• Joonho Byun, Jong Hyun Kim, Sang Woo Song, Young-Hoon Kim, Chang Ki Hong, and Jeong Hoon Kim.
• Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. Electronic address: drjunho2@gmail.com.
• World Neurosurg. 2022 Jul 1; 163: e207-e214.

BackgroundThe fate of residual tumor after salvage surgery for recurrent vestibular schwannoma (VS) after radiosurgery has not been elucidated so far. We reviewed our surgical series of salvage surgery for recurrent VS, with focus on the natural history of the residual tumor after salvage surgery.MethodsThis study enrolled 14 patients who underwent salvage surgical resection in our institute and were followed up for >12 months.ResultsThe study included 3 men and 11 women with a median age of 55 years (range: 16-70 years). The median pre-stereotactic radiosurgery tumor volume was 6591 mm3. All patients were treated using gamma knife radiosurgery. The median duration from gamma knife radiosurgery to surgery was 52 months (range: 10-116 months). Solid tumor growth and cyst formation were observed in 6 (42.9%) and 8 (57.1%) patients, respectively. Subtotal resection and partial resection were performed in 13 (92.8%) patients, and gross total resection was achieved in only one (7.2%) patient. Postoperative facial paresis and surgical complication occurred in 5 (35.7%) and 2 (14.3%) patients, respectively. After salvage resection for irradiated VS, no patient showed tumor progression or recurrence during the follow-up period (13 subtotal/partial resections and 1 total resection). In addition, 2 patients in the subtotal resection group showed residual tumor shrinkage after salvage surgery during the follow-up period.ConclusionsThe behavior of residual tumors after salvage surgery for irradiated VS was stable. Adjuvant treatment for these residual tumors may not be necessary.Copyright © 2022 Elsevier Inc. All rights reserved.

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