J Neurol Surg B Skull Base 2016; 77 - PO-04
DOI: 10.1055/s-0036-1592650

Surgical Treatment of Patients with Vestibular Schwannoma after Stereotactic Radiological Treatment

Djemil Odamanov 1, Vadim Shimansky 1, Sergey Tanyashin 1, Andrey Golanov 1, Dmitriy Usachev 1, Vasiliy Karnaukhov 1, Vladimir Poshataev 1, Kirill Shevchenko 1, Sergey Kondrahov 1
  • 1Burdenko Neurosurgery Institute, Moscow, Russia

Introduction: Despite the effectiveness of the stereotactic radiosurgery and radiotherapy for vestibular schwannoma, in 2 to 12% of patients, radioresistant tumors were found. Surgical removal of the previously irradiated vestibular schwannoma is the only reasonable treatment option.

Objective: The aim of the study was to determine the indications, contraindications and timing for surgical treatment of vestibular schwannoma after radiological treatment, indications for total and subtotal removal, as well as evaluation the results of surgical treatment.

Materials and Methods: Twenty-two patients underwent surgical removal of vestibular schwannoma after stereotactic radiological treatment at Burdenko Neurosurgery Institute in the period from 2006 to 2015. These patients were divided into group 1 (subtotal or partial tumor removal followed by radiosurgery prior to current surgery) and group 2 (radiological treatment prior to surgery).

Results: In group 1, total resection was performed in 50%, subtotal - in 50%. In group 2, 27% of patients underwent total removal, 73% - subtotal resection. Satisfactory facial nerve function (House-Brackmann I-III) in group 1 was 40% of patients; in group 2 - 64%.

Conclusion: Results of surgical treatment of vestibular schwannoma after radiological treatment are worse than in patients operated primarily.