic Radiosurgery.

Otolaryngol Head Neck Surg 2017 05 14;156(5):857-862. Epub 2017 Feb 14.

1 University of California, Irvine Medical Center, Department of Otolaryngology-Head and Neck Surgery, Irvine, California, USA.

Objective To examine the relationship between the prescribed target dose and the dose to healthy neurovascular structures in patients with vestibular schwannomas treated with stereotactic radiosurgery (SRS). Study Design Case series with chart review. Setting SRS center from 2011 to 2013. Read More

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http://dx.doi.org/10.1177/0194599817691452DOI Listing
May 2017
16 Reads

Low-Dose Gamma Knife Radiosurgery for Vestibular Schwannomas: Tumor Control and Cranial Nerve Function Preservation After 11 Gy.

J Neurol Surg B Skull Base 2017 02 31;78(1):2-10. Epub 2016 May 31.

Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States.

Objectives: This study aims to report tumor control rates and cranial nerve function after low dose (11.0 Gy) Gamma knife radiosurgery (GKRS) in patients with vestibular schwannomas.

Methods: A retrospective chart review was performed on 30 consecutive patients with vestibular schwannomas treated from March 2004 to August 2010 with GKRS at the Robert H. Read More

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http://dx.doi.org/10.1055/s-0036-1584231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288117PMC
February 2017
20 Reads

Lateral skull base surgery in a pediatric population: A 25-year experience in a referral skull base center.

Int J Pediatr Otorhinolaryngol 2017 Mar 14;94:70-75. Epub 2017 Jan 14.

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

Objective: To analyze the pathology and surgical outcomes of lateral skull base (LSB) procedures in a pediatric population.

Study Design: Retrospective case review in a referral skull base center.

Methods: Charts of pediatric patients who underwent defined LSB procedures from 1983 to 2015 for various pathologies were evaluated at our center. Read More

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http://dx.doi.org/10.1016/j.ijporl.2017.01.017DOI Listing
March 2017
14 Reads
1 Citation
1.320 Impact Factor

Adverse Events Following Vestibular Schwannoma Surgery: A Comparison of Surgical Approach.

Otol Neurotol 2017 04;38(4):551-554

Department of Otolaryngology, Tripler Army Medical Center, Honolulu, Hawaii.

Objective: Compare complications of vestibular schwannoma (VS) resection by surgical approach.

Study Design: Retrospective cohort.

Setting: The 2008 to 2013 American College of Surgeons-National Surgical Quality Improvement Program. Read More

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http://dx.doi.org/10.1097/MAO.0000000000001323DOI Listing
April 2017
2 Reads

Delayed Vestibular Schwannoma Regrowth Following Shrinkage After Stereotactic Radiosurgery: Implication for Life-Long Surveillance.

Otol Neurotol 2017 02;38(2):260-263

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

Objective: To enhance understanding of the behavior of vestibular schwannomas (VS) after stereotactic radiosurgery (SRS), including the potential for late tumor regrowth, and the need for lifelong radiological and clinical surveillance.

Patients: From a total of 540 patients with VS and out of 95 patients receiving SRS for their growing VS, the cases of two women patients aged 58 and 59 years with medium sized, growing VS are presented.

Intervention: Both patients were treated with SRS. Read More

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http://dx.doi.org/10.1097/MAO.0000000000001280DOI Listing
February 2017
5 Reads