Neurological complications after acoustic neurinoma radiosurgery: revised risk factors based on long-term follow-up
- 1 January 2007
- journal article
- research article
- Published by Taylor & Francis Ltd in Acta Oto-Laryngologica
- Vol. 127 (559), 65-70
- https://doi.org/10.1080/03655230701596467
Abstract
Conclusions. The precise risk factors for neurological complications after acoustic neurinoma radiosurgery were identified on long-term follow-up. Type 2 neurofibromatosis was found to be a risk factor for hearing loss and peripheral tumor dose was a risk factor for seventh and fifth cranial nerve injuries. These risk factors corresponded to those reported at other institutions. At the present time, controversy exists regarding history of prior surgical resection and tumor size as risk factors for cranial nerve complications. Objectives. To identify more precisely the risk factors for neurological complications after stereotactic radiosurgery (SRS) based on long-term follow-up. Patients and methods. Between June 1990 and September 1998, 138 patients with acoustic neurinomas had SRS at Tokyo University Hospital. Of these, the 125 patients who were followed up for at least 6 months were entered into the present study. The patients’ ages ranged from 13 to 77 years (median 53 years). The average tumor diameter ranged from 6.7 to 25.4 mm (mean 13.9 mm). The maximum tumor doses ranged from 20 to 40 Gy (mean 29.8 Gy), and the peripheral doses ranged from 12 to 25 Gy (mean 15.4 Gy). One to 12 isocenters were used (median 4). The follow-up period ranged from 6 to 191 months (median 60 months). The potential risk factors for neurological complications were analyzed using two univariate actuarial analyses. The neurological complications studied included hearing loss, facial palsy, and trigeminal nerve dysfunction. The variables analyzed were age, gender, prior operation, neurofibromatosis type 2 (NF2), tumor diameter, maximum tumor dose, peripheral tumor irradiation dose, and the number of isocenters. Variables with significant p values (Results. NF2 was significantly correlated with both total hearing loss and pure tone threshold (PTA) elevation; a history of prior surgical resection, tumor size, and the peripheral tumor dose were significantly correlated with facial palsy; and the peripheral tumor dose was significantly correlated with trigeminal neuropathy.Keywords
This publication has 14 references indexed in Scilit:
- Long-term outcome of stereotactic radiosurgery (SRS) in patients with acoustic neuromasInternational Journal of Radiation Oncology*Biology*Physics, 2006
- Radiosurgery of vestibular schwannomas: summary of experience in 829 casesJournal of Neurosurgery, 2005
- Safety and Efficacy of Tiered Limited-Dose Gamma Knife Stereotactic Radiosurgery for Unilateral Acoustic NeuromaStereotactic and Functional Neurosurgery, 2004
- Acoustic neuroma radiosurgery with marginal tumor doses of 12 to 13 gyInternational Journal of Radiation Oncology*Biology*Physics, 2004
- Gamma knife stereotactic radiosurgery for unilateral acoustic neuromasJournal of Neurology, Neurosurgery & Psychiatry, 2003
- Relative Indications for Radiosurgery and Microsurgery for Acoustic SchwannomaPublished by Springer Science and Business Media LLC ,2003
- Long-Term Complications following Gamma Knife Radiosurgery of Vestibular SchwannomasStereotactic and Functional Neurosurgery, 1998
- Neuro-otological Findings After Radiosurgery for Acoustic NeurinomasJAMA Otolaryngology–Head & Neck Surgery, 1996
- Gamma Knife: An Alternative Treatment for Acoustic NeurinomasAnnals of Otology, Rhinology & Laryngology, 1988
- Stereotactic Radiosurgery in Cases of Acoustic Neurinoma: Further ExperiencesNeurosurgery, 1983