{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:11:47Z","timestamp":1789740707317,"version":"4.0.1"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,1,13]],"date-time":"2015-01-13T00:00:00Z","timestamp":1421107200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The management of a sporadic vestibular schwannoma (VS) has changed with the introduction of stereotactic radiosurgery (SRS). Because functional outcome is important, particularly regarding the facial nerve, a policy of near\u2010total surgical resection of a large\u2010size VS has emerged, minimizing damage to the facial nerve. The debate remains whether the surgical remnant should be treated immediately or after established growth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A consecutive cohort of 55 patients underwent a retrosigmoid craniotomy and near\u2010total removal of a large\u2010size VS at our university medical center between 2005 and 2011 and had a follow\u2010up of a least 3 years. Documented growth of the VS remnant after surgery necessitating adjuvant SRS was the primary outcome measure using analysis of variance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 45 patients (81.8%), a small tumor remnant was left during surgery. The mean preoperative tumor volume was 12.2 cm<jats:sup>3<\/jats:sup> (range, 1.13\u201350.16 cm<jats:sup>3<\/jats:sup>); the mean volume of the remnant was 0.22 cm<jats:sup>3<\/jats:sup> (range, 0\u20131.52 cm<jats:sup>3<\/jats:sup>). The mean postoperative follow\u2010up time was 35.4 months (range, 3\u201376 months). Salvage SRS was deemed necessary in seven patients (13.0%). The size of the postoperative tumor remnant was a significant predictor for the necessity of postoperative adjuvant SRS. Normal facial nerve function (House\u2010Brackmann [HB] I) was preserved in 30 patients (57.7%), 17 patients (32.7%) experienced a permanent mild facial nerve deficit (HB II, III), and five patients (9.6%) experienced a severe facial nerve deficit (HB grade IV\u2013VI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Initial observation after near total surgical removal of VS is a feasible strategy, with only a minority requiring salvage radiosurgery during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 125:1703\u20131707, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25115","type":"journal-article","created":{"date-parts":[[2015,1,13]],"date-time":"2015-01-13T14:24:02Z","timestamp":1421159042000},"page":"1703-1707","source":"Crossref","is-referenced-by-count":29,"title":["Near total extirpation of vestibular schwannoma with salvage radiosurgery"],"prefix":"10.1002","volume":"125","author":[{"given":"Hanne Rinck","family":"Jeltema","sequence":"first","affiliation":[{"name":"Department of Neurosurgery University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolaas A.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik P.","family":"Bijl","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Wagemakers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan D. M.","family":"Metzemaekers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Marc C.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,1,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1215\/S1522851704001097"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e31826dba9e"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1333621"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.moo.0000244186.72645.d4"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.10.010"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21799"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000219217.14930.14"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.6.FOCUS12163"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000156709"},{"key":"e_1_2_6_11_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3171\/2012.6.GKS12697","article-title":"Intracapsular decompression or radical resection followed by Gamma Knife surgery for patients harboring a large vestibular schwannoma","volume":"117","author":"Pan HC","year":"2012","journal-title":"J Neurosurg"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328357b220"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988509300202"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-011-0307-8"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000156904"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.01.055"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.25115","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.25115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T01:54:14Z","timestamp":1696384454000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.25115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,13]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2015,7]]}},"alternative-id":["10.1002\/lary.25115"],"URL":"https:\/\/doi.org\/10.1002\/lary.25115","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,13]]}}}