{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T12:49:27Z","timestamp":1759495767481},"reference-count":48,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Laryngorhinootologie"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Hintergrund\u2002Vestibularisschwannome (VS) sind benigne Tumoren, die anhand der Hannover-Klassifikation bzw. der Koos-Klassifizierung eingeteilt werden. Trotz der umfangreichen Literatur sind die Klinik und die Behandlungskonzepte speziell bei gro\u00dfen VS selten beschrieben.<\/jats:p><jats:p>Material und Methoden\u2002Zwischen 2003 und 2018 wurden 61 Patienten mit VS Typ IV durch die Arbeitsgruppe Sch\u00e4delbasischirurgie am Klinikum Dortmund behandelt. Die radiologischen und klinischen Daten wurden retrospektiv ausgewertet. Zudem erfolgte eine Subgruppenanalyse zwischen Patienten mit und ohne Kompression des IV. Ventrikels.<\/jats:p><jats:p>Ergebnisse\u2002Neben einer H\u00f6rminderung bei 55 Patienten (90\u200a%) hatten die meisten Patienten multiple Symptome wie eine Trigeminusaffektion bei 16 (26\u200a%), eine Fazialisparese bei 7 (12\u200a%), eine Ataxie bei 27 (45\u200a%) und Symptome eines Hirndruckanstiegs durch einen Hydrozephalus bei 4 Patienten (7\u200a%). Bei Patienten mit einem VS Typ IVb wurde signifikant h\u00e4ufiger eine Ataxie, eine tonsill\u00e4re Herniation bzw. ein Hydrozephalus festgestellt. Eine komplette Resektion wurde in 48 Patienten (78\u200a%) erreicht und eine weitestgehende Tumorentfernung in 12 Patienten (20\u200a%). In der Langzeituntersuchung zeigten 90\u200a% einen g\u00fcnstigen Outcome bez\u00fcglich des Nervus facialis (House-und-Brackman-Grad I\u2013III). 6 Patienten (10\u200a%) ben\u00f6tigten einen dauerhaften ventrikulo-peritonealen Shunt. Mehr als 90\u200a% der Patienten erzielten einen Karnofsky-Index &gt;\u200a70\u200a%.<\/jats:p><jats:p>Diskussion\u2002VS Typ IV sind h\u00e4ufig assoziiert mit Hydrozephalus, Ataxie, multiplen Hirnnervenausf\u00e4llen und gelegentlich Zeichen eines intrakraniellen Druckanstiegs. Die prim\u00e4re mikrochirurgische Resektion ist weiterhin eine entscheidende Therapieoption.<\/jats:p>","DOI":"10.1055\/a-1130-6321","type":"journal-article","created":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T23:06:48Z","timestamp":1594076808000},"page":"613-619","source":"Crossref","is-referenced-by-count":4,"title":["Management von Patienten mit Vestibularisschwannomen Typ IV"],"prefix":"10.1055","volume":"99","author":[{"given":"Ali","family":"Harati","sequence":"additional","affiliation":[{"name":"Neurosurgical Department, Klinikum Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Oni","sequence":"additional","affiliation":[{"name":"Neurosurgical Department, Klinikum Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Schulthei\u00df","sequence":"additional","affiliation":[{"name":"Neurosurgical Department, Klinikum Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Deitmer","sequence":"additional","affiliation":[{"name":"HNO-Klinik, Klinikum Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,7,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"506","DOI":"10.3171\/jns.1998.88.3.0506","article-title":"Neurotopographic considerations in the microsurgical treatment of small acoustic neurinomas","volume":"88","author":"W T Koos","year":"1998","journal-title":"J Neurosurg"},{"key":"ref2","first-page":"1","article-title":"Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation","volume":"40","author":"C Matthies","year":"1997","journal-title":"Neurosurgery"},{"key":"ref3","first-page":"S152","article-title":"Diagnosis and Management of Vestibular Schwannomas \u2013 An Interdisciplinary Challenge","volume":"96","author":"S Rosahl","year":"2017","journal-title":"Laryngorhinootologie"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"3187","DOI":"10.1007\/s00405-014-3375-x","article-title":"Experience of multidisciplinary team meetings in vestibular schwannoma: a preliminary report","volume":"272","author":"C Daveau","year":"2015","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1055\/s-0037-1607319","article-title":"A Cross-sectional Survey of the North American Skull Base Society: Current Practice Patterns