The Wait and See Strategy for Intracanalicular Vestibular Schwannomas

Roche, Pièrre-Hugues; Soumaré, Outouma; Thomassin, J M; Régis, Jean

doi:10.1159/000156710

Cited by 17 publications

(9 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Deferring definitive treatment may lead to progression of hearing impairment or to evolution from an easily resectable lesion to one that carries increased surgical (9,13,14) or radiosurgical risk (15). The inherent heterogeneity of the behavior of vestibular schwannomas has motivated a search for factors that may be predictive of tumor growth and injury patterns (16).…”

mentioning

confidence: 99%

Predictors of Vestibular Schwannoma Growth and Clinical Implications

Agrawal

Clark

Limb

et al. 2010

Otology &Amp; Neurotology

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Predictors of Vestibular Schwannoma Growth and Clinical Implications

Agrawal

Clark

Limb

et al. 2010

Otology &Amp; Neurotology

View full text Add to dashboard Cite

show abstract

“…Patients with asymptomatic presentations frequently have quiescent tumors; however, tumor growth may not parallel hearing deterioration. Patients may progressively lose hearing, even when the tumor appears unchanged on imaging (11–13). …”

mentioning

confidence: 99%

Long-Term Hearing Preservation After Microsurgical Excision of Vestibular Schwannoma

Woodson

Dempewolf²,

Gubbels³

et al. 2010

Otology &Amp; Neurotology

View full text Add to dashboard Cite

Objective To examine long-term hearing outcomes after microsurgical excision of vestibular schwannoma (VS). Study Design Retrospective case review. Setting Tertiary referral center. Patients Forty-nine subjects at a single institution who had undergone microsurgical excision of a VS via middle cranial fossa (MCF) approach between 1994 and 2007 with immediate postoperative (PO) hearing preservation and for whom long-term audiograms were available. Intervention Diagnostic. Main Outcome Measures Word Recognition Score (WRS) is defined by speech discrimination scores (SDS) greater than 70% (grade I), 50% to 70% (grade II), less than 50% (grade III), and 0% (grade IV). Results For subjects with more than 2 years of follow-up, WRS I hearing was present PO in 42 of 49 patients and was preserved at the latest follow-up in 38 (90%) of 42 patients. No subjects fell beyond WRS II. WRS I hearing was maintained in 23 (88%) of 26 patients with more than 5 years of follow-up. Postoperative WRS I to II hearing was maintained in 28 (96%) of 29 patients with more than 5 years of follow-up. The patient who lost significant hearing in the ear operated on had sensorineural hearing loss that paralleled deterioration in her ear that was not operated on. Conclusion Most subjects maintain their initial PO SDS after microsurgical VS removal, and therefore, the initial PO WRS is predictive of long-term hearing. Postsurgical changes do not alter the natural rate or pattern of progressive bilateral sensorineural hearing loss in individual subjects.

show abstract

“…However, studies using other classification systems (e.g. the Gardner-Robertson system) have indeed been published 2731 . It should be noted that an international consensus on the reporting of hearing in patients with a VS does not exist and is accordingly warranted.…”

Section: Discussionmentioning

confidence: 99%

Surgery of the lateral skull base: a 50-year endeavour

Zanoletti¹,

Mazzoni²,

Martini³

et al. 2019

Acta Otorhinolaryngol Ital

100

View full text Add to dashboard Cite

SUMMARY Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.

show abstract

The Wait and See Strategy for Intracanalicular Vestibular Schwannomas

Cited by 17 publications

References 5 publications

Predictors of Vestibular Schwannoma Growth and Clinical Implications

Predictors of Vestibular Schwannoma Growth and Clinical Implications

Long-Term Hearing Preservation After Microsurgical Excision of Vestibular Schwannoma

Surgery of the lateral skull base: a 50-year endeavour

Contact Info

Product

Resources

About