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Treatment Options for Acoustic Neuroma, Including Stereotactic Radiosurgery

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Surgery of the Cerebellopontine Angle

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Abstract

Vestibular schwannoma (VS) represents a challenging intracranial tumor to treat. Almost a century ago, the most prominent neurosurgeons in Europe reported operative mortality rates greater than 70% [1–3]. Harvey Cushing, in the US, advocated for a wide bilateral posterior fossa decompression and intracapsular internal decompression of the tumor to achieve a safe subtotal resection (STR) and reduced the operative mortality to ~20% [4, 5]. Walter Dandy, on the other hand, described a unilateral craniectomy and complete tumor removal with the necessary sacrifice of cranial nerves VII and VIII but obviating the risk of tumor regrowth and need for additional treatment [6–9]. Over the next several decades, the integration of the operating microscope, improvement in neuroanesthetic techniques, and development of intraoperative electromyographic (EMG) monitoring have markedly improved the outcome from microsurgical resection of VS.

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Author information

Authors and Affiliations

  1. Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA

    Panagiotis Kerezoudis & Michael J. Link

  2. Department of Surgery, Department of Neurosurgery, Department of Otolaryngology, Head and Neck Cancer Center, Mayo Clinic, Phoenix, AZ, USA

    Peter A. Weisskopf

  3. Department of Otolaryngology—Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA

    Colin L. W. Driscoll

  4. Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA

    Michael J. Link

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  1. Panagiotis Kerezoudis
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  2. Peter A. Weisskopf
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  3. Colin L. W. Driscoll
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  4. Michael J. Link
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Correspondence to Panagiotis Kerezoudis .

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Editors and Affiliations

  1. Chair of Neurological Surgery, Vice President and Director, The Neurological Institute, University Hospitals of Cleveland, Cleveland, OH, USA

    Nicholas C. Bambakidis

  2. Chief Executive Officer, University Hospitals Health System, Jane and Henry Meyer Distinguished CEO, Endowed Chair, Professor of Otolaryngology Head and Neck Surgery, Professor of Neurological Surgery, Case Western Reserve University, School of Medicine, Cleveland, OH, USA

    Cliff A. Megerian

  3. Emeritus President and CEO, Emeritus Chair, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA

    Robert F. Spetzler

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Kerezoudis, P., Weisskopf, P.A., Driscoll, C.L.W., Link, M.J. (2022). Treatment Options for Acoustic Neuroma, Including Stereotactic Radiosurgery. In: Bambakidis, N.C., Megerian, C.A., Spetzler, R.F. (eds) Surgery of the Cerebellopontine Angle. Springer, Cham. https://doi.org/10.1007/978-3-031-12507-2_10

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