of Vestibular Schwannoma Evaluation and Management in North America","volume":"79","author":"M L Carlson","year":"2018","journal-title":"J\u00a0Neurol Surg B Skull Base"},{"key":"ref6","first-page":"Doc03","article-title":"Diagnostics and therapy of vestibular schwannomas \u2013 an interdisciplinary challenge","volume":"16","author":"S Rosahl","year":"2017","journal-title":"GMS Curr Top Otorhinolaryngol Head Neck Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"860","DOI":"10.3171\/2009.7.JNS0989","article-title":"Functional outcome after complete surgical removal of giant vestibular schwannomas","volume":"112","author":"M Samii","year":"2010","journal-title":"J Neurosurg"},{"key":"ref8","first-page":"894","article-title":"Large vestibular schwannomas","volume":"115","author":"N C Bambakidis","year":"2011","journal-title":"J\u00a0Neurosurg"},{"key":"ref9","first-page":"161","article-title":"Facial nerve function after large cystic vestibular schwannomas surgery via the retrosigmoid approach","volume":"23","author":"M Wang","year":"2013","journal-title":"Turk Neurosurg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.3171\/2012.7.FOCUS12208","article-title":"A stepwise illustration of the translabyrinthine approach to a large cystic vestibular schwannoma","volume":"33","author":"C M Nickele","year":"2012","journal-title":"Neurosurg Focus"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1227\/NEU.0b013e31820777b1","article-title":"Hearing preservation after microsurgical resection of large vestibular schwannomas","volume":"68","author":"S Di Maio","year":"2011","journal-title":"Neurosurgery"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1055\/s-0031-1287680","article-title":"Management of large and giant vestibular schwannomas","volume":"21","author":"I Pai","year":"2011","journal-title":"Skull Base"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1080\/02688690802159031","article-title":"Giant vestibular schwannomas: focusing on the differences between the solid and the cystic variants","volume":"22","author":"N Mehrotra","year":"2008","journal-title":"Br J Neurosurg"},{"key":"ref14","first-page":"79","article-title":"Microsurgical treatment and facial nerve preservation in 400 cases of giant acoustic neuromas","volume":"28","author":"X Yang","year":"2014","journal-title":"Zhongguo Xiu Fu\u00a0Chong Jian Wai Ke Za Zhi"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1136\/jnnp.2003.010827","article-title":"Removal of large acoustic neurinomas (vestibular schwannomas) by the retrosigmoid approach with no mortality and minimal morbidity","volume":"75","author":"I Yamakami","year":"2004","journal-title":"J Neurol Neurosurg Psychiatr"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.3171\/2010.10.JNS1029","article-title":"Hydrocephalus associated with vestibular schwannomas: management options and factors predicting the outcome","volume":"114","author":"V M Gerganov","year":"2011","journal-title":"J Neurosurg"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1097\/00129492-200307000-00019","article-title":"New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma","volume":"24","author":"J Kanzaki","year":"2003","journal-title":"Otol Neurotol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1097\/MAO.0000000000001004","article-title":"Sudden Death Due to Vestibular Schwannoma: Caution in Emergent Management","volume":"37","author":"A Mohammadi","year":"2016","journal-title":"Otol Neurotol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.jocn.2007.01.007","article-title":"Cystic acoustic neuromas: surgical outcome in a series of 58 patients","volume":"15","author":"S Sinha","year":"2008","journal-title":"J Clin Neurosci"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1258\/0022215001904653","article-title":"Cystic vestibular schwannoma: surgical outcome","volume":"114","author":"P Fundov\u00e1","year":"2000","journal-title":"J Laryngol Otol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1080\/00016480510038013","article-title":"Conservative management versus surgery for small vestibular schwannomas","volume":"125","author":"A Bozorg Grayeli","year":"2005","journal-title":"Acta