Surgical Treatment of Acoustic Neuroma: Outcomes and Indications

Overview

Journal Rep Pract Oncol Radiother

Specialty Oncology

Date 2016 Jun 23

PMID 27330426

Citations 5

Authors

Elisabetta Zanoletti

Chiara Faccioli

Alessandro Martini

Affiliations

Soon will be listed here.

Abstract

Aim: Surgery for acoustic neuroma has developed over the years with a gradual improvement in outcome. The goal of surgery should be cure of the disease and a low morbidity, preserving facial nerve function - and hearing, too, whenever feasible (i.e. in small tumors). The most appropriate approach must be decided case by case.

Background: Results of microsurgery remain heterogeneous, however, probably due to the different amount of experience gained at different centers.

Materials And Methods: Surgical series reported in the recent literature (2012-2015) were critically reviewed, along with some older papers with particularly representative series.

Results And Conclusion: Considering patients' age, surgical morbidity of different approaches, tumor size and hearing, some principles can be identified on which to base surgical indications with a view to achieving the goals of curing the disease with a low morbidity, preserving facial nerve function and hearing, too, whenever feasible (i.e. in patients with small tumors). Different therapeutic approaches are discussed.

Citing Articles

Significance of Preoperative Nerve Reconstruction Using Diffusion Tensor Imaging Tractography for Facial Nerve Protection in Vestibular Schwannoma.

Zhang Y, Ge H, Xu M, Mei W J Korean Neurosurg Soc. 2022; 66(2):183-189.

PMID: 36239080 PMC: 10009239. DOI: 10.3340/jkns.2022.0134.

Impact of extent of internal acoustic meatus tumor removal using translabyrinthine approach for acoustic neuroma surgery.

Chiang K, Hsu S, Yang T, Wang M PLoS One. 2021; 16(8):e0253338.

PMID: 34351928 PMC: 8341598. DOI: 10.1371/journal.pone.0253338.

National Trends in Vestibular Schwannoma Surgery: Influence of Patient Characteristics on Outcomes.

Hatch J, Bauschard M, Nguyen S, Lambert P, Meyer T, Mcrackan T Otolaryngol Head Neck Surg. 2018; 159(1):102-109.

PMID: 29584554 PMC: 6712975. DOI: 10.1177/0194599818765717.

CT- and MRI-based gross target volume comparison in vestibular schwannomas.

Kulkarni B, Bajwa H, Chandrashekhar M, Sharma S, Singareddy R, Gudipudi D Rep Pract Oncol Radiother. 2017; 22(3):201-208.

PMID: 28461783 PMC: 5403802. DOI: 10.1016/j.rpor.2017.02.002.

The management of skull base tumours: A challenge claiming for a multidisciplinary collaboration.

Krengli M Rep Pract Oncol Radiother. 2016; 21(4):285-7.

PMID: 27330414 PMC: 4899425. DOI: 10.1016/j.rpor.2016.03.004.

References

Mazzoni A, Calabrese V, Danesi G . A modified retrosigmoid approach for direct exposure of the fundus of the internal auditory canal for hearing preservation in acoustic neuroma surgery. Am J Otol. 2000; 21(1):98-109. DOI: 10.1016/s0196-0709(00)80082-4. View

Sanna M, Khrais T, Russo A, Piccirillo E, Augurio A . Hearing preservation surgery in vestibular schwannoma: the hidden truth. Ann Otol Rhinol Laryngol. 2004; 113(2):156-63. DOI: 10.1177/000348940411300215. View

Sanna M, Taibah A, Russo A, Falcioni M, Agarwal M . Perioperative complications in acoustic neuroma (vestibular schwannoma) surgery. Otol Neurotol. 2004; 25(3):379-86. DOI: 10.1097/00129492-200405000-00029. View

Ebersold M, Harner S, Beatty C, Harper Jr C, Quast L . Current results of the retrosigmoid approach to acoustic neurinoma. J Neurosurg. 1992; 76(6):901-9. DOI: 10.3171/jns.1992.76.6.0901. View

