738 results match your criteria Skull Base Acoustic Neuroma Vestibular Schwannoma

Pediatric vestibular schwannoma without evidence of neurofibromatosis: consecutive 18 microsurgical experiences.

Childs Nerv Syst 2022 May 19. Epub 2022 May 19.

Department of Neurosurgery, Tokyo Metropolitan Police Hospital, Tokyo, Japan.

Purpose: Sporadic vestibular schwannoma (VS) is rare in children in contrast to adults, and detailed investigations of case series of these patients using a single fixed protocol are scarce. This study presents our surgical experience of pediatric VSs without clinical evidence of neurofibromatosis type 2 (NF2) at the initial diagnosis.

Methods: Among 1385 consecutive sporadic VS surgeries, 18 pediatric patients (1. Read More

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Cochlear Fibrosis after Vestibular Schwannoma Resection via the Middle Cranial Fossa Approach.

Audiol Neurootol 2022 4;27(3):243-248. Epub 2022 Apr 4.

Department of Otolaryngology, Head and Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Objective: The aim of this study was to determine the incidence of cochlear fibrosis after vestibular schwannoma (VS) resection via middle cranial fossa (MCF) approach.

Design: A retrospective case review was conducted.

Setting: The review was conducted in a tertiary care academic medical center. Read More

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Evidence-based surveillance protocol for vestibular schwannomas: a long-term analysis of tumor growth using conditional probability.

J Neurosurg 2022 Feb 18:1-8. Epub 2022 Feb 18.

1Department of Skull Base Surgery, Cambridge University Hospitals, Cambridge.

Objective: The growth characteristics of vestibular schwannomas (VSs) under surveillance can be studied using a Bayesian method of growth risk stratification by time after surveillance onset, allowing dynamic evaluations of growth risks. There is no consensus on the optimum surveillance strategy in terms of frequency and duration, particularly for long-term growth risks. In this study, the long-term conditional probability of new VS growth was reported for patients after 5 years of demonstrated nongrowth. Read More

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February 2022

Three-Corridors Procedure to Operate in the Infralabyrinthine Cervico-Jugulo-Carotico-Tympanic Area.

ORL J Otorhinolaryngol Relat Spec 2022 3;84(2):147-152. Epub 2022 Feb 3.

Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.

Introduction: The aim of the study was to present the results of our experience in three-corridors procedures applied for the tumors and inflammatory lesions of the infralabyrinthine cervico-jugulo-carotico-tympanic area.

Methods: The lesions located in the infralabyrinthine cervico-jugulo-carotico-tympanic area were operated in 13 patients using the 3-corridors technique. The anatomical and functional integrity of the external and middle ears and the facial nerve (FN) could be preserved. Read More

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Automated objective surgical planning for lateral skull base tumors.

Int J Comput Assist Radiol Surg 2022 Mar 28;17(3):427-436. Epub 2022 Jan 28.

Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA.

Purpose: Surgical removal of pathology at the lateral skull base is challenging because of the proximity of critical anatomical structures which can lead to significant morbidity when damaged or traversed. Pre-operative computed surgical approach planning has the potential to aid in selection of the optimal approach to remove pathology and minimize complications.

Methods: We propose an automated surgical approach planning algorithm to derive the optimal approach to vestibular schwannomas in the internal auditory canal for hearing preservation surgery. Read More

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Analysis of Hearing Preservation in Middle Cranial Fossa Resection of Vestibular Schwannoma.

Otol Neurotol 2022 03;43(3):395-399

Acoustic Neuroma Program, University of California, San Diego, La Jolla, California, and Vanderbilt University Medical Center, Nashville, Tennessee.

Objective: Describe the effect of preoperative hearing on the likelihood of hearing preservation after middle cranial fossa (MCF) approach for resection of vestibular schwannoma (VS) and the effect of hearing preservation on disease-specific quality of life (QOL).

Study Design: Retrospective chart review.

Setting: Academic tertiary care skull base surgery program. Read More

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Opioid Prescribing Patterns After Skull Base Surgery for Vestibular Schwannoma.

