PMID- 34026409
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2193-6331 (Print)
IS  - 2193-634X (Electronic)
IS  - 2193-634X (Linking)
VI  - 82
IP  - 3
DP  - 2021 Jun
TI  - Comparison of Surgical Outcomes and Recurrence Rates of Cystic and Solid 
      Vestibular Schwannomas.
PG  - 333-337
LID - 10.1055/s-0039-1697039 [doi]
AB  - Objective  Cystic vestibular schwannomas (CVSs) are anecdotally believed to have 
      worse clinical and tumor-control outcomes than solid vestibular schwannomas 
      (SVSs); however, no data have been reported to support this belief. In this 
      study, we characterize the clinical outcomes of patients with CVSs versus those 
      with SVSs. Design  This is a retrospective review of prospectively collected 
      data. Setting  This study is set at single high-volume neurosurgical institute. 
      Participants  We queried a database for details on all patients diagnosed with 
      vestibular schwannomas between January 2009 and January 2014. Main Outcome 
      Measures  Records were retrospectively reviewed and analyzed using univariate and 
      multivariate analyses to study the differences in clinical outcomes and tumor 
      progression or recurrence. Results  Of a total of 112 tumors, 24% ( n  = 27) were 
      CVSs and 76% ( n  = 85) were SVSs. Univariate analysis identified the extent of 
      resection, Koos grade, and tumor diameter as significant predictors of recurrence 
      ( p  </= 0.005). However, tumor diameter was the only significant predictor of 
      recurrence in the multivariate analysis ( p  = 0.007). Cystic change was not a 
      predictor of recurrence in the univariate or multivariate analysis ( p  >/= 0.40). 
      Postoperative facial nerve and hearing outcomes were similar for both CVSs and 
      SVSs ( p  >/= 0.47). Conclusion  Postoperative facial nerve outcome, hearing, tumor 
      progression, and recurrence are similar for patients with CVSs and SVSs. As CVS 
      growth patterns and responses to radiation are unpredictable, we favor 
      microsurgical resection over radiosurgery as the initial treatment. Our data do 
      not support the commonly held belief that cystic tumors behave more aggressively 
      than solid tumors or are associated with increased postoperative facial nerve 
      deficits.
CI  - Thieme. All rights reserved.
FAU - Almefty, Rami O
AU  - Almefty RO
AD  - Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital 
      and Medical Center, Phoenix, Arizona, United States.
FAU - Xu, David S
AU  - Xu DS
AD  - Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital 
      and Medical Center, Phoenix, Arizona, United States.
FAU - Mooney, Michael A
AU  - Mooney MA
AD  - Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital 
      and Medical Center, Phoenix, Arizona, United States.
FAU - Montoure, Andrew
AU  - Montoure A
AD  - Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital 
      and Medical Center, Phoenix, Arizona, United States.
FAU - Naeem, Komal
AU  - Naeem K
AD  - Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital 
      and Medical Center, Phoenix, Arizona, United States.
FAU - Coons, Stephen W
AU  - Coons SW
AD  - Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital 
      and Medical Center, Phoenix, Arizona, United States.
FAU - Spetzler, Robert F
AU  - Spetzler RF
AD  - Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital 
      and Medical Center, Phoenix, Arizona, United States.
FAU - Porter, Randall W
AU  - Porter RW
AD  - Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital 
      and Medical Center, Phoenix, Arizona, United States.
LA  - eng
PT  - Journal Article
DEP - 20191021
PL  - Germany
TA  - J Neurol Surg B Skull Base
JT  - Journal of neurological surgery. Part B, Skull base
JID - 101580780
PMC - PMC8133812
OTO - NOTNLM
OT  - acoustic neuroma
OT  - facial nerve
OT  - hearing
OT  - microsurgical resection
OT  - preservation
OT  - stereotactic radiosurgery
OT  - vestibular schwannoma
COIS- Conflict of Interest None declared.
EDAT- 2021/05/25 06:00
MHDA- 2021/05/25 06:01
PMCR- 2022/06/01
CRDT- 2021/05/24 08:10
PHST- 2019/06/11 00:00 [received]
PHST- 2019/08/08 00:00 [accepted]
PHST- 2021/05/24 08:10 [entrez]
PHST- 2021/05/25 06:00 [pubmed]
PHST- 2021/05/25 06:01 [medline]
PHST- 2022/06/01 00:00 [pmc-release]
AID - 190178 [pii]
AID - 10.1055/s-0039-1697039 [doi]
PST - ppublish
SO  - J Neurol Surg B Skull Base. 2021 Jun;82(3):333-337. doi: 10.1055/s-0039-1697039. 
      Epub 2019 Oct 21.