German Medical Science GMS Publishing House; Düsseldorf
ESBS 2005: Skull Base Surgery: An Interdisciplinary Challenge;
7th Congress of the European Skull Base Society held in association with the 13th Congress of the German Society of Skull Base Surgery;
The aim of this work is a comparison of results in two groups: primary radical removal of vestibular schwannoma (VS) and secondary radical removal following unsuccessful partial surgery and/or gamma knife stereoradiosurgery (GKS) and assessing the favorable one. Between 1997 and 2004, 106 patients with VS were operated on, 8 (7.5%) were after previous subtotal/partial resection and/or unsuccessful GKS. All VS from both groups were microsurgically removed by the same retromastoideal approach using intraoperative nerve monitoring. From primarily treated group 96% ended with good or satisfactory n. VII function and in 7.5% with useful hearing; group with previous subtotal partial resection and/or GKS ended without hearing and only in 25% with satisfactory function n. VII. The worst results of management of VS both microsurgically and by GKS are after previous partial resection. Total removal of VS after subtotal/partial resection and/or stereoradiosurgery is much more difficult. The subtotal/partial resection of VS should be therefore avoided. In all operated patients after GKS a living, biologically active tumour has been proved histologically. Only minimal regressive changes have been observed. This finding unambiguously proves that the stereoradiosurgery did not devitalize tumour as expected. Growing tumours (VS) should be treated by a primary radical microsurgery.
gamma knife stereoradiosurgery