The emerging role of hearing loss rehabilitation in patients with vestibular schwannoma treated with Gamma Knife radiosurgery: literature review

2020 ◽  
Author(s):  
Carlotta Morselli ◽  
N. Boari ◽  
M. Artico ◽  
M. Bailo ◽  
L. O. Piccioni ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Literature Review ◽  
Gamma Knife ◽  
Vestibular Schwannoma ◽  
Gamma Knife Radiosurgery

scholarly journals Absence of residual tumor tissue after Gamma Knife radiosurgery followed by resection of a vestibular schwannoma: illustrative case

2022 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Gamma Knife ◽  
Vestibular Schwannoma ◽  
Tumor Tissue ◽  
Gamma Knife Radiosurgery ◽  
Residual Tumor ◽  
Resected Specimen ◽  
Histopathological Analysis ◽  
Illustrative Case ◽  
Histopathological Evidence

BACKGROUND Late pathology after vestibular schwannoma radiosurgery is uncommon. The authors presented a case of a resected hemorrhagic mass 13 years after radiosurgery, when no residual tumor was found. OBSERVATIONS A 56-year-old man with multiple comorbidities, including myelodysplastic syndrome cirrhosis, received Gamma Knife surgery for a left vestibular schwannoma. After 11 years of stable imaging assessments, the lesion showed gradual growth until a syncopal event occurred 2 years later, accompanied by progressive facial weakness and evidence of intralesional hemorrhage, which led to resection. However, histopathological analysis of the resected specimen showed hemorrhage and reactive tissue but no definitive residual tumor. LESSONS This case demonstrated histopathological evidence for the role of radiosurgery in complete elimination of tumor tissue. Radiosurgery for vestibular schwannoma carries a rare risk for intralesional hemorrhage in select patients.

The role of gamma knife radiosurgery in children

2001 ◽  
Vol 17 (6) ◽  
pp. 347-347
Author(s):  
Massimo Scerrati
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery

The role of gamma knife radiosurgery in children

2001 ◽  
Vol 17 (6) ◽  
pp. 341-346 ◽  
Author(s):  
Hans Eder ◽  
Klaus Leber ◽  
Sandro Eustacchio ◽  
Gerhard Pendl
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery

Gamma Knife radiosurgery for acromegaly: Evaluating the role of the biological effective dose associated with endocrine remission in a series of 42 consecutive cases

2020 ◽  
Author(s):  
Anne Balossier ◽  
Constantin Tuleasca ◽  
Christine Cortet‐Rudelli ◽  
Gustavo Soto‐Ares ◽  
Marc Levivier ◽  
...  
Keyword(s):  
Effective Dose ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Biological Effective Dose

scholarly journals Gamma Knife Radiosurgery does not alter the copy number aberration profile in sporadic vestibular schwannoma

2020 ◽  
Vol 149 (3) ◽  
pp. 373-381
Author(s):  
Aril Løge Håvik ◽  
Ove Bruland ◽  
Dhanushan Dhayalan ◽  
Morten Lund-Johansen ◽  
Per-Morten Knappskog
Keyword(s):  
Radiation Exposure ◽  
Gamma Knife ◽  
Vestibular Schwannoma ◽  
Copy Number ◽  
Statistical Tests ◽  
Gamma Knife Radiosurgery ◽  
Copy Number Aberration ◽  
Recurrent Event ◽  
Chromosome 22 ◽  
Increased Risk

