Surgery for Vestibular Neuroma: Resection, Residue, and Recurrence
Introduction: In surgery for vestibular schwannoma (VS), clinical indicators may necessitate resection that is less than total. A number of papers have indicated that near-total resection does not lead to an increased risk of clinically important recurrence. MRI scanning may give results that are di...
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| Main Authors: | , , , |
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| Format: | Conference Proceeding |
| Language: | eng |
| Online Access: | Get full text |
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| Summary: | Introduction:
In surgery for vestibular schwannoma (VS), clinical indicators may necessitate resection that is less than total. A number of papers have indicated that near-total resection does not lead to an increased risk of clinically important recurrence. MRI scanning may give results that are difficult to interpret. We present the findings from a series of patients treated in Southampton, looking at the results of interval scanning 3 years after surgery.
Material and Methods:
From a series of 314 VS resections performed in Southampton between 1989 and May 2002, patients were identified in whom all the following information was available: surgical approach; totality of resection; histology; 3-year postoperative MRI scan. The MRI findings were classified as: no recurrence; linear enhancement; nodular enhancement.
Results:
Most patients underwent translabyrinthine or retrosigmoid surgery and had a total resection. The MRI features suggestive of recurrent tumor will be discussed, particularly the significance of enhancement that is purely linear. Cases with nodular enhancement will be discussed in relation to the totality of their resection.
Conclusions:
Surgery for removal of acoustic neuromas is a balance between total removal of the tumor and preservation of hearing and neurological function. Any patient may develop recurrence, even if the primary resection was thought to be complete. Postoperative interval MRI scanning is therefore important, but MRI findings are not always easy to interpret. Active management of recurrence should take into account the findings of repeated interval MRI scanning over several years as well as other factors. |
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| ISSN: | 1531-5010 1532-0065 |