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Surgical Salvage after Failed Irradiation for Vestibular Schwannoma

2005; Wiley; Volume: 115; Issue: 10 Linguagem: Inglês

10.1097/01.mlg.0000175063.76945.75

1531-4995

Rick A. Friedman, Derald E. Brackmann, William E. Hitselberger, Marc S. Schwartz, Zarina Iqbal, Karen I. Berliner,

Vascular Malformations Diagnosis and Treatment

The LaryngoscopeVolume 115, Issue 10 p. 1827-1832 Article Surgical Salvage after Failed Irradiation for Vestibular Schwannoma Rick A. Friedman MD, PhD, Corresponding Author Rick A. Friedman MD, PhD [email protected] House Clinic and House Ear Institute, Los Angeles, California, U.S.A.Dr. Rick A. Friedman, Clinical Studies Department, House Ear Institute, Fifth Floor, 2100 West Third Street, Los Angeles, CA 90057.Search for more papers by this authorDerald E. Brackmann MD, Derald E. Brackmann MD House Clinic and House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this authorWilliam E. Hitselberger MD, William E. Hitselberger MD House Clinic and House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this authorMarc S. Schwartz MD, Marc S. Schwartz MD House Clinic and House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this authorZarina Iqbal MPH, Zarina Iqbal MPH House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this authorKaren I. Berliner PhD, Karen I. Berliner PhD House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this author Rick A. Friedman MD, PhD, Corresponding Author Rick A. Friedman MD, PhD [email protected] House Clinic and House Ear Institute, Los Angeles, California, U.S.A.Dr. Rick A. Friedman, Clinical Studies Department, House Ear Institute, Fifth Floor, 2100 West Third Street, Los Angeles, CA 90057.Search for more papers by this authorDerald E. Brackmann MD, Derald E. Brackmann MD House Clinic and House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this authorWilliam E. Hitselberger MD, William E. Hitselberger MD House Clinic and House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this authorMarc S. Schwartz MD, Marc S. Schwartz MD House Clinic and House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this authorZarina Iqbal MPH, Zarina Iqbal MPH House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this authorKaren I. Berliner PhD, Karen I. Berliner PhD House Ear Institute, Los Angeles, California, U.S.A.Search for more papers by this author First published: 03 January 2009 https://doi.org/10.1097/01.mlg.0000175063.76945.75Citations: 80Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Objectives/Hypothesis: Compare vestibular schwannoma (VS) surgical outcome between patients with prior irradiation and those not previously treated. Study Design: Retrospective review with matched control group. Methods: Review of tumor adherence to the facial nerve, facial nerve grade, and complications in 38 patients with radiotherapy as a primary procedure before VS surgical removal and a matched random sample of 38 patients with primary surgery. The majority of the irradiated group had gamma knife radiation therapy. Mean time from irradiation to surgical salvage was 3.3 years (SD = 3.2), with a minimum of 5.2 months and a maximum of 15.8 years. Most (89.5%) patients in each group underwent a translabyrinthine approach. Mean tumor size at surgery was 2.6 cm in each group. Results: The irradiated group had more moderate to severe adherence of tumor than the controls (89% vs. 63%, P ≤ .01). They also had a lower rate of good facial function (House-Brackmann grade I/II) (37% vs. 70%) and a higher rate of poor function (grades V or VI) (50% vs. 18%) at follow-up (P ≤ .019). Results were similar when including only those with good preoperative function (50% vs. 72% and 32% vs. 15%) but did not achieve statistical significance. Surgical time and complications did not differ. Conclusion: Patients who have undergone irradiation for VS and require surgical salvage may have a more difficult surgery and poorer outcomes than those not previously irradiated. When making their initial choice of treatment, patients should be counseled that surgery might be more difficult after failed stereotactic irradiation. Citing Literature Volume115, Issue10October 2005Pages 1827-1832 RelatedInformation