27 - Complications in Vestibular Schwannoma Patients

Abstract

Radiosurgery is now considered as the first line management option for the majority of small to medium sized acoustic (vestibular schwannomas) patients who desire facial and auditory nerve preservation. The goals of VS radiosurgery are to control tumor growth and preserve cranial nerve function. Preservation of auditory and facial nerve function is related to various factors that include dose planning and dose delivery technique, margin dose, tumor volume, and cranial nerve function at the time of the procedure. In Gamma Knife radiosurgery (GKRS) a dose of 12–12.5 Gy is typically prescribed to the isodose line that conforms to the tumor margin. With current techniques useful hearing preservation can be preserved in majority of patients and facial nerve preservation in almost all patients. For patients with large tumors with symptomatic mass effect, partial tumor resection followed by planned radiosurgery offers the best chance of preserving facial and cochlear function in such patients. Cystic VS often respond with significant tumor regression. GKRS remains the best procedure to perform for patients with small to moderate size VS. This report describes the current radiosurgery techniques and clinical outcomes.