Salvage Management of Vestibular Schwannoma

Emily Kay-Rivest; John Thomas Roland Jr

doi:10.1016/j.otc.2023.02.014

Salvage Management of Vestibular Schwannoma

Otolaryngol Clin North Am. 2023 Jun;56(3):557-565. doi: 10.1016/j.otc.2023.02.014. Epub 2023 Mar 22.

Authors

Emily Kay-Rivest¹, John Thomas Roland Jr²

Affiliations

¹ Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada; Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, New York University, New York, NY, USA. Electronic address: Emily.kay-rivest@mcgill.ca.
² Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, New York University, New York, NY, USA.

PMID: 36964093
DOI: 10.1016/j.otc.2023.02.014

Abstract

The current management of vestibular schwannomas (VS) includes observation, microsurgery (MS), and stereotactic radiosurgery (SRS) or radiotherapy, and treatment failures may occur with any primary modality. SRS is most often used for microsurgical failures, as it carries a low risk of adverse events. Salvage MS following previous MS is reserved for specific cases and can present certain surgical challenges. Irradiation failures can be managed with both salvage MS and repeat SRS. This article is intended to review an approach to the failure of primary interventions for VS, with a focus on the time interval between modalities, rates of tumor control, functional outcomes, and possible complications.

Keywords: Functional outcomes; Microsurgery; Revisions; Stereotactic radiosurgery; Treatment failures; Vestibular schwannomas.

Publication types

Review

MeSH terms

Humans
Microsurgery
Neuroma, Acoustic* / therapy
Neurosurgical Procedures
Radiosurgery* / adverse effects
Retrospective Studies
Treatment Outcome