Otolaryngologic clinics of North America
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Otolaryngol. Clin. North Am. · Jun 2015
ReviewStereotactic radiosurgery in the management of vestibular schwannoma and glomus jugulare: indications, techniques, and results.
Gamma Knife stereotactic radiosurgery (GKS) has become an important management strategy for an increasing number of patients with skull base tumors. For select patients with lateral skull base disorders, given the proximity to sensitive critical structures such as the brainstem, cranial nerves, and cochlea, this technology has emerged as a first-line treatment to achieve the paramount goals of long-term tumor control and maintenance of existing neurologic function. This article reviews the indications, technique, and results of GKS for the treatment of vestibular schwannoma and glomus jugulare tumors, and highlights our experience in treating these tumors at the Mayo Clinic.
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Vestibular schwannomas (VS) comprise 8% of all intracranial tumors and 90% of cerebellopontine angle and internal auditory canal neoplasms. Secondary to the widespread adoption of screening protocols for asymmetrical hearing loss and the increasing use of advanced imaging, the number of VS diagnosed each year continues to rise, while the average size has declined. Microsurgery remains the treatment of choice for large tumors, however the management of small- to medium-sized VS remains highly controversial with options including observation, radiotherapy, or microsurgery. Within this chapter, the authors provide an overview of the contemporary management of VS, reviewing important considerations and common controversies.
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Otolaryngol. Clin. North Am. · Jun 2015
Review Historical ArticleHistorical perspective on evolution in management of lateral skull base tumors.
This article gives a history of the major advances that have contributed to the current management of lateral skull base lesions. These advances include changes in surgical technique, better understanding of the natural history of these lesions, and the advent of stereotactic radiosurgery. An understanding of how treatment has evolved over time improves understanding of how the current treatment methods have been developed.