Skip to main content Accessibility help
×
Home

Residual tumour after vestibular schwannoma surgery

  • C H Hahn (a1), S E Stangerup (a1) (a2) and P Caye-Thomasen (a1) (a2)

Abstract

Objective:

To evaluate residual tumour occurrence after vestibular schwannoma surgery, based on intra-operative registration and magnetic resonance imaging one year post-operatively.

Methods:

Patients undergoing translabyrinthine surgery for vestibular schwannoma in Denmark between 1976 and 2008 were registered in a national database covering 5.5 million inhabitants.

Results:

Translabyrinthine surgery was undertaken on 1143 patients. Of these, 978 had total, 140 near-total and 25 subtotal tumour excision, as assessed intra-operatively by the surgeon. One year after surgery, 65 per cent of small tumour remnants and 11 per cent of large tumour remnants were not visible on magnetic resonance imaging. The mean pre-operative size was significantly smaller for totally excised tumours, compared with near-totally and subtotally excised tumours. Revision surgery was performed for 14 patients (1.2 per cent), of whom 2 had received total, 5 near-total and 6 subtotal excisions initially.

Conclusion:

Most residual tumours disappear spontaneously, probably due to devascularisation. Few patients with a small residual vestibular schwannoma will require revision surgery or secondary radiotherapy.

Copyright

Corresponding author

Address for correspondence: Dr Christoffer Holst Hahn, Gjorslevvej 14, 2720 Vanløse, Denmark Fax: +45 39773476 E-mail: christoffer.holst@gmail.com

References

Hide All
1Stangerup, SE, Tos, M, Thomsen, J, Caye-Thomasen, P. True incidence of vestibular schwannoma? Neurosurgery 2010;67:1335–40
2Lalwani, AK. Current Diagnosis and Treatment in Otolaryngology Head and Neck Surgery, 2nd edn.New York: McGraw Hill, 2008;765772
3Arriaga, MA, Luxford, WM, Atkins, JS, Kwartler, JA. Predicting long-term facial nerve outcome after acoustic neuroma surgery. Otolaryngol Head Neck Surg 1993;108:220–4
4Lownie, SP, Drake, CG. Radical intracapsular removal of acoustic neurinomas. Long-term follow-up review of 11 patients. J Neurosurg 1991;74:422–5
5Arlt, F, Trantakis, C, Seifert, V, Bootz, F, Strauss, G, Meixensberger, J. Recurrence rate, time to progression and facial nerve function in microsurgery of vestibular schwannoma. Neurol Res 2011;33:1032–7
6Martin, TPC, Fox, H, Ho, E-C, Holder, R, Walsh, R, Irving, RM. Facial nerve outcomes in functional vestibular schwannoma surgery: less than total tumour excision significantly improves results. J Laryngol Otol 2012;126:120–4
7Freeman, SRM, Ramsden, RT, Saeed, SR, Alzoubi, FQ, Simo, R, Rutherford, SA et al. Revision surgery for residual or recurrent vestibular schwannoma. Otol Neurotol 2007;28:1076–82
8Godefroy, WP, van der Mey, AG, de Bruine, FT, Hoekstra, ER, Malessy, JA. Surgery for large vestibular schwannoma: residual tumor and outcome. Otol Neurotol 2009;30:629–34
9Kanzaki, J, Tos, M, Sanna, M, Moffat, D. New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma. Otol Neurotol 2003;24:642–8
10Sanna, M, Falcioni, M, Taibah, A, Donato, GD, Russo, A, Piccirillo, E. Treatment of residual vestibular schwannoma. Otol Neurotol 2002;23:980–7
11Lye, RH, Pace-Balzan, A, Ramsden, RT, Gillespie, JE, Dutton, JM. The fate of tumour rests following removal of acoustic neuromas: an MRI Gd-DTPA study. Br J Neurosurg 1992;6:195201
12Donzelli, R, Motta, G, Cavallo, LM, Maiuri, F, De Divitiis, E. One-stage removal of residual intracanalicular acoustic neuroma and hemihypoglossal-intratemporal facial nerve anastomosis: technical note. Neurosurgery 2003;53:1444–7
13Cayé-Thomasen, P, Werther, K, Nalla, A, Bøg-Hansen, TC, Nielsen, HJ, Stangerup, S-E et al. VEGF and VEGF receptor-1 concentration in vestibular schwannoma homogenates correlates to tumor growth rate. Otol Neurotol 2005;26:98101
14Carlson, ML, Van Abel, KM, Driscoll, CL, Neff, BA, Beatty, CW, Lane, JI et al. Magnetic resonance imaging surveillance following vestibular schwannoma resection. Laryngoscope 2012;122:378–88
15Beatty, CW, Ebersold, MJ, Harner, SG. Residual and recurrent acoustic neuromas. Laryngoscope 1987;97:1168–71
16Bloch, DC, Oghalai, JS, Jackler, RK, Osofsky, M, Pitts, LH. The fate of the tumor remnant after less-than-complete acoustic neuroma resection. Otolaryngol Head Neck Surg 2004;130:104–12
17El-Kashlan, HK, Zeitoun, H, Arts, HA, Hoff, JT, Telian, SA. Recurrence of acoustic neuroma after incomplete resection. Am J Otol 2000;21:389–92
18Kemink, JL, Langman, AW, Niparko, JK, Graham, MD. Operative management of acoustic neuromas: the priority of neurologic function over complete resection. Otolaryngol Head Neck Surg 1991;104:96–9
19Silverstein, H, Rosenberg, SI, Flanzer, JM, Wannamaker, HH, Seidman, MD. An algorithm for the management of acoustic neuromas regarding age, hearing, tumor size, and symptoms. Otolaryngol Head Neck Surg 1993;108:110
20Curley, JW, Ramsden, RT, Howell, A, Healy, K, Lye, RH. Oestrogen and progesterone receptors in acoustic neuroma. J Laryngol Otol 1990;104:865–7
21Falcioni, M, Fois, P, Taibah, A, Sanna, M. Facial nerve function after vestibular schwannoma surgery. J Neurosurg 2011;115:820–6
22Arriaga, MA, Chen, DA. Facial function in hearing preservation acoustic neuroma surgery. Arch Otolaryngol Head Neck Surg 2001;127:543–6
23Gjuric, M, Wigand, ME, Wolf, SR. Enlarged middle fossa vestibular schwannoma surgery: experience with 735 cases. Otol Neurotol 2001;22:223–30

Keywords

Residual tumour after vestibular schwannoma surgery

  • C H Hahn (a1), S E Stangerup (a1) (a2) and P Caye-Thomasen (a1) (a2)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed