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Vestibular Schwannoma: Current State of the Art

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Samii's Essentials in Neurosurgery

Abstract

“If any neurologic surgeon were asked to name the most difficult tumor to extirpate, his answer would doubtless be the acoustic tumor.” Dandy (1941) [10] Approximately seven decades separate this comment from current days. In this interim, several developments regarding imaging modalities and microsurgical techniques, as well as intraoperative neuromonitoring have been responsible for significant reductions in the morbidity of patients suffering from cerebellopontine angle (CPA) pathologies [25, 37, 55, 67, 70]. The progress of neurosurgery as a specialty is intrinsically related to the history of treatment for acoustic neuroma (vestibular schwannoma) [70]. Dealing with vestibular schwannomas (VSs) has developed from almost a death sentence at the beginning of the century [29, 55, 67] to the current concept of “functional microsurgery” [68].

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References

  1. Akagami R, Dong CC, Westerberg BD (2005) Localized transcranial electrical motor evoked potentials for monitoring cranial nerves in cranial base surgery. Neurosurgery 57:ONS78–85

    Google Scholar 

  2. Badie B, Pyle GM, Nguyen PH, Hadar EJ (2001) Elevation of internal auditory canal pressure by vestibular schwannomas. Otol Neurotol 22:696–700

    Article  PubMed  CAS  Google Scholar 

  3. Berrettini S, Ravecca F, Sellari-Franceschini S, Bruschini P, Casani A, Padolecchia R (1996) Acoustic neuroma: correlations between morphology and otoneurological manifestations. J Neurol Sci 144:24–33

    Article  PubMed  CAS  Google Scholar 

  4. Bozorg Grayeli A, Kalamarides M, Ferrary E, Bouccara D, El Gharem H, Rey A, Sterkers O (2005) Conservative management versus surgery for small vestibular schwannomas. Acta Otolaryngol 125:1063–1068

    Article  PubMed  Google Scholar 

  5. Chandrasekhar SS, Brackmann DE, Devgan KK (1995) Utility of auditory brainstem response audiometry in diagnosis of acoustic neuromas. Am J Otol 16:63–67

    PubMed  CAS  Google Scholar 

  6. Chang SD, Gibbs IC, Sakamoto GT, Lee E, Oyelese A, Adler JR Jr (2005) Staged stereotactic irradiation for acoustic neuroma. Neurosurgery 56:1254–1263

    Article  PubMed  Google Scholar 

  7. Colletti V, Fiorino FG, Carner M, Giarbini N, Sacchetto L, Cumer G (2000) The retrosigmoid approach for auditory brainstem implantation. Am J Otol 21:826–836

    PubMed  CAS  Google Scholar 

  8. Chung WY, Liu KD, Shiau CY, Wu HM, Wang LW, Guo WY, Ho DM, Pan DH (2005) Gamma knife surgery for vestibular schwannoma: 10-year experience of 195 cases. J Neurosurg 102:S87–96

    Google Scholar 

  9. Colletti V, Fiorino FG, Mocella S, Policante Z (1998) ECochG, CNAP and ABR monitoring during vestibular Schwannoma surgery. Audiology 37:27–37

    PubMed  CAS  Google Scholar 

  10. Dandy WE (1941) Results of removal of acoustic tumours by the unilateral approach. Arch Surg 42:1026–1033

    Google Scholar 

  11. Ekelund A, Reinstrup P, Ryding E, Andersson AM, Molund T, Kristiansson KA, Romner B, Brandt L, Saveland H (2002) Effects of iso- and hypervolemic hemodilution on regional cerebral blood flow and oxygen delivery for patients with vasospasm after aneurysmal subarachnoid hemorrhage. Acta Neurochir (Wien) 144:703–713

    Article  CAS  Google Scholar 

  12. Flickinger JC, Kondziolka D, Niranjan A, Lunsford LD (2001) Results of acoustic neuroma radiosurgery: an analysis of 5 year’s experience using current methods. J Neurosurg 94:1–6 14. Gharabaghi A, Koerbel A, Samii A, Kaminsky J, von Goesseln H, Tatagiba M, Samii M (2006) The impact of hypotension due to the trigeminocardiac reflex on auditory function in vestibular schwannoma surgery. J Neurosurg 104:369–375