Otolaryngol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"811","DOI":"10.3171\/JNS\/2008\/109\/11\/0811","article-title":"Transient expansion of vestibular schwannoma following stereotactic radiosurgery","volume":"109","author":"O Nagano","year":"2008","journal-title":"J Neurosurg"},{"key":"ref23","first-page":"875","article-title":"Management of large vestibular schwannoma. Part I. Planned subtotal resection followed by Gamma Knife surgery: radiological and clinical aspects","volume":"115","author":"R van de Langenberg","year":"2011","journal-title":"J\u00a0Neurosurg"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"885","DOI":"10.3171\/2011.6.JNS101963","article-title":"Management of large vestibular schwannoma. Part II. Primary Gamma Knife surgery: radiological and clinical aspects","volume":"115","author":"R van de Langenberg","year":"2011","journal-title":"J Neurosurg"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"e599","DOI":"10.1016\/j.wneu.2019.03.218","article-title":"Predictive Factors of Early Postoperative and Long-Term Facial Nerve Function After Large Vestibular Schwannoma Surgery","volume":"127","author":"L Troude","year":"2019","journal-title":"World Neurosurg"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.wneu.2015.03.012","article-title":"Functional Preservation After Planned Partial Resection Followed by Gamma Knife Radiosurgery for Large Vestibular Schwannomas","volume":"84","author":"Y Iwai","year":"2015","journal-title":"World Neurosurg"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1007\/s00701-017-3194-0","article-title":"Preserving normal facial nerve function and improving hearing outcome in large vestibular schwannomas with a combined approach: planned subtotal resection followed by gamma knife radiosurgery","volume":"159","author":"R T Daniel","year":"2017","journal-title":"Acta Neurochir (Wien)"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1002\/lary.22411","article-title":"Magnetic resonance imaging surveillance following vestibular schwannoma resection","volume":"122","author":"M L Carlson","year":"2012","journal-title":"Laryngoscope"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"S362","DOI":"10.1055\/s-0038-1668540","article-title":"The Changing Paradigm for the Surgical Treatment of Large Vestibular Schwannomas","volume":"79","author":"R T Daniel","year":"2018","journal-title":"J Neurol Surg B Skull Base"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1055\/s-0030-1253576","article-title":"Malignant transformation of acoustic neuroma\/vestibular schwannoma 10 years after gamma knife stereotactic radiosurgery","volume":"20","author":"A K Demetriades","year":"2010","journal-title":"Skull Base"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s00701-016-3031-x","article-title":"Radiation-induced osteosarcoma after Gamma Knife surgery for vestibular schwannoma: a case report and literature review","volume":"159","author":"Y B Se","year":"2017","journal-title":"Acta Neurochir (Wien)"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"713","DOI":"10.3171\/2011.12.JNS111682","article-title":"Surgical treatment of patients with vestibular schwannomas after failed previous radiosurgery","volume":"116","author":"V M Gerganov","year":"2012","journal-title":"J Neurosurg"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"E9","DOI":"10.3171\/2012.6.FOCUS12190","article-title":"Surgical approaches for resection of vestibular schwannomas: translabyrinthine, retrosigmoid, and middle fossa approaches","volume":"33","author":"R Chamoun","year":"2012","journal-title":"Neurosurg Focus"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1288\/00005537-199412000-00006","article-title":"Long-term results of treatment for glomus jugulare and glomus vagale tumors with radiotherapy","volume":"104","author":"J M Cole","year":"1994","journal-title":"Laryngoscope"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"E14","DOI":"10.3171\/2012.6.FOCUS12163","article-title":"Surgery for vestibular schwannomas: a systematic review of complications by approach","volume":"33","author":"S F Ansari","year":"2012","journal-title":"Neurosurg