Samii M, Gerganov V, Samii A . Improved preservation of hearing and facial nerve function in vestibular schwannoma surgery via the retrosigmoid approach in a series of 200 patients. J Neurosurg. 2006; 105(4):527-35. DOI: 10.3171/jns.2006.105.4.527. View

Mazzoni A, Calabrese V, Moschini L . Residual and recurrent acoustic neuroma in hearing preservation procedures: neuroradiologic and surgical findings. Skull Base Surg. 1996; 6(2):105-12. PMC: 1656582. DOI: 10.1055/s-2008-1058651. View

Brackmann D, Cullen R, Fisher L . Facial nerve function after translabyrinthine vestibular schwannoma surgery. Otolaryngol Head Neck Surg. 2007; 136(5):773-7. DOI: 10.1016/j.otohns.2006.10.009. View

Samii M, Gerganov V, Samii A . Hearing preservation after complete microsurgical removal in vestibular schwannomas. Prog Neurol Surg. 2008; 21:136-141. DOI: 10.1159/000156900. View

Fukuda M, Oishi M, Hiraishi T, Natsumeda M, Fujii Y . Clinicopathological factors related to regrowth of vestibular schwannoma after incomplete resection. J Neurosurg. 2011; 114(5):1224-31. DOI: 10.3171/2010.11.JNS101041. View

10.

Nuseir A, Sequino G, De Donato G, Taibah A, Sanna M . Surgical management of vestibular schwannoma in elderly patients. Eur Arch Otorhinolaryngol. 2011; 269(1):17-23. DOI: 10.1007/s00405-011-1566-2. View

11.

Falcioni M, Fois P, Taibah A, Sanna M . Facial nerve function after vestibular schwannoma surgery. J Neurosurg. 2011; 115(4):820-6. DOI: 10.3171/2011.5.JNS101597. View

12.

Friedman R, Berliner K, Bassim M, Ursick J, Slattery 3rd W, Schwartz M . A paradigm shift in salvage surgery for radiated vestibular schwannoma. Otol Neurotol. 2011; 32(8):1322-8. DOI: 10.1097/MAO.0b013e31822e5b76. View

13.

Friedman R, Goddard J, Wilkinson E, Schwartz M, Slattery 3rd W, Fayad J . Hearing preservation with the middle cranial fossa approach for neurofibromatosis type 2. Otol Neurotol. 2011; 32(9):1530-7. DOI: 10.1097/MAO.0b013e3182355855. View

14.

Mazzoni A, Biroli F, Foresti C, Signorelli A, Sortino C, Zanoletti E . Hearing preservation surgery in acoustic neuroma. Slow progress and new strategies. Acta Otorhinolaryngol Ital. 2011; 31(2):76-84. PMC: 3203745. View

15.

Ben Ammar M, Piccirillo E, Topsakal V, Taibah A, Sanna M . Surgical results and technical refinements in translabyrinthine excision of vestibular schwannomas: the Gruppo Otologico experience. Neurosurgery. 2012; 70(6):1481-91. DOI: 10.1227/NEU.0b013e31824c010f. View

16.

Arriaga M, Lin J . Translabyrinthine approach: indications, techniques, and results. Otolaryngol Clin North Am. 2012; 45(2):399-415, ix. DOI: 10.1016/j.otc.2011.12.009. View

17.

Angeli S . Middle fossa approach: indications, technique, and results. Otolaryngol Clin North Am. 2012; 45(2):417-38, ix. DOI: 10.1016/j.otc.2011.12.010. View

18.

Mazzoni A, Zanoletti E, Calabrese V . Hearing preservation surgery in acoustic neuroma: long-term results. Acta Otorhinolaryngol Ital. 2012; 32(2):98-102. PMC: 3383081. View

19.

Nickele C, Akture E, Gubbels S, Baskaya M . A stepwise illustration of the translabyrinthine approach to a large cystic vestibular schwannoma. Neurosurg Focus. 2012; 33(3):E11. PMC: 3675780. DOI: 10.3171/2012.7.FOCUS12208. View

20.

Ansari S, Terry C, Cohen-Gadol A . Surgery for vestibular schwannomas: a systematic review of complications by approach. Neurosurg Focus. 2012; 33(3):E14. DOI: 10.3171/2012.6.FOCUS12163. View