Otol Neurotol 2022 01;43(1):e116-e121

Division of Otolaryngology Head and Neck Surgery, Department of Surgery.

Objective: Excessive opioid prescription is a source of prescription diversion and could contribute to chronic opioid abuse. This study describes the opioid prescribing patterns and risk factors for additional opioid prescription after surgical resection of vestibular schwannoma (VS).

Study Design: Retrospective chart review. Read More

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January 2022

Intraoperative Continuous Neuromonitoring for Vestibular Schwannoma Surgery: Real-Time, Quantitative, and Functional Evaluation.

World Neurosurg 2021 Dec 1;158:189. Epub 2021 Dec 1.

Department of Neurosurgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.

In vestibular schwannoma surgery, neuromonitoring is essential to accomplish sufficient tumor resection while avoiding neurologic damage. An ideal neuromonitoring method should include a real-time alert system, quantitative evaluation, and functional (not mechanical) assessment.Video 1 demonstrates facial and hearing preservation surgery for vestibular schwannoma by the retrosigmoid transmeatal approach, under intraoperative continuous facial nerve monitoring and auditory brainstem response. Read More

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December 2021

Auditory brainstem response prior to MRI compared to standalone MRI in the detection of vestibular schwannoma: A modelling study.

Clin Otolaryngol 2022 03 24;47(2):295-303. Epub 2021 Nov 24.

Department of Operating Rooms, Radboud Institute of Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.

Objectives: To determine the cost-effectiveness of auditory brainstem response prior to MRI (ABR-MRI) compared to standalone MRI to diagnose vestibular schwannoma.

Design: A state transition model was developed to simulate costs and effects (quality-adjusted life years [QALY]) for both diagnostic strategies for patients suspected of a vestibular schwannoma. Model input was derived from literature, hospital databases and expert opinions. Read More

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Cochlear Implantation in Vestibular Schwannoma: A Systematic Literature Review.

J Neurol Surg B Skull Base 2021 Dec 8;82(6):643-651. Epub 2021 Jun 8.

Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, United States.

 Ipsilateral cochlear implantation (CI) in vestibular schwannoma (VS) has been an emerging trend over the last two decades. We conducted the first systematic review of hearing outcomes comparing neurofibromatosis 2 (NF2) and sporadic VS undergoing CI. A comparison of the two populations and predictor of outcome was assessed. Read More

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December 2021

Imaging of the Vestibular Schwannoma: Diagnosis, Monitoring, and Treatment Planning.

Steve E J Connor

Neuroimaging Clin N Am 2021 Nov;31(4):451-471

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK; Neuroradiology Department, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK. Electronic address:

Appropriate imaging strategies for the detection, treatment planning, and posttreatment monitoring of vestibular schwannomas will be discussed. The typical and variant imaging appearances of vestibular schwannomas, as well as the imaging features that should prompt consideration of differential diagnoses, will be illustrated. Understanding the natural history of vestibular schwannomas, optimal measurement and definition of tumour growth helps the radiologist evaluate for the failure of conservative management and requirement for surgery or radiotherapy. Read More

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November 2021

Rate of Development of Venous Thromboembolism in Lateral Skull Base Surgery.

Laryngoscope 2022 03 11;132(3):662-667. Epub 2021 Oct 11.

Michigan Ear Institute, Farmington Hills, Michigan, U.S.A.

Objectives: Venous thromboembolism (VTE) is a major cause of morbidity and mortality for surgical patients. This article aims to determine factors that may have contributed to the development of VTE in patients undergoing lateral skull base surgery, to assess the validity of the Caprini Risk Assessment Model (RAM) score in this subset of patients, and to determine the efficacy of mechanical DVT prophylaxis alone in preventing VTE.

Study Design: Retrospective chart review. Read More

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Retrolabyrinthine transsigmoid approach to complex parabrainstem tumors in the posterior fossa.

J Neurosurg 2022 04 8;136(4):1097-1102. Epub 2021 Oct 8.

2Division of Neurosurgery, Duke University Medical Center, Durham, North Carolina.

