Journal Reviews
Is Gamma Knife Surgery effective for intracanalicular vestibular schwannomas?
Vestibular schwannomas (VSs) are rare, occurring in approximately five per 100,000 adults a year. In circa 8% of cases, the VS is contained within the internal auditory canal, i.e. intracanalicular (iVS). Although radiosurgery is a recognised treatment modality for VSs,...
Global incidence of sporadic vestibular schwannoma
The incidence rate of sporadic vestibular schwannoma (VS) has commonly been quoted as one in 100,000. However, since the advent of screening for asymmetrical hearing loss and increased availability of modern MRI scanning, more recent studies have shown the incidence...
Does Koos classification predict facial nerve dysfunction?
The Koos classification is a grading system used often for preoperative evaluation of acoustic tumours on imaging studies. It indirectly correlates to the size of the tumour. Size of the vestibular schwannoma is often considered the main determinant for hearing...
Lateral skull base surgery using the endoscope
Endoscopic lateral skull base surgery could be performed via less invasive techniques due to wide panoramic visualisation of the operative field. With less invasive techniques, patients have been shown to require shorter recovery time and reduced postoperative pain. In this...
Impaired vestibulo-ocular reflex (VOR) gain correlates with hearing loss in vestibular schwannoma
The lack of correlation between the size of vestibular schwannoma (VS) and degree of hearing loss and vestibular function tests is well known. In this retrospective study, the focus was on the correlation between VOR gain of semicircular canal function,...
Is there a need for magnetic resonance imaging six-month post-radiosurgery for vestibular schwannoma?
With advances in imaging and radiation technologies, small, slowly growing vestibular schwannomas (VS) are treated primarily with either observation or stereotactic radiosurgery (SRS). Routine magnetic resonance (MRI) scans with gadolinium are obtained six months and one year after SRS in...
Treatment outcomes and dose rate effects following gamma knife stereotactic radiosurgery for vestibular schwannomas
Gamma knife radiosurgery (GKRS) is one of the definitive stereotactic radiotherapy treatment modalities for vestibular schwannoma (VS) management. Its efficacy depends on the cobalt-60 source which has a half-life of 5.26 years. According to the study authors, the actual rate...
Salvage surgery vs. repeat stereotactic radiosurgery for progressing vestibular schwannomas
This large multicentre case series of patients treated twice with stereotactic radiosurgery (SRS) for progressing vestibular schwannomas (VS) is reported by the International Gamma Knife Radiosurgery consortium. Progression of tumour growth after primary SRS is rare but does occur. Complications...
Reliability of Koos classification
Vestibular schwannoma (VS) tumour size has been considered the primary determinant of hearing outcomes and facial nerve function according to several published studies. Varying methods are used to estimate the size and volume of the VS with very little consensus...
Centralisation of care for acoustic tumour surgeries?
Several factors are responsible for readmission after acoustic tumour removal. The authors retrospectively studied the association between hospital, patient and insurance factors with the rate of readmission following acoustic tumour removal in the United States using the Nationwide Readmission Database...
Extrapolating lessons from vestibular schwannoma management
This paper presents a delightfully simple and sensible hypothesis for the management of benign schwannomas in the head and neck region. They have taken the approach used for the management of vestibular schwannomas and used the same principles to assess...
Results of hypoglossal-facial nerve anastamosis techniques for facial palsy
Preserving facial nerve function is of prime importance in acoustic neuroma surgery. A comprehensive knowledge of anatomy, experience and surgical precautions can reduce the incidence significantly. Important considerations are when and how to repair if injury occurs. Several options include:...
