Facial schwannoma: results of a large case series and review

McMonagle, Brent; Alsanosi, Abdulrahman; Croxson, Glen; Fagan, Paul

doi:10.1017/s0022215107000667

Cited by 115 publications

(124 citation statements)

References 22 publications

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“…Currently, the safe resection of FNSs is one of the big- 23 reported a series of 53 patients with FNSs, 33 (62%) of whom underwent resection (with a total of 36 procedures). Although total tumor resection was achieved in 21 of the 36 procedures, the facial nerve was sacrificed in 20 of the 21 total resections.…”

Section: Discussion Treatment Optionsmentioning

confidence: 99%

“…Microsurgical resection is restricted to patients who have severe HB Grade IV to VI facial palsy. 23 During the last 3 decades, SRS has emerged as another possible treatment option. There are several reports that showed the safety and efficacy of SRS for patients with FNSs, 2,3,5,17,18,21,22 but the reported studies generally included a small number of patients.…”

Section: Discussion Treatment Optionsmentioning

confidence: 99%

“…Despite recent microsurgical techniques, it is still challenging to avoid deterioration of facial nerve function after complete resection. 4,23,24,30 Tumor resection with nerve reconstruction results in facial nerve recovery of HouseBrackmann (HB) Grade III at best. 24,27,28 Consequently, observation using serial follow-up imaging has been the primary course of management for most asymptomatic patients or those with mild facial palsy.…”

mentioning

confidence: 99%

“…24,27,28 Consequently, observation using serial follow-up imaging has been the primary course of management for most asymptomatic patients or those with mild facial palsy. 23 Recently, stereotactic radiosurgery (SRS) has emerged as a minimally invasive treatment. There have been a number of articles demonstrating the safety and efficacy of SRS for vestibular schwannomas.…”

mentioning

confidence: 99%

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Gamma Knife surgery for patients with facial nerve schwannomas: a multiinstitutional retrospective study in Japan

Hasegawa

Kato

Kida

et al. 2016

JNS

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obJective The aim of this study was to explore the efficacy and safety of stereotactic radiosurgery for patients with facial nerve schwannomas (FNSs). methods This study was a multiinstitutional retrospective analysis of 42 patients with FNSs treated with Gamma Knife surgery (GKS) at 1 of 10 medical centers of the Japan Leksell Gamma Knife Society (JLGK1301). The median age of the patients was 50 years. Twenty-nine patients underwent GKS as the initial treatment, and 13 patients had previously undergone surgery. At the time of the GKS, 33 (79%) patients had some degree of facial palsy, and 21 (50%) did not retain serviceable hearing. Thirty-five (83%) tumors were solid, and 7 (17%) had cystic components. The median tumor volume was 2.5 cm 3 , and the median prescription dose to the tumor margin was 12 Gy. results The median follow-up period was 48 months. The last follow-up images showed partial remission in 23 patients and stable tumors in 19 patients. Only 1 patient experienced tumor progression at 60 months, but repeat GKS led to tumor shrinkage. The actuarial 3- and 5-year progression-free survival rates were 100% and 92%, respectively. During the follow-up period, 8 patients presented with newly developed or worsened preexisting facial palsy. The condition was transient in 3 of these patients. At the last clinical follow-up, facial nerve function improved in 8 (19%) patients, remained stable in 29 (69%), and worsened in 5 (12%; House-Brackmann Grade III in 4 patients, Grade IV in 1 patient). With respect to hearing function, 18 (90%) of 20 evaluated patients with a pure tone average of ≤ 50 dB before treatment retained serviceable hearing. coNclusioNs GKS is a safe and effective treatment option for patients with either primary or residual FNSs. All patients, including 1 patient who required repeat GKS, achieved good tumor control at the last follow-up. The incidence of newly developed or worsened preexisting facial palsy was 12% at the last clinical follow-up. In addition, the risk of hearing deterioration as an adverse effect of radiation was low. These results suggest that GKS is a safe alternative to resection.

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Section: Discussion Treatment Optionsmentioning

confidence: 99%

Section: Discussion Treatment Optionsmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Gamma Knife surgery for patients with facial nerve schwannomas: a multiinstitutional retrospective study in Japan

Hasegawa

Kato

Kida

et al. 2016

JNS

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“…Facial nerve schwannoma, or facial neurinoma, is an uncommon disease that accounts for less than 1% of temporal bone tumors [1]. The age of presentation reportedly varies.…”

Section: Introductionmentioning

confidence: 99%