Modern Management of Acoustic NeuromaJean Régis, Pierre-Hugues Roche Acoustic neuroma outcomes have been greatly improved by advances in microsurgical techniques, and recently by the long-term application of radiosurgery, which has proven to be an appropriate, verifiable, and extremely clinically relevant treatment strategy. This volume brings together the latest opinions of outstanding physicians and surgeons who treat patients with acoustic neuromas, commonly known as vestibular neuromas. Since the days of Cushing, when partial tumor removal seemed the best method for saving a patient's life, the management of this relatively rare tumor has sparked enormous clinical interest. The book outlines the various stages in the evolution of vestibular schwannoma surgery and presents the full spectrum of current therapeutic possibilities. The novel concept of combining microsurgical with radiosurgical skills should eliminate problems such as facial palsy and hearing loss which were previously associated with the therapeutic management of these tumors. The excellent research findings published here by leading experts in the field will help neurosurgeons, otologists and radiation oncologists to understand the enormous strides made during the last two decades in vestibular schwannoma surgery and radiosurgery. |
Contents
Introduction | 1 |
History of Vestibular Schwannoma Surgery | 6 |
Genesis and Biology of Vestibular Schwannomas | 24 |
Radiobiology Principle and Technique of Radiosurgery | 32 |
Microanatomy Applied to Vestibular Schwannomas | 43 |
Operative Technique Pitfalls and Tips | 54 |
Technical Note and Surgical Results of 896 Operations | 65 |
Operative Technique | 73 |
Hearing Preservation in Patients with Unilateral Vestibular Schwannoma after Gamma Knife Surgery | 142 |
Surgical Removal of Vestibular Schwannoma after Failed Gamma Knife Radiosurgery | 152 |
Microsurgical Removal of Vestibular Schwannomas after Failed Previous Microsurgery | 158 |
Vestibular Schwannoma Radiosurgery after Previous Surgical Resection or Stereotactic Radiosurgery | 163 |
Indications and Results | 169 |
Radiosurgery for Type II Neurofibromatosis | 176 |
Microsurgical Treatment of Intracanalicular Vestibular Schwannomas | 183 |
Radiosurgery for Intracanalicular Vestibular Schwannomas | 192 |
Management of Large Vestibular Schwannomas by Combined Surgical Resection and Gamma Knife Radiosurgery | 79 |
The Wait and See Strategy for Intracanalicular Vestibular Schwannomas | 83 |
Recurrence of Vestibular Schwannomas after Surgery | 89 |
Pitfalls and Diagnosis of Failure | 93 |
Tissue Changes after Radiosurgery for Vestibular Schwannomas | 98 |
Facial Nerve Outcome after Microsurgical Resection of Vestibular Schwannoma | 103 |
Facial Nerve Function Insufficiency after Radiosurgery versus Microsurgery | 108 |
Surgical Treatment of Facial Nerve Schwannomas | 119 |
Gamma Knife Surgery for Facial Nerve Schwannomas | 131 |
Hearing Preservation after Complete Microsurgical Removal in Vestibular Schwannomas | 136 |
Considerations about the Impact of Gamma Knife Radiosurgery | 200 |
Radiosurgery and Carcinogenesis Risk | 207 |
Complications of Microsurgery | 214 |
An EvidenceBased Comparison of Stereotactic Radiosurgery and Microsurgical Resection | 222 |
Linear Accelerator Radiosurgery for Vestibular Schwannomas | 228 |
Radiotherapy of Cranial Nerve Schwannomas | 238 |
Future Perspectives in Acoustic Neuroma Management | 247 |
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Modern Management of Acoustic Neuroma Jean Régis,P.-H. Roche,L.D. Lunsford No preview available - 2008 |
Common terms and phrases
acoustic neuroma acoustic neuroma surgery acoustic tumors arachnoid Basel brain brainstem cell cerebellopontine angle cistern clinical cochlear nerve complications cranial nerve diagnosis dose planning facial nerve facial nerve function Flickinger JC follow-up fossa approach fractionated functional hearing fundus Gamma Knife Gamma Knife radiosurgery gery hearing loss hearing preservation hydrocephalus imaging intracanalicular intracranial irradiation isocenters Karger Kondziolka Koos Leksell lesion LINAC long-term Lunsford LD Management of Acoustic margin dose Marseille median meningioma microsurgery microsurgical middle cranial fossa middle fossa months nerve preservation neurinomas Neurosurg Neurosurgery normal operated Otol Otolaryngol outcome patients porus postoperative preoperative preservation of hearing Prog Neurol Surg radiotherapy recurrence Régis reported retrosigmoid approach risk Roche PH Samii scan stereotactic radiosurgery surgical resection symptoms technique tients tinnitus tion tissue translabyrinthine treated trigeminal tumor tumor control tumor growth tumor removal tumor volume vestibular schwannomas