Objective: The surgical management of large and complex tumors of the posterior fossa poses a formidable challenge in neurosurgery. The standard retrosigmoid craniotomy approach has been performed at most neurosurgical centers; however, the retrosigmoid approach may not provide enough working space without significant retraction of the cerebellum. The transsigmoid approach provides wider and shallower surgical fields; however, there have been few clinical and no cadaveric studies on its usefulness. Read More

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The Role of Endoscopy in the Resection of Sporadic Vestibular Schwannomas: A Systematic Review of Surgical Outcomes.

Otol Neurotol 2022 01;43(1):2-11

Department of Neurosurgery, Royal Preston Hospital, Preston, United Kingdom.

Background: Vestibular schwannomas (VS) are benign intracranial tumors originating from the vestibular division of the eighth cranial nerve. Treatment options include microsurgery, radiotherapy, and surveillance. Endoscopy is becoming more widely used as an adjunct in skull base surgery and may influence outcomes in surgically managed VS. Read More

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January 2022

Is Cochlear Implantation Effective for Auditory Rehabilitation Following Vestibular Schwannoma Treatment?

Laryngoscope 2022 06 20;132(6):1140-1141. Epub 2021 Aug 20.

Department of Otolaryngology/Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, U.S.A.

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An Endoscopic Transcanal Transpromontorial Approach for Vestibular Schwannomas using a Computer-Based Three-Dimensional Imaging System.

J Vis Exp 2021 07 28(173). Epub 2021 Jul 28.

Department of Medical Education, Chang Gung Memorial Hospital and Chang Gung University.

A 2D monocular endoscope has been used in transcanal transpromontory vestibular schwannoma surgery instead of craniotomy. However, the absence of depth perception is the limitation of this approach. With the loss of depth perception, the surgeon will be not able to perform delicate and particularly complicated surgery. Read More

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Simultaneous Cochlear Implantation After Translabyrinthine Vestibular Schwannoma Resection: A Report of 41 Cases.

Otol Neurotol 2021 10;42(9):1414-1421

Otolaryngology, Alex. University, Egypt.

Objective: To study the auditory outcome of simultaneous translabyrinthine vestibular schwannoma (VS) resection and cochlear implantation (CI) after successful cochlear nerve preservation.

Study Design: A retrospective case series and patient questionnaire.

Setting: Quaternary referral center for skull base pathologies. Read More

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October 2021

The Clinical Implications of Spontaneous Hemorrhage in Vestibular Schwannomas.

J Neurol Surg B Skull Base 2021 Jul 16;82(Suppl 3):e22-e32. Epub 2020 Mar 16.

Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, United States.

 Spontaneous hemorrhage into vestibular schwannomas (VSs) is rare and can render more rapid symptom onset and a seemingly poorer prognosis for an otherwise benign pathology. We describe our series of hemorrhagic VS (HVSs) and systematically reviewed the literature to better understand relevant clinical factors and outcomes.  Retrospective case review series and systematic review of the literature using PRISMA guidelines. Read More

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Initial Observation among Patients with Vestibular Schwannoma.

J Neurol Surg B Skull Base 2021 Jul 24;82(Suppl 3):e15-e21. Epub 2020 Jan 24.

Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, United States.

 Vestibular schwannomas (VS) are slow growing tumors. Although there are a wide variety of available treatment options, these tumors are often initially observed. We aimed to establish the presenting symptoms and outcomes of patients treated with initial observation at our institution. Read More

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Progressive Vestibular Schwannoma following Subtotal or Near-Total Resection: Dose-Escalated versus Standard-Dose Salvage Stereotactic Radiosurgery.

J Neurol Surg B Skull Base 2021 Jul 26;82(Suppl 3):e9-e14. Epub 2020 May 26.

Department of Radiation Oncology, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, United States.

 Local failure of incompletely resected vestibular schwannoma (VS) following salvage stereotactic radiosurgery (SRS) using standard doses of 12 to 13 Gy is common. We hypothesized that dose-escalated SRS, corrected for biologically effective dose, would have superior local control of high-grade VS progressing after subtotal or near-total resection compared with standard-dose SRS.  Retrospective cohort study. Read More

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A Review of Particle Therapy for Skull Base Tumors: Modern Considerations and Future Directions.