    Google Scholar 

  13. Gharabaghi A, Acioly de Sousa MA, Tatagiba M (2006) Detection and prevention of the trigeminocardiac reflex during cerebellopontine angle surgery. Acta Neurochir (Wien) 148:1223

    Article  CAS  Google Scholar 

  14. Gharabaghi A, Samii A, Koerbel A, Rosahl SK, Tatagiba M, Samii M (2007) Preservation of function in vestibular schwannoma surgery. Neurosurgery 60:ONS124–128

    Google Scholar 

  15. Graamans K, Van Dijk JE, Janssen LW (2003) Hearing deterioration in patients with a non-growing vestibular schwannoma. Acta Otolaryngol 123:51–54

    Article  PubMed  Google Scholar 

  16. Grundy BL, Jannetta PJ, Procopio PT, Lina A, Boston JR, Doyle E (1982) Intraoperative monitoring of brain-stem auditory evoked potentials. J Neurosurg 57:674–681

    Article  PubMed  CAS  Google Scholar 

  17. Hoistad DL, Melnik G, Mamikoglu B, Battista R, O’Connor CA, Wiet RJ (2001) Update on conservative management of acoustic neuroma. Otol Neurotol 22:682–685

    Article  PubMed  CAS  Google Scholar 

  18. House JW, Brackmann DE (1985) Facial nerve grading system. Otolaryngol Head Neck Surg 93:146–147 18. Hasegawa T, Fujitani S, Katsumata S, Kida Y, Yoshimoto M, Koike J (2005) Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years. Neurosurgery 57:257–265

    Google Scholar 

  19. Ishihara H, Saito K, Nishizaki T, Kajiwara K, Nomura S, Yoshikawa K, Harada K, Suzuki M (2004) CyberKnife radiosurgery for vestibular schwannoma. Minim Invasive Neurosurg 47:290–293

    Article  PubMed  CAS  Google Scholar 

  20. Iwai Y, Yamanaka K, Yamagata K, Yasui T (2007) Surgery after radiosurgery for acoustic neuromas: surgical strategy and histological findings. Neurosurgery 60:ONS75–82

    Google Scholar 

  21. James ML, Husain AM (2005) Brainstem auditory evoked potential monitoring. when is change in wave V significant? Neurology 65:1551–1555

    Article  PubMed  Google Scholar 

  22. Kluwe L, Mautner V, Heinrich B, Dezube R, Jacoby LB, Friedrich RE, MacCollin M (2003) Molecular study of frequency of mosaicism in neurofibromatosis 2 patients with bilateral vestibular schwannomas. J Med Genet 40:109–114

    Article  PubMed  CAS  Google Scholar 

  23. Koerbel A, Gharabaghi A, Safavi-Abbasi S, Tatagiba M, Samii M (2005) Evolution of vestibular schwannoma surgery: the long journey to current success. Neurosurg Focus 18:e10

    Article  PubMed  Google Scholar 

  24. Koerbel A, Gharabaghi A, Samii A, Gerganov V, von Gosseln H, Tatagiba M, Samii M (2005) Trigeminocardiac reflex during skull base surgery: mechanism and management. Acta Neurochir (Wien) 147:727–733

    Article  CAS  Google Scholar 

  25. Koh ES, Millar BA, Menard C, Michaels H, Heydarian M, Ladak S, McKinnon S, Rutka JA, Guha A, Pond GR, Laperriere NJ (2007) Fractionated stereotactic radiotherapy for acoustic neuroma: single-institution experience at The Princess Margaret Hospital. Cancer 109:1203–1210

    Article  PubMed  Google Scholar 

  26. Kondziolka D, Lunsford LD, McLaughlin MR, Flickinger JC (1998) Long-term outcomes after radiosurgery for acoustic neuromas. N Engl J Med 339:1426–1433

    Article  PubMed  CAS  Google Scholar 

  27. Krause F (1911) Surgery of the Brain and Spinal Cord, vol. II. Rebmann, New York, pp 3–32

    Google Scholar 

  28. Lapsiwala SB, Pyle GM, Kaemmerle AW, Sasse FJ, Badie B (2002) Correlation between auditory function and internal auditory canal pressure in patients with vestibular schwannomas. J Neurosurg 96:872–876

