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Vestibular Schwannoma

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Adult CNS Radiation Oncology

Abstract

Vestibular schwannoma (VS) or acoustic neuromas are benign tumors arising from the vestibular branch of the vestibulocochlear nerve. VS is derived from Schwann cells normally wrapping around the supporting nerve fibers. All functions of the facial and vestibulocochlear brain nerves may be affected when this tumorous lesion is growing in the tight internal auditory meatus. Typical symptoms of vestibular schwannomas are hearing impairment, gait disturbances, dizziness, and tinnitus, which reduce the quality of life of patients. Treatment options include conservative management, microsurgery, stereotactic radiosurgery, hypofractionated stereotactic radiotherapy, and fractionated stereotactic radiotherapy.

This chapter provides detailed information about VS and its types, epidemiological factors, pathogenesis, risk factors, diagnosis, staging, prognosis, and treatment strategies. Predictive factors and long-term outcomes of different methods of vestibular schwannoma management are described. Different treatment strategies are explained and compared with the main focus on radiotherapeutic approaches. A detailed insight into treatment planning of VS radiotherapy is given. At the end of this chapter, a case report highlighting the use of fractionated radiotherapy in a patient with VS is presented.

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Authors and Affiliations

  1. Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Munich, Bavaria, Germany

    Michael Mayinger & Stephanie E. Combs

  2. Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Oberschleißheim, Bavaria, Germany

    Stephanie E. Combs

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  1. Michael Mayinger
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Correspondence to Stephanie E. Combs .

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Editors and Affiliations

  1. Department of Radiation Oncology, Keck School of Medicine of USC, Norris Cancer Hospital, Los Angeles, California, USA

    Eric L. Chang

  2. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA

    Paul D. Brown

  3. Department of Radiation Oncology, University of Washington Medical Center, Seattle, Washington, USA

    Simon S. Lo

  4. Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

    Arjun Sahgal

  5. Department of Radiation Oncology, Taussig Cancer Institute Cleveland Clinic, Cleveland, Ohio, USA

    John H. Suh

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Mayinger, M., Combs, S.E. (2018). Vestibular Schwannoma. In: Chang, E., Brown, P., Lo, S., Sahgal, A., Suh, J. (eds) Adult CNS Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-42878-9_4

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