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This study aims to better characterize facial nerve (FN) outcomes in VS after GKRS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A query of six medical databases was conducted following PRISMA guidelines. Eligible studies exclusively reported VS managed with single-fraction GKRS and included House-Brackmann (HB) scale assessments prior to and following GKRS. Data was analyzed using random-effects modeling, and FN preservation was defined as HB I or II at last follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Data was analyzed from 15 articles with 3,155 patients at an mean age of 55.0\u00a0years. Mean tumor volume, radiation dose, follow-up, tumor control, and hearing preservation were 4.28 cm<jats:sup>3<\/jats:sup>, 13.3\u00a0Gy, 59.4\u00a0months, 92.7%, and 62.6%, respectively. The pooled FN preservation rate was 92.9%. Mean preoperative tumor volume\u2009&gt;\u20092.5 cm<jats:sup>3<\/jats:sup> and age\u2009&gt;\u200960\u00a0years were significantly associated with worse preoperative FN function (<jats:italic>p<\/jats:italic>\u2009=\u20090.019, <jats:italic>p<\/jats:italic>\u2009=\u20090.023, respectively). Normal FN function (HB\u2009=\u20091) at last follow up was 95.8% for VS volume\u2009&lt;\u20092.5 cm<jats:sup>3<\/jats:sup> and 89.4% with larger volumes (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Doses\u2009\u2264\u200913\u00a0Gy were significantly associated with superior FN preservation (96.5%) compared to higher doses (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Tumor control and hearing preservation were not significantly associated with FN preservation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This meta-analysis identifies tumor volume and radiation dose as prognostic factors for FN preservation. A FN preservation rate of 93% may be expected at five years after GKRS. This study provides a unique characterization of FN outcome that should be considered in the management of VS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00701-024-06405-3","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T07:29:57Z","timestamp":1738394997000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characterization of facial nerve outcomes following radiosurgery for vestibular schwannoma: a meta-analysis"],"prefix":"10.1007","volume":"167","author":[{"given":"Gabrielle E. 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