caa a22 4500 445329076 CHVBK 20180317142731.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s10143-011-0307-8 doi (NATIONALLICENCE)springer-10.1007/s10143-011-0307-8 A review of treatment modalities for vestibular schwannoma [Elektronische Daten] [Benjamin Arthurs, Robert Fairbanks, John Demakas, Wayne Lamoreaux, Neil Giddings, Alexander Mackay, Barton Cooke, Ameer Elaimy, Christopher Lee] Vestibular schwannomas are benign intracranial tumors arising from the vestibular nerve. Treatment options include observation, stereotactic radiosurgery, fractionated radiotherapy, and microsurgery. We review the evidence describing efficacy and side-effect profiles of each of these modalities. This was accomplished by outlining the results of published meta-analyses and performing a systematic search of the literature for individual studies published between 2004 and June 2009. Without intervention, 29-54% of tumors will grow and 16-26% of patients require additional treatment, with 54-63% preserving functional hearing. With radiosurgery, only 2-4% require additional treatment and hearing preservation is accomplished in 44-66% of cases. Reviewing contemporary studies, it appears that reduced marginal doses may have decreased morbidity risks associated with radiosurgery without sacrificing efficacy. With fractionated radiotherapy, 3-7% will require additional treatment and hearing preservation is reported at 59-94% of patients, although long-term outcomes are not known. Microsurgery is an alternative for eligible patients, with fewer than 2% requiring additional treatment; however, the risk of hearing loss, facial neuropathy, and other morbidities is relatively high. There are significant limitations with comparing the efficacy and morbidity rates across interventions because of selection bias and confounding factors. Additional prospective comparative trials and randomized studies are needed to improve our understanding of the relative benefits of each modality. Springer-Verlag, 2011 Vestibular schwannoma nationallicence Acoustic neuroma nationallicence Radiosurgery nationallicence Microsurgery nationallicence Radiotherapy nationallicence Observation nationallicence Arthurs Benjamin Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut Fairbanks Robert Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut Demakas John Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut Lamoreaux Wayne Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut Giddings Neil Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut Mackay Alexander Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut Cooke Barton Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut Elaimy Ameer Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut Lee Christopher Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut Neurosurgical Review Springer-Verlag 34/3(2011-07-01), 265-279 0344-5607 34:3<265 2011 34 10143 https://doi.org/10.1007/s10143-011-0307-8 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10143-011-0307-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Arthurs Benjamin Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut NATIONALLICENCE 700 1- Fairbanks Robert Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut NATIONALLICENCE 700 1- Demakas John Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut NATIONALLICENCE 700 1- Lamoreaux Wayne Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut NATIONALLICENCE 700 1- Giddings Neil Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut NATIONALLICENCE 700 1- Mackay Alexander Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut NATIONALLICENCE 700 1- Cooke Barton Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut NATIONALLICENCE 700 1- Elaimy Ameer Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut NATIONALLICENCE 700 1- Lee Christopher Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, 99204, Spokane, WA, USA aut NATIONALLICENCE 773 0- Neurosurgical Review Springer-Verlag 34/3(2011-07-01), 265-279 0344-5607 34:3<265 2011 34 10143 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer