Rate of recurrent vestibular schwannoma after total removal via different surgical approaches

Objective: The objective of this study was to assess the differences in the recurrence rates of vestibular schwannoma (VS) after total tumor removal through enlarged translabyrinthine (ETLA), retrosigmoid (RS) and middle cranial fossa (MCF) approaches. Our results were compared with previously publi...

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Main Authors:	Raja Lope Ahmad, Raja Ahmad Al'konee, Sivalingam, Shailendar, Topsakal, Vedat, Russo, Alessandra, Taibah, Abdelkader, Sanna, Mario
Format:	Article
Language:	English
Published:	Annals Publishing Company 2012
Subjects:	RF Otorhinolaryngology
Online Access:	http://irep.iium.edu.my/23081/ http://irep.iium.edu.my/23081/ http://irep.iium.edu.my/23081/1/Recurrent_VS.Ann_Otol_Rhinol_Laryngol.2012.pdf

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spelling	iium-230812012-07-06T03:08:49Z http://irep.iium.edu.my/23081/ Rate of recurrent vestibular schwannoma after total removal via different surgical approaches Raja Lope Ahmad, Raja Ahmad Al'konee Sivalingam, Shailendar Topsakal, Vedat Russo, Alessandra Taibah, Abdelkader Sanna, Mario RF Otorhinolaryngology Objective: The objective of this study was to assess the differences in the recurrence rates of vestibular schwannoma (VS) after total tumor removal through enlarged translabyrinthine (ETLA), retrosigmoid (RS) and middle cranial fossa (MCF) approaches. Our results were compared with previously published data, and literature reviews were done to identify the possible causes for the recurrence of VS. Methods: We performed a retrospective analysis of 2,400 cases of VS that underwent removal at the Gruppo Otologico, Piacenza, Italy from 1983 until 2010. The minimum postoperative follow-up was 12 months. We also reviewed the previously published data on recurrence rates of VS after ETLA, RS, and MCF approaches. Results: Total tumor removal was achieved in 2,252 cases (93.8%). The recurrence rate was 0.05% for ETL approach, 0.7% for RS approach, and 1.8% for the MCF approach. Literature reviews of 3 previously published case series utilizing the translabyrinthine approach showed that none of the primary tumors were less than 2.0 cm in size. Recurrences were seen between 1 and 13 years after the initial surgery. Conclusion: The rate of VS recurrence after total removal is exceptionally low in experienced hands. Undetected microscopic deposits left on crucial points such as the facial nerve, the preserved cochlea nerve or the fundus of the internal auditory canal could be possible causes for the recurrence. A definite advantage of an ETL approach is the excellent internal auditory canal exposure, resulting in an extremely low rate of VS recurrence. The patients should be followed up to 15 years with gadolinium-enhanced magnetic resonance imaging (with fat suppression sequence in ETL approach cases). Recurrent VS may exhibit a faster growth rate as than primary VS. Key Words:middle cranial fossa approach, recurrence, retrosigmoid approach, translabyrinthine approach, vestibular schwannoma Annals Publishing Company 2012-03 Article PeerReviewed application/pdf en http://irep.iium.edu.my/23081/1/Recurrent_VS.Ann_Otol_Rhinol_Laryngol.2012.pdf Raja Lope Ahmad, Raja Ahmad Al'konee and Sivalingam, Shailendar and Topsakal, Vedat and Russo, Alessandra and Taibah, Abdelkader and Sanna, Mario (2012) Rate of recurrent vestibular schwannoma after total removal via different surgical approaches. Annals of Otology, Rhinology and Laryngology, 121 (3). pp. 156-161. ISSN 0003-4894 http://www.annals.com/toc/auto_abstract.php?id=15830
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RF Otorhinolaryngology
spellingShingle	RF Otorhinolaryngology Raja Lope Ahmad, Raja Ahmad Al'konee Sivalingam, Shailendar Topsakal, Vedat Russo, Alessandra Taibah, Abdelkader Sanna, Mario Rate of recurrent vestibular schwannoma after total removal via different surgical approaches
description	Objective: The objective of this study was to assess the differences in the recurrence rates of vestibular schwannoma (VS) after total tumor removal through enlarged translabyrinthine (ETLA), retrosigmoid (RS) and middle cranial fossa (MCF) approaches. Our results were compared with previously published data, and literature reviews were done to identify the possible causes for the recurrence of VS. Methods: We performed a retrospective analysis of 2,400 cases of VS that underwent removal at the Gruppo Otologico, Piacenza, Italy from 1983 until 2010. The minimum postoperative follow-up was 12 months. We also reviewed the previously published data on recurrence rates of VS after ETLA, RS, and MCF approaches. Results: Total tumor removal was achieved in 2,252 cases (93.8%). The recurrence rate was 0.05% for ETL approach, 0.7% for RS approach, and 1.8% for the MCF approach. Literature reviews of 3 previously published case series utilizing the translabyrinthine approach showed that none of the primary tumors were less than 2.0 cm in size. Recurrences were seen between 1 and 13 years after the initial surgery. Conclusion: The rate of VS recurrence after total removal is exceptionally low in experienced hands. Undetected microscopic deposits left on crucial points such as the facial nerve, the preserved cochlea nerve or the fundus of the internal auditory canal could be possible causes for the recurrence. A definite advantage of an ETL approach is the excellent internal auditory canal exposure, resulting in an extremely low rate of VS recurrence. The patients should be followed up to 15 years with gadolinium-enhanced magnetic resonance imaging (with fat suppression sequence in ETL approach cases). Recurrent VS may exhibit a faster growth rate as than primary VS. Key Words:middle cranial fossa approach, recurrence, retrosigmoid approach, translabyrinthine approach, vestibular schwannoma
format	Article
author	Raja Lope Ahmad, Raja Ahmad Al'konee Sivalingam, Shailendar Topsakal, Vedat Russo, Alessandra Taibah, Abdelkader Sanna, Mario
author_facet	Raja Lope Ahmad, Raja Ahmad Al'konee Sivalingam, Shailendar Topsakal, Vedat Russo, Alessandra Taibah, Abdelkader Sanna, Mario
author_sort	Raja Lope Ahmad, Raja Ahmad Al'konee
title	Rate of recurrent vestibular schwannoma after total removal via different surgical approaches
title_short	Rate of recurrent vestibular schwannoma after total removal via different surgical approaches
title_full	Rate of recurrent vestibular schwannoma after total removal via different surgical approaches
title_fullStr	Rate of recurrent vestibular schwannoma after total removal via different surgical approaches
title_full_unstemmed	Rate of recurrent vestibular schwannoma after total removal via different surgical approaches
title_sort	rate of recurrent vestibular schwannoma after total removal via different surgical approaches
publisher	Annals Publishing Company
publishDate	2012
url	http://irep.iium.edu.my/23081/ http://irep.iium.edu.my/23081/ http://irep.iium.edu.my/23081/1/Recurrent_VS.Ann_Otol_Rhinol_Laryngol.2012.pdf
first_indexed	2023-09-18T20:34:58Z
last_indexed	2023-09-18T20:34:58Z
_version_	1777408985226280960

Rate of recurrent vestibular schwannoma after total removal via different surgical approaches

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