    Article  PubMed  Google Scholar 

  29. Lenarz T, Lim HH, Reuter G, Patrick JF, Lenarz M (2006) The auditory midbrain implant: a new auditory prosthesis for neural deafness-concept and device description. Otol Neurotol 27:838–843

    Article  PubMed  Google Scholar 

  30. Loiselle DL, Nuwer MR (2005) When should we warn the surgeon? Diagnosis-based warning criteria for BAEP monitoring. Neurology 65:1522–1523

    Article  PubMed  Google Scholar 

  31. Ludemann W, Stan AC, Tatagiba M, Samii M (2000) Sporadic unilateral vestibular schwannoma with islets of meningioma: case report. Neurosurgery 47:451–454

    Article  PubMed  CAS  Google Scholar 

  32. Luse SA (1960) Electron microscopic studies of brain tumors. Neurology 10:881–905

    PubMed  CAS  Google Scholar 

  33. Magdziarz DD, Wiet RJ, Dinces EA, Adamiec LC (2000) Normal audiologic presentations in patients with acoustic neuroma: an evaluation using strict audiologic parameters. Otolaryngol Head Neck Surg 122:157–162

    Article  PubMed  CAS  Google Scholar 

  34. Matthies C, Samii M, Krebs S (1997) Management of vestibular schwannomas (acoustic neuromas): radiological features in 202 cases – their value for diagnosis and their predictive importance. Neurosurgery 40:469–482

    Article  PubMed  CAS  Google Scholar 

  35. Matthies C, Samii M (1997) Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation. Neurosurgery 40:1–10

    Article  PubMed  CAS  Google Scholar 

  36. Matthies C, Samii M (1997) Management of vestibular schwannomas (acoustic neuromas): the value of neurophysiology for evaluation and prediction of auditory function in 420 cases. Neurosurgery 40:919–930

    Article  PubMed  CAS  Google Scholar 

  37. Matthies C, Samii M (1997) Management of vestibular schwannomas (acoustic neuromas): the value of neurophysiology for intraoperative monitoring of auditory function in 200 cases. Neurosurgery 40:459–466

    Article  PubMed  CAS  Google Scholar 

  38. Matthies C, Samii M (2002) Vestibular schwannomas and auditory function: options in large T3 and T4 tumors? Neurochirurgie 48:461–470

    PubMed  CAS  Google Scholar 

  39. Matthies C, Thomas S, Moshrefi M, Lesinski-Schiedat A, Frohne C, Battmer RD, Lenarz T, Samii M (2000) Auditory brainstem implants: current neurosurgical experiences and perspective. J Laryngol Otol Suppl 27:32–36

    Article  PubMed  Google Scholar 

  40. Mautner VF, Lindenau M, Baser ME, Hazim W, Tatagiba M, Haase W, Samii M, Wais R, Pulst SM (1996) The neuroimaging and clinical spectrum of neurofibromatosis 2. Neurosurgery 38:880–886

    Article  PubMed  CAS  Google Scholar 

  41. Moffat DA, Golledge J, Baguley DM, Hardy DG (1993) Clinical correlates of acoustic neuroma morphology. J Laryngol Otol 107:290–294

    PubMed  CAS  Google Scholar 

  42. Moffat DA, Hardy DG, Baguley DM (1989) Strategy and benefits of acoustic neuroma searching. J Laryngol Otol 103:51–59

    PubMed  CAS  Google Scholar 

  43. Moller AR, Jannetta PJ (1983) Monitoring auditory functions during cranial nerve microvascular decompression operations by direct recording from the eighth nerve. J Neurosurg 59:493–499

    PubMed  CAS  Google Scholar 

  44. Moller MB (1994) Audiological evaluation. J Clin Neurophysiol 11:309–318

    Article  PubMed  CAS  Google Scholar 

  45. Mori K, Arai H, Nakajima K, Tajima A, Maeda M (1995) Hemorheological and hemodynamic analysis of hypervolemic hemodilution therapy for cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Stroke 26:1620–1626

    PubMed  CAS  Google Scholar 

  46. Nager GT, Baltimore MD (1969) Acoustic neuromas. Arch Otolaryngol 89:68–95

    Google Scholar 

  47. Nakamura M, Roser F, Domiani M, Samii M, Matthies C (2005) Intraoperative auditory brainstem responses in patients with cerebellopontine angle meningiomas involving the inner auditory canal: analysis of the predictive value of the responses. J Neurosurg 102:637–642