Abstract Introduction Ionizing radiation is a known etiologic factor in tumorigenesis and its role in inducing malignancy in the treatment of vestibular schwannoma has been debated. The purpose of this study was to identify a copy number aberration (CNA) profile or specific CNAs associated with radiation exposure which could either implicate an increased risk of malignancy or elucidate a mechanism of treatment resistance. Methods 55 sporadic VS, including 18 treated with Gamma Knife Radiosurgery (GKRS), were subjected to DNA whole-genome microarray and/or whole-exome sequencing. CNAs were called and statistical tests were performed to identify any association with radiation exposure. Hierarchical clustering was used to identify CNA profiles associated with radiation exposure. Results A median of 7 (0–58) CNAs were identified across the 55 VS. Chromosome 22 aberration was the only recurrent event. A median aberrant cell fraction of 0.59 (0.25–0.94) was observed, indicating several genetic clones in VS. No CNA or CNA profile was associated with GKRS. Conclusion GKRS is not associated with an increase in CNAs or alteration of the CNA profile in VS, lending support to its low risk. This also implies that there is no major issue with GKRS treatment failure being due to CNAs. In agreement with previous studies, chromosome 22 aberration is the only recurrent CNA. VS consist of several genetic clones, addressing the need for further studies on the composition of cells in this tumor.

Clinical experience of 300 vestibular schwannoma treated by gamma knife radiosurgery using a 12-Gy margin dose

2009 ◽  
Vol 71 (1) ◽  
pp. 136-137
Author(s):  
N. Massager ◽  
S. Lonneville ◽  
C. Delbrouck ◽  
L. Abeloos ◽  
D. Devriendt ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Clinical Experience ◽  
Vestibular Schwannoma ◽  
Gamma Knife Radiosurgery

Hearing preservation in patients with vestibular schwannoma treated with Gamma Knife surgery

2013 ◽  
Vol 118 (3) ◽  
pp. 571-578 ◽  
Author(s):  
Andrew M. Baschnagel ◽  
Peter Y. Chen ◽  
Dennis Bojrab ◽  
Daniel Pieper ◽  
Jack Kartush ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Gamma Knife ◽  
Vestibular Schwannoma ◽  
Hearing Preservation ◽  
Gamma Knife Surgery ◽  
Speech Discrimination ◽  
Before And After ◽  
Nerve Dysfunction ◽  
Preservation Rate

Object Hearing loss after Gamma Knife surgery (GKS) in patients with vestibular schwannoma has been associated with radiation dose to the cochlea. The purpose of this study was to evaluate serviceable hearing preservation in patients with VS who were treated with GKS and to determine if serviceable hearing loss can be correlated with the dose to the cochlea. Methods Forty patients with vestibular schwannoma with serviceable hearing were treated using GKS with a median marginal dose of 12.5 Gy (range 12.5–13 Gy) to the 50% isodose volume. Audiometry was performed prospectively before and after GKS at 1, 3, and 6 months, and then every 6 months thereafter. Hearing preservation was based on pure tone average (PTA) and speech discrimination (SD). Serviceable hearing was defined as PTA less than 50 dB and SD greater than 50%. Results The median cochlear maximum and mean doses were 6.9 Gy (range 1.6–16 Gy) and 2.7 Gy (range 0.7–5.0 Gy), respectively. With a median audiological follow-up of 35 months (range 6–58 months), the 1-, 2-, and 3-year actuarial rates of maintaining serviceable hearing were 93%, 77%, and 74%, respectively. No patient who received a mean cochlear dose less than 2 Gy experienced serviceable hearing loss (p = 0.035). Patients who received a mean cochlear dose less than 3 Gy had a 2-year hearing preservation rate of 91% compared with 59% in those who received a mean cochlear dose of 3 Gy or greater (p = 0.029). Those who had more than 25% of their cochlea receiving 3 Gy or greater had a higher rate of hearing loss (p = 0.030). There was no statistically significant correlation between serviceable hearing loss and age, tumor size, pre-GKS PTA, pre-GKS SD, pre-GKS Gardner-Robertson class, maximum cochlear dose, or the percentage of cochlear volume receiving 5 Gy. On multivariate analysis there was a trend toward significance for serviceable hearing loss with a mean cochlear dose of 3 Gy or greater (p = 0.074). Local control was 100% at 24 months. No patient developed facial or trigeminal nerve dysfunction. Conclusions With a median mean cochlear dose of 2.7 Gy, the majority of patients with serviceable hearing retained serviceable hearing 3 years after GKS. A mean cochlear dose less than 3 Gy was associated with higher serviceable hearing preservation.

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