{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:02:22Z","timestamp":1790251342937,"version":"4.1.0"},"reference-count":81,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The choice of an appropriate strategy for intracanalicular vestibular schwannoma (ICVS) is still debated. We conducted a systematic review and meta-analysis with the aim to compare treatment outcomes amongst management strategies (conservative surveillance (CS), microsurgical resection (MR), or stereotactic radiosurgery (SRS)) aiming to inform guideline recommendations on behalf of the International Stereotactic Radiosurgery Society (ISRS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using PRISMA guidelines, we reviewed manuscripts published between January 1990 and October 2021 referenced in PubMed or Embase. Inclusion criteria were peer-reviewed clinical studies or case series reporting a cohort of ICVS managed with CS, MR, or SRS. Primary outcome measures included tumor control, the need for additional treatment, hearing outcomes, and posttreatment neurological deficits. These were pooled using meta-analytical techniques and compared using meta-regression with random effect.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty studies were included (2371 patients). The weighted pooled estimates for tumor control were 96% and 65% in SRS and CS series, respectively (P\u2005&amp;lt;\u2005.001). Need for further treatment was reported in 1%, 2%, and 25% for SRS, MR, and CS, respectively (P\u2005=\u2005.001). Hearing preservation was reported in 67%, 68%, and 55% for SRS, MR, and CS, respectively (P\u2005=\u2005.21). Persistent facial nerve deficit was reported in 0.1% and 10% for SRS and MR series, respectively (P\u2005=\u2005.01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>SRS is a noninvasive treatment with at least equivalent rates of tumor control and hearing preservation as compared to MR, with the caveat of better facial nerve preservation. As compared to CS, upfront SRS is an effective treatment in achieving tumor control with similar rates of hearing preservation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/neuonc\/noad253","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T00:30:26Z","timestamp":1703291426000},"page":"429-443","source":"Crossref","is-referenced-by-count":18,"title":["Management of sporadic intracanalicular vestibular schwannomas: A critical review and International Stereotactic Radiosurgery Society (ISRS) practice guidelines"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9858-3766","authenticated-orcid":false,"given":"Anne","family":"Balossier","sequence":"first","affiliation":[{"name":"AP-HM, Timone Hospital, Functional and Stereotactic Neurosurgery , Marseille , France"},{"name":"Aix-Marseille Universit\u00e9, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Institut de Neurosciences des Syst\u00e8mes (INS) UMR1106 , Marseille , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Sahgal","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupesh","family":"Kotecha","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida , Miami, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Fariselli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Unit of Radiotherapy, Fondazione IRCCS Istituto Neurologico C. Besta , Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Gorgulho","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, State University of S\u00e3o Paulo, NeuroSapiens Group, and, D\u2019Or Institute for Research and Education , Sa\u0303o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Levivier","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois , Lausanne , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Southern California , Los Angeles, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3820-8654","authenticated-orcid":false,"given":"Ian","family":"Paddick","sequence":"additional","affiliation":[{"name":"Queen Square Radiosurgery Centre, National Hospital for Neurology and Neurosurgery , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E","family":"Pollock","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia , Charlottesville, Virginia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic , Cleveland, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Yomo","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Aizawa Comprehensive Cancer Center, Aizawa Hospital , Matsumoto , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center of Advanced Analytics, Baptist Health South Florida , Miami, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Regis","sequence":"additional","affiliation":[{"name":"AP-HM, Timone Hospital, Functional and