    PubMed  Google Scholar 

  48. Neary WJ, Newton VE, Laoide-Kemp SN, Ramsden RT, Hillier VF, Kan SW (1996) A clinical, genetic and audiological study of patients and families with unilateral vestibular schwannomas. II. Audiological findings in 93 patients with unilateral vestibular schwannomas. J Laryngol Otol 110:1120–1128

    PubMed  CAS  Google Scholar 

  49. Neff BA, Ting J, Dickinson SL, Welling DB (2005) Facial nerve monitoring parameters as a predictor of postoperative facial nerve outcomes after vestibular schwannoma resection. Otol Neurotol 26:728–732

    Article  PubMed  Google Scholar 

  50. Neu M, Strauss C, Romstock J, Bischoff B, Fahlbusch R (1999) The prognostic value of intraoperative BAEP patterns in acoustic neurinoma surgery. Clin Neurophysiol 110:1935–1941

    Article  PubMed  CAS  Google Scholar 

  51. Olivecrona H (1967) Acoustic tumors. J Neurosurg 26:6–13

    PubMed  CAS  Google Scholar 

  52. Otto SR, Brackmann DE, Hitselberger WE, Shannon RV, Kuchta J (2002) Multichannel auditory brainstem implant: update on performance in 61 patients. J Neurosurg 96:1063–1071

    PubMed  Google Scholar 

  53. Penzholz H (1984) Development and present state of cerebellopontine angle surgery from the neuro- and otosurgical point of view. Arch Otorhinolaryngol 240:167–174

    PubMed  CAS  Google Scholar 

  54. Pollock BE, Lunsford LD, Flickinger JC, Clyde BL, Kondziolka D (1998) Vestibular schwannoma management. Part I. Failed microsurgery and the role of delayed stereotactic radiosurgery. J Neurosurg 89:944–948

    PubMed  CAS  Google Scholar 

  55. Pollock BE, Lunsford LD, Kondziolka D, Sekula R, Subach BR, Foote RL, Flickinger JC (1998) Vestibular schwannoma management. Part II. Failed radiosurgery and the role of delayed microsurgery. J Neurosurg 89:949–955

    Article  PubMed  CAS  Google Scholar 

  56. Rand RW, Kurze T (1968) Preservation of vestibular, cochlear, and facial nerves during microsurgical removal of acoustic tumors. Report of two cases. J Neurosurg 28:158–161

    PubMed  CAS  Google Scholar 

  57. Romstock J, Strauss C, Fahlbusch R (2000) Continuous electromyography monitoring of motor cranial nerves during cerebellopontine angle surgery. J Neurosurg 93:586–593

    PubMed  CAS  Google Scholar 

  58. Rosahl SK, Tatagiba M, Gharabaghi A, Matthies C, Samii M (2000) Acoustic evoked response following transection of the eighth nerve in the rat. Acta Neurochir (Wien) 142:1037–1045

    Article  CAS  Google Scholar 

  59. Rosenberg SI (2000) Natural history of acoustic neuromas. Laryngoscope 110:497–508

    Article  PubMed  CAS  Google Scholar 

  60. Rutten I, Baumert BG, Seidel L, Kotolenko S, Collignon J, Kaschten B, Albert A, Martin D, Deneufbourg JM, Demanez JP, Stevenaert A (2007) Long-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma. Radiother Oncol 82:83–89

    Article  PubMed  Google Scholar 

  61. Samii A, Lenarz M, Majdani O, Lim HH, Samii M, Lenarz T (2007) Auditory midbrain implant: a combined approach for vestibular schwannoma surgery and device implantation. Otol Neurotol 28:31–38

    Article  PubMed  Google Scholar 

  62. Samii M, Gerganov V, Samii A (2006) Improved preservation of hearing and facial nerve function in vestibular schwannoma surgery via the retrosigmoid approach in a series of 200 patients. J Neurosurg 105:527–535

    PubMed  Google Scholar 

  63. Samii M, Matthies C, Tatagiba M (1997) Management of vestibular schwannomas (acoustic neuromas): auditory and facial nerve function after resection of 120 vestibular schwannomas in patients with neurofibromatosis 2. Neurosurgery 40:696–706

