To assess the contribution of multidisciplinary team meetings (MTM) on vestibular schwannoma management as well as to (1) compare professional compliance to national guidelines and (2) study the percentage of loss to follow-up in cases of conservative management by radiologic observation. A retrospective descriptive study of MTMs held between January 2011 and May 2013 in a tertiary referral center. Patients were classified in three groups according to the MTM decision (observation, surgery or radiotherapy). A total of 363 cases were discussed during the study period (29 months). One hundred and ninety-four decisions (53.4%) were for conservative management with radiologic observation, 130 (35.8%) for surgery, and 39 (10.7%) for radiation therapy. The sex ratio was 0.94, and the patients had a median age of 59 years (range 18-86 years). Most of the vestibular schwannomas (74.2%) were small (stages I and II). Global concordance between the MTM decision and International Radiosurgery Association guidelines was 88.7%. Twenty-three percent of the 104 files that were discussed in MTMs between January 2011 and July 2012, for which conservative management was decided, were lost to follow-up by 18 months. Management of vestibular schwannoma remains controversial, but it usually depends on the evolutive status. MTMs improve practice and facilitate the creation and maintenance of local registries. Future studies in MTMs are warranted to evaluate the benefit and evaluated if MTM could optimize long-term follow-up, limiting loss to follow-up in the observation of vestibular schwannomas that may be evolutive.
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http://dx.doi.org/10.1007/s00405-014-3375-x | DOI Listing |
Front Oncol
December 2024
Department of Neurosurgery, The Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Background: Surgery for tumors in the cerebellopontine angle is always a significant challenge due to the densely packed neurovascular structures, the narrow deep location, and the complex relationship between the lesions and surrounding neurovascular structures. Recently, great attention has been given to the neuroendoscope for its exclusive advantages, which have added a new dimension to many classical microscopic surgeries. However, the feasibility and advisability of fully endoscopic neurosurgery for cerebellopontine angle tumors remain to be further evaluated.
View Article and Find Full Text PDFJ Pers Med
December 2024
Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA 92697, USA.
This study aimed to develop a machine learning (ML) algorithm that can predict unplanned reoperations and surgical/medical complications after vestibular schwannoma (VS) surgery. All pre- and peri-operative variables available in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (n = 110), except those directly related to our outcome variables, were used as input variables. A deep neural network model consisting of seven layers was developed using the Keras open-source library, with a 70:30 breakdown for training and testing.
View Article and Find Full Text PDFEur Arch Otorhinolaryngol
December 2024
ENT Department, Sydney Adventist Hospital, Sydney, NSW, Australia.
Background: Meniere's disease (MD) is a disabling disease of the inner ear, having a substantial effect on a patient's quality of life. While various postulations regarding its aetiology exists, due to the difficulty with accessing inner ear tissue, there have been limited histological studies in patients with active MD.
Methods: Tissue was collected during labyrinthectomy from 8 patients with intractable MD who had failed medical therapy (22 samples), and 9 patients undergoing translabyrinthine resection of vestibular schwannoma (19 samples).
J Formos Med Assoc
December 2024
Medical Department of Zhuangshi Street Community Health Service Center, Zhenhai District, Ningbo City, Zhejiang Province, China. Electronic address:
Pak J Med Sci
December 2024
Asif Shabbir Associate Professor, Department of Neurosurgery, Neurosurgery Unit-I, Punjab Institutes of Neurosciences Lahore, Pakistan.
Paragangliomas are slow-growing, extra-adrenal neuroendocrine tumors with rare intracranial presentation. Although benign, they can be locally aggressive tumors causing bone destruction and compression related symptoms. We report the case of a 19 years old, normotensive female who presented with headache and vertigo for the past six months.
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