Focus"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/mao.0b013e31815c2ad7","article-title":"Magnetic resonance imaging and neuropsychological testing after middle fossa vestibular schwannoma surgery","volume":"29","author":"B Schick","year":"2008","journal-title":"Otol Neurotol"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/00129492-200203000-00020","article-title":"Translabyrinthine approach for the management of large and giant vestibular schwannomas","volume":"23","author":"B Mamikoglu","year":"2002","journal-title":"Otol Neurotol"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"554","DOI":"10.3171\/2014.6.JNS132471","article-title":"Retrosigmoid removal of small acoustic neuroma: curative tumor removal with preservation of function","volume":"121","author":"I Yamakami","year":"2014","journal-title":"J Neurosurg"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1080\/00016480701762516","article-title":"Functional outcome of retrosigmoid approach in vestibular schwannoma surgery","volume":"128","author":"J Yang","year":"2008","journal-title":"Acta Otolaryngol"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"527","DOI":"10.3171\/jns.2006.105.4.527","article-title":"Improved preservation of hearing and facial nerve function in vestibular schwannoma surgery via the retrosigmoid approach in a series of 200 patients","volume":"105","author":"M Samii","year":"2006","journal-title":"J Neurosurg"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/978-3-7091-6898-1_6","article-title":"Hearing preservation in acoustic tumour surgery","volume":"22","author":"M Samii","year":"1995","journal-title":"Adv Tech Stand Neurosurg"},{"key":"ref42","first-page":"ONS124\u2013127","article-title":"Preservation of function in vestibular schwannoma surgery","volume":"60","author":"A Gharabaghi","year":"2007","journal-title":"Neurosurgery"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1007\/s00405-011-1596-9","article-title":"Functional outcomes in retrosigmoid approach microsurgery and gamma knife stereotactic radiosurgery in vestibular schwannoma","volume":"268","author":"C E Park","year":"2011","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1227\/01.NEU.0000154059.34990.B8","article-title":"Suboccipital retrosigmoid approach for removal of vestibular schwannomas: facial nerve function and hearing preservation","volume":"56","author":"I Ciric","year":"2005","journal-title":"Neurosurgery"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1227\/NEU.0000000000000547","article-title":"Facial nerve preservation surgery for koos grade 3 and 4 vestibular schwannomas","volume":"75","author":"A N Anaizi","year":"2014","journal-title":"Neurosurgery"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.wneu.2015.11.089","article-title":"Improved Postoperative Facial Nerve and Hearing Function in Retrosigmoid Vestibular Schwannoma Surgery Significantly Associated with Semisitting Position","volume":"87","author":"K Roessler","year":"2016","journal-title":"World Neurosurg"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.3171\/2012.1.JNS111402","article-title":"Staged resection of large vestibular schwannomas","volume":"116","author":"A M Raslan","year":"2012","journal-title":"J Neurosurg"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s10143-018-1044-z","article-title":"Continuous dynamic mapping to avoid accidental injury of the facial nerve during surgery for large vestibular schwannomas","volume":"43","author":"K Seidel","year":"2020","journal-title":"Neurosurg Rev"}],"container-title":["Laryngo-Rhino-Otologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1130-6321.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T11:00:17Z","timestamp":1723201217000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1130-6321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,6]]},"references-count":48,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2020,8,26]]},"published-print":{"date-parts":[[2020,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1130-6321","relation":{},"ISSN":["0935-8943","1438-8685"],"issn-type":[{"type":"print","value":"0935-8943"},{"type":"electronic","value":"1438-8685"}],"subject":[],"published":{"date-parts":[[2020,7,6]]}}}