    Article  PubMed  CAS  Google Scholar 

  64. Samii M, Matthies C (1995) Acoustic neurinomas associated with vascular compression syndromes. Acta Neurochir (Wien) 134:148–154

    Article  CAS  Google Scholar 

  65. Samii M, Matthies C (1997) Management of 1000 vestibular schwannomas (acoustic neuromas): surgical management and results with an emphasis on complications and how to avoid them. Neurosurgery 40:11–23

    Article  PubMed  CAS  Google Scholar 

  66. Samii M, Matthies C (1997) Management of 1000 vestibular schwannomas (acoustic neuromas): hearing function in 1000 tumor resections. Neurosurgery 40:248–262

    Article  PubMed  CAS  Google Scholar 

  67. Samii M, Matthies C (1997) Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve-preservation and restitution of function. Neurosurgery 40:684–695

    Article  PubMed  CAS  Google Scholar 

  68. Sampath P, Long DM (2004) Acoustic Neuroma. In: Winn HR (ed) Youmans Neurological Surgery. Saunders, Philadelphia, pp 1147–1168

    Google Scholar 

  69. Schaller B, Probst R, Strebel S, Gratzl O (1999) Trigeminocardiac reflex during surgery in the cerebellopontine angle. J Neurosurg 90:215–220

    PubMed  CAS  Google Scholar 

  70. Sekhar LN (2007) Surgery after radiosurgery for acoustic neuromas: surgical strategy and histological findings. Neurosurgery 60:ONS82

    Google Scholar 

  71. Selesnick SH, Jackler RK (1992) Clinical manifestations and audiologic diagnosis of acoustic neuromas. Otolaryngol Clin North Am 25:521–551

    PubMed  CAS  Google Scholar 

  72. Shin YJ, Lapeyre-Mestre M, Gafsi I, Cognard C, Deguine O, Tremoulet M, Fraysse B (2003) Neurotological complications after radiosurgery versus conservative management in acoustic neuromas: a systematic review-based study. Acta Otolaryngol 123:59–64

    Article  PubMed  Google Scholar 

  73. Skinner HA (1929) The origin of acoustic nerve tumours. Br J Surg 16:440–463

    Article  Google Scholar 

  74. Smouha EE, Yoo M, Mohr K, Davis RP (2005) Conservative management of acoustic neuroma: a meta-analysis and proposed treatment algorithm. Laryngoscope 115:450–454

    Article  PubMed  Google Scholar 

  75. Somers T, Casselman J, de Ceulaer G, Govaerts P, Offeciers E (2001) Prognostic value of magnetic resonance imaging findings in hearing preservation surgery for vestibular schwannoma. Otol Neurotol 22:87–94

    Article  PubMed  CAS  Google Scholar 

  76. Strauss C, Bischoff B, Neu M, Berg M, Fahlbusch R, Romstock J (2001) Vasoactive treatment for hearing preservation in acoustic neuroma surgery. J Neurosurg 95:771–777

    PubMed  CAS  Google Scholar 

  77. Strauss C, Fahlbusch R, Romstock J, Schramm J, Watanabe E, Taniguchi M, Berg M (1991) Delayed hearing loss after surgery for acoustic neurinomas: clinical and electrophysiological observations. Neurosurgery 28:559–565

    Article  PubMed  CAS  Google Scholar 

  78. Walsh RM, Bath AP, Bance ML, Keller A, Rutka JA (2000) Consequences to hearing during the conservative management of vestibular schwannomas. Laryngoscope 110:250–255

    Article  PubMed  CAS  Google Scholar 

  79. Watanabe E, Schramm J, Strauss C, Fahlbusch R (1989) Neurophysiologic monitoring in posterior fossa surgery. II. BAEP-waves I and V and preservation of hearing. Acta Neurochir (Wien) 98:118–128

    Article  CAS  Google Scholar 

  80. Yamakami I, Uchino Y, Kobayashi E, Yamaura A (2003) Conservative management, gamma-knife radiosurgery, and microsurgery for acoustic neurinomas: a systematic review of outcome and risk of three therapeutic options. Neurol Res 25:682–690

    Article  PubMed  Google Scholar 

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Tatagiba, M., Acioly, M. (2008). Vestibular Schwannoma: Current State of the Art. In: Samii's Essentials in Neurosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-49250-4_18

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