Scholarlink

Purpose <p>Gamma Knife radiosurgery (GKRS) is a precise and efficacious treatment modality for vestibular schwannoma (VS) with favorable cranial nerve preservation rates. This study aims to better characterize facial nerve (FN) outcomes in VS after GKRS.</p> Methods <p>A query of six medical databases was conducted following PRISMA guidelines. Eligible studies exclusively reported VS managed with single-fraction GKRS and included House-Brackmann (HB) scale assessments prior to and following GKRS. Data was analyzed using random-effects modeling, and FN preservation was defined as HB I or II at last follow-up.</p> Results <p>Data was analyzed from 15 articles with 3,155 patients at an mean age of 55.0&#xa0;years. Mean tumor volume, radiation dose, follow-up, tumor control, and hearing preservation were 4.28 cm<sup>3</sup>, 13.3&#xa0;Gy, 59.4&#xa0;months, 92.7%, and 62.6%, respectively. The pooled FN preservation rate was 92.9%. Mean preoperative tumor volume &gt; 2.5 cm<sup>3</sup> and age &gt; 60&#xa0;years were significantly associated with worse preoperative FN function (<i>p</i> = 0.019, <i>p</i> = 0.023, respectively). Normal FN function (HB = 1) at last follow up was 95.8% for VS volume &lt; 2.5 cm<sup>3</sup> and 89.4% with larger volumes (<i>p</i> &lt; 0.001). Doses ≤ 13&#xa0;Gy were significantly associated with superior FN preservation (96.5%) compared to higher doses (<i>p</i> &lt; 0.001). Tumor control and hearing preservation were not significantly associated with FN preservation.</p> Conclusion <p>This meta-analysis identifies tumor volume and radiation dose as prognostic factors for FN preservation. A FN preservation rate of 93% may be expected at five years after GKRS. This study provides a unique characterization of FN outcome that should be considered in the management of VS.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Characterization of facial nerve outcomes following radiosurgery for vestibular schwannoma: a meta-analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年2月1日

查看全文
  • Gabrielle E. A. Hovis,
  • Anubhav Chandla,
  • Aryan Pandey,
  • Zoe Teton,
  • Isaac Yang

摘要

Purpose

Gamma Knife radiosurgery (GKRS) is a precise and efficacious treatment modality for vestibular schwannoma (VS) with favorable cranial nerve preservation rates. This study aims to better characterize facial nerve (FN) outcomes in VS after GKRS.

Methods

A query of six medical databases was conducted following PRISMA guidelines. Eligible studies exclusively reported VS managed with single-fraction GKRS and included House-Brackmann (HB) scale assessments prior to and following GKRS. Data was analyzed using random-effects modeling, and FN preservation was defined as HB I or II at last follow-up.

Results

Data was analyzed from 15 articles with 3,155 patients at an mean age of 55.0 years. Mean tumor volume, radiation dose, follow-up, tumor control, and hearing preservation were 4.28 cm3, 13.3 Gy, 59.4 months, 92.7%, and 62.6%, respectively. The pooled FN preservation rate was 92.9%. Mean preoperative tumor volume > 2.5 cm3 and age > 60 years were significantly associated with worse preoperative FN function (p = 0.019, p = 0.023, respectively). Normal FN function (HB = 1) at last follow up was 95.8% for VS volume < 2.5 cm3 and 89.4% with larger volumes (p < 0.001). Doses ≤ 13 Gy were significantly associated with superior FN preservation (96.5%) compared to higher doses (p < 0.001). Tumor control and hearing preservation were not significantly associated with FN preservation.

Conclusion

This meta-analysis identifies tumor volume and radiation dose as prognostic factors for FN preservation. A FN preservation rate of 93% may be expected at five years after GKRS. This study provides a unique characterization of FN outcome that should be considered in the management of VS.