Cochlear implant in vestibular schwannomas: long-term outcomes and critical analysis of indications

A critical analysis of the literature relating to the history of problems in intercollegiate athletics, and efforts to resolve them, revealed the following: (a) The nature of the recurring problems was much the same, as was (b) the approach to resolution, and (c) the resulting long-term outcomes. In addition, it was found that efforts at resolution historically excluded involvement of the institution’s external communities. It was concluded that future efforts should employ a trinity model, composed of representation from the university, sport, and society. The institution’s external power brokers (society) should have a sense of joint authorship and accountability for maintaining the integrity of the model.

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Long-term outcomes in patients with vestibular schwannomas treated using gamma knife surgery: 10-year follow up

Journal of Neurosurgery ◽

10.3171/jns.2005.102.1.0010 ◽

2005 ◽

Vol 102 (1) ◽

pp. 10-16 ◽

Cited By ~ 138

Author(s):

Toshinori Hasegawa ◽

Yoshihisa Kida ◽

Tatsuya Kobayashi ◽

Masayuki Yoshimoto ◽

Yoshimasa Mori ◽

...

Keyword(s):

Effective Treatment ◽

Gamma Knife ◽

Gamma Knife Surgery ◽

Vestibular Schwannomas ◽

Long Term Outcomes ◽

Content Type ◽

The Mean ◽

Fine Print

Object. Gamma knife surgery (GKS) has been a safe and effective treatment for vestibular schwannomas in both the short and long term, although less is known about long-term outcomes in the past 10 years. The aim of this study was to clarify long-term outcomes in patients with vestibular schwannomas treated using GKS based on techniques in place in the early 1990s. Methods. Eighty patients harboring a vestibular schwannoma (excluding neurofibromatosis Type 2) were treated using GKS between May 1991 and December 1993. Among these, 73 patients were assessed; seven were lost to follow up. The median duration of follow up was 135 months. The mean patient age at the time of GKS was 56 years old. The mean tumor volume was 6.3 cm3, and the mean maximal and marginal radiation doses applied to the tumor were 28.4 and 14.6 Gy, respectively. Follow-up magnetic resonance images were obtained in 71 patients. Forty-eight patients demonstrated partial tumor remission, 14 had tumors that remained stable, and nine demonstrated tumor enlargement or radiation-induced edema requiring resection. Patients with larger tumors did not fare as well as those with smaller lesions. The actuarial 10-year progression-free survival rate was 87% overall, and 93% in patients with tumor volumes less than 10 cm3. No patient experienced malignant transformation. Conclusions. Gamma knife surgery remained an effective treatment for vestibular schwannomas for longer than 10 years. Although treatment failures usually occurred within 3 years after GKS, it is necessary to continue follow up in patients to reveal delayed tumor recurrence.

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Long-Term Outcomes for Vestibular Schwannomas: A population-Based Analysis of Patients Treated With Radiation or Surgery in a Multidisciplinary Setting

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2016.06.865 ◽

2016 ◽

Vol 96 (2) ◽

pp. E108-E109

Author(s):

M. Dosani ◽

S. Makarenko ◽

R. Akagami ◽

R. Ma ◽

A.C. Lo ◽

...

Keyword(s):

Population Based ◽

Vestibular Schwannomas ◽

Long Term Outcomes

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Long-term outcomes of vestibular schwannomas treated with fractionated stereotactic radiotherapy: An institutional experience

Yearbook of Otolaryngology-Head and Neck Surgery ◽

10.1016/j.yoto.2012.03.055 ◽

2012 ◽

Vol 2012 ◽

pp. 134-136

Author(s):

B.J. Balough

Keyword(s):

Stereotactic Radiotherapy ◽

Fractionated Stereotactic Radiotherapy ◽

Vestibular Schwannomas ◽

Long Term Outcomes ◽

Institutional Experience

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Long-term Outcomes in Patients With Vestibular Schwannomas Treated Using Gamma Knife Surgery: 10-Year Follow Up

Yearbook of Otolaryngology-Head and Neck Surgery ◽

10.1016/s1041-892x(08)70056-8 ◽

2006 ◽

Vol 2006 ◽

pp. 58-59

Author(s):

M.M. Paparella

Keyword(s):

Gamma Knife ◽

Gamma Knife Surgery ◽

Vestibular Schwannomas ◽

Long Term Outcomes

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Long-term outcomes after Gamma Knife surgery for vestibular schwannomas: a 10-year experience

Journal of Neurosurgery ◽

10.3171/sup.2006.105.7.149 ◽

2006 ◽

Vol 105 (Supplement) ◽

pp. 149-153 ◽

Cited By ~ 16

Author(s):

Dong Liu ◽

Desheng Xu ◽

Zhiyuan Zhang ◽

Yipei Zhang ◽

Ligao Zheng

Keyword(s):

Gamma Knife ◽

Gamma Knife Surgery ◽

Vestibular Schwannomas ◽

Hearing Improvement ◽

Long Term Outcomes ◽

Peripheral Dose ◽

Function Preservation ◽

The Mean

ObjectThe authors sought to assess the results of Gamma Knife surgery (GKS) in patients with vestibular schwannomas (VSs).MethodsSeventy-four consecutive patients (33 men and 41 women) were evaluated by means of serial imaging studies, clinical examinations, and questionnaires. Nineteen patients had undergone resection of their VS. Facial nerve function was normal in 63 patients (85.1%) before GKS, and 63.5% of them had useful hearing. The prescription peripheral dose varied between 10 and 14 Gy (mean 12.27 ± 0.96 Gy); the corresponding central dose was 21 to 30 Gy (mean 24.9 ± 2.18 Gy). The mean volume of the tumor at GKS was 10.79 ± 5.52 ml (range 0.11–27.8 ml). A mean of eight isocenters (range 3–17) was used for treating these lesions.At a median follow-up period of 68.3 months (range 30–122 months), tumor shrinkage was observed in 60 patients (81.1%), and the tumor size was stable in 11 (14.8%). Persistent neuroimaging demonstrated evidence of progression in only three patients (4.1%): two underwent repeated GKS after an interval of 18 months and one continues to be observed. Five patients experienced trigeminal dysfunction: in three the dysfunction was transient and in the other two the dysfunction persists. Three patients suffered facial palsy. Useful hearing was preserved in 34 patients. Thirteen patients experienced some degree of hearing improvement. Deterioration of hearing was found in 13 of 62 patients who had Class I or II hearing before treatment.Conclusions Gamma Knife surgery prevents tumor growth; it achieves excellent neurological function preservation and produces few treatment-related complications.

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