Hearing preservation in patients with unilateral vestibular schwannoma after gamma knife surgery.

Introduction: The majority of patients still lose the functionality of their hearing in spite of the technical advances in microsurgery. Our aim was to evaluate the hearing preservation potential of Gamma Knife Surgery. We have reviewed our experience and the literature in order to evaluate the probability to obtain such functional preservation and the factors influencing it.

Recurrence of vestibular schwannomas after surgery.

The issue of recurrence of vestibular schwannomas is poorly studied by the surgical literature and is probably underestimated. Our own long-term retrospective analysis after translabyrinthine approach has indicated a 9.2% recurrence rate.

Translabyrinthine approach for vestibular schwannomas: operative technique.

For large vestibular schwannomas (VSs) for which removal is the primary therapy, the goals are complete tumor resection and maintenance of normal neurological function. The authors analyzed their results about facial nerve preservation, extent of resection and complications following resection of large VSs via a widened translabyrinthine approach. Between 1991 and 2001, 110 patients with a unilateral large VS (Koos stage IV) were operated on using the same technique in the same institution.

History of vestibular schwannoma surgery.

Attempts of surgical removal of vestibular schwannomas started 150 years ago with major limitations in terms of diagnosis and understanding of the disease but also in respect of surgical technique and instrumentation. Then came Cushing followed by Dandy, two pioneers and legendary neurosurgeons who understood the natural history of the disease and set the landmarks of the current surgery of the cerebellopontine angle. In this century of medicine, results and expectations shifted from a life-threatening affection to the actual standard of cranial nerve preservation and conservation of quality of life.

Management of invasive juvenile nasopharyngeal angiofibromas: the role of a multimodality approach.

Objective: Juvenile nasopharyngeal angiofibromas involving the cranial base and intracranial compartment are challenging tumors. We reviewed our experience of these tumors and analyzed the efficacy of a multimodality management.

Methods: Between 1981 and 2000, 15 extensive juvenile nasopharyngeal angiofibromas (Fisch Grade III or IV) were treated at our institution.

Modern management of vestibular schwannomas.

Within the last 3 decades, microsurgery and stereotactic radiosurgery (SRS) have become well-established management options for vestibular schwannomas (VSs). Advancement in the management of VSs can be separated into three periods: the microsurgical pioneer period, the demonstration of SRS as a first-line therapy for small and medium-sized VSs, and currently, a period of SRS maturity based on a large worldwide patient accrual. The Marseille SRS experience includes 1,500 patients, with 1,000 patients having follow-up longer than 3 years.

Long-term outcome in intensive care unit survivors after mechanical ventilation for intracerebral hemorrhage.

Objective: To evaluate long-term survival and functional outcome in intensive care unit survivors after mechanical ventilation for intracerebral hemorrhage.

Design: Retrospective chart review and prospective follow-up study.

Setting: Outpatient follow-up.

Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas.

Object: Microsurgical excision is an established treatment for vestibular schwannoma (VS). In 1992 the authors used a patient questionnaire to evaluate the functional outcome and quality of life in a series of 224 consecutive patients. In addition, starting with gamma knife surgery (GKS) in 1992, the authors decided to use the same methodology to evaluate prospectively the results of this modality to compare the two alternatives.

Results of the MXM Digisonic auditory brainstem implant clinical trials in Europe.

Objective: To assess the potential benefit of the MXM auditory brainstem implant for patients with neurofibromatosis type 2.

Study Design: Retrospective case review.

Setting: Tertiary referral centers.