{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:08:10Z","timestamp":1790309290789,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,4,23]],"date-time":"2016-04-23T00:00:00Z","timestamp":1461369600000},"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":[[2016,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate outcomes of salvage surgery for vestibular schwannoma (VS) that failed primary stereotactic radiosurgery (SRS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Case\u2010control study of 37 patients who underwent surgical resection of sporadic VS following prior SRS at two tertiary academic referral centers between 2003 and 2015. A cohort of nonirradiated control subjects, matched according to tumor size, age, and treatment center, were used as comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010seven patients were included. The median time from radiation to surgical salvage was 36 months (range 9.6\u2013153 months). Following tumor progression after SRS, 18 (49%) patients underwent gross total resection, 10 (27%) underwent near\u2010total resection, and nine (24%) underwent subtotal resection. Postoperative complications following salvage surgery included one (3%) case of stroke, four (11%) cases of cerebrospinal fluid leak, and two (5%) cases of meningitis. Twenty\u2010seven (73%) patients had good postoperative facial nerve outcome (House\u2010Brackmann Score I\u2013II) at long\u2010term follow\u2010up. There were no cases of tumor recurrence or regrowth after a median length of 26 months following microsurgical salvage (range 3\u2013114 months). The rate of satisfactory postoperative facial nerve function was not different between study and control subjects (73% vs. 76%; <jats:italic>P<\/jats:italic> = 0.8); however, less\u2010than\u2010complete resection was utilized more frequently among previously radiated patients (<jats:italic>P<\/jats:italic> = 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Microsurgical salvage of VS following primary radiation therapy is challenging. Less\u2010than\u2010complete resection is required in a greater percentage of patients to preserve facial nerve integrity and prevent neurological complications. Long\u2010term follow\u2010up is needed to determine the risk of delayed progression following incomplete tumor removal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3b. <jats:italic>Laryngoscope<\/jats:italic>, 126:2580\u20132586, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25943","type":"journal-article","created":{"date-parts":[[2016,4,23]],"date-time":"2016-04-23T14:29:50Z","timestamp":1461421790000},"page":"2580-2586","source":"Crossref","is-referenced-by-count":55,"title":["Surgical salvage of recurrent vestibular schwannoma following prior stereotactic radiosurgery"],"prefix":"10.1002","volume":"126","author":[{"given":"Stephanie C.","family":"Wise","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota U.S.A."},{"name":"Department of Neurologic Surgery Mayo Clinic School of Medicine Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8ystein Vesterli","family":"Tveiten","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Haukeland University Hospital Bergen Norway"},{"name":"Department of Clinical Medicine University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin L.","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota U.S.A."},{"name":"Department of Neurologic Surgery Mayo Clinic School of Medicine Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erling","family":"Myrseth","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Lund\u2010Johansen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Haukeland University Hospital Bergen Norway"},{"name":"Department of Clinical Medicine University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic School of Medicine Rochester Minnesota U.S.A."},{"name":"Department of Neurologic Surgery Mayo Clinic School of Medicine Rochester Minnesota U.S.A."},{"name":"Department of Neurosurgery Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.11.JNS14594"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2015.02.003"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815590105"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2015.02.010"},{"key":"e_1_2_7_6_1","unstructured":"Society LGK(2014)Leksell Gamma Knife: Indications Treated 1986 to 2013 (68%\u2013100% of sites reporting). 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