Int J Part Ther 2021 25;8(1):168-178. Epub 2021 Jun 25.

MedAustron Ion Therapy Center, Wiener Neustadt, Austria.

Skull base tumors constitute one of the established indications for particle therapy, specifically proton therapy. However, a number of prognostic factors, practical clinical management issues, and the emerging role of carbon ion therapy remain subjects of active clinical investigation. This review summarizes these topics, assesses the present status, and reflects on future research directions focusing on the management of chordomas, one of the most aggressive skull base tumors. Read More

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Cochlear implantation after radiosurgery for vestibular schwannoma.

J Neurosurg 2021 07 24;135(1):126-135. Epub 2021 Jun 24.

1Department of Otolaryngology-Head and Neck Surgery, and.

Objective: The object of this study was to ascertain outcomes of cochlear implantation (CI) following stereotactic radiosurgery (SRS) for vestibular schwannoma (VS).

Methods: The authors conducted a retrospective chart review of adult patients with VS treated with SRS who underwent CI between 1990 and 2019 at a single tertiary care referral center. Patient demographics, tumor features, treatment parameters, and pre- and postimplantation audiometric and clinical outcomes are presented. Read More

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Tumor-Related and Patient-Related Variables Affecting Length of Hospital Stay Following Vestibular Schwannoma Microsurgery.

Ann Otol Rhinol Laryngol 2022 May 1;131(5):535-543. Epub 2021 Jul 1.

Listen for Life Center, Department of Otolaryngology-Head and Neck Surgery, Virginia Mason Medical Center, Seattle, WA 98101, USA.

Objective: Review a single institution's vestibular schwannoma (VS) microsurgery experience to determine (1) correlations between demographics, comorbidities, and/or surgical approach on hospital length of stay (LOS) and discharge disposition and (2) trends in surgical approach over time.

Methods: Retrospective case series from a multidisciplinary skull base program at a tertiary care, academic hospital. All adult (>18 years) patients undergoing primary microsurgery for VS between 2008 and 2018 were included. Read More

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Cochlear T2 Signal May Predict Hearing Outcomes After Resection of Acoustic Neuroma.

Otol Neurotol 2021 10;42(9):1399-1407

University of California San Diego School of Medicine, La Jolla, California.

Objective: Examine the impact of preoperative cochlear Fast Imaging Employing Steady-state Acquisition (FIESTA) and Constructive Interference in Steady State (CISS) signal intensity on hearing outcomes after middle cranial fossa (MCF) resection of acoustic neuroma (AN).

Methods: Adult patients (≥18 years) who underwent MCF AN resection for hearing preservation (HP) between November 2017 and September 2019 were retrospectively reviewed. All patients had preoperative word recognition score (WRS) ≥50%. Read More

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October 2021

Biological Treatments of Neurofibromatosis Type 2 and Other Skull Base Disorders.

Otolaryngol Clin North Am 2021 Aug 11;54(4):789-801. Epub 2021 Jun 11.

Gilbert Family Neurofibromatosis Institute, Children's National Hospital, 111 Michigan Avenue Northwest, Washington, DC 20010, USA; Department of Pediatric Hematology-Oncology; Center for Genetics Research, Children's National Hospital, 111 Michigan Avenue Northwest, Washington, DC 20010, USA. Electronic address:

Studies of genomic alterations that occur in skull base tumors have provided information regarding biological aberrations that are necessary for the growth and maintenance of these tumors. This has led to the development and initiation of clinical trials incorporating biological treatments for many skull base tumors. The exciting developments of molecularly targeted therapy for the treatment of skull base tumors may provide noninvasive therapeutic options for patients that can be used either alone or in combination with surgery and/or radiation therapy. Read More

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

Ann Otol Rhinol Laryngol 2022 Mar 28;131(3):277-280. 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 2022 Jan 25;279(1):467-479. 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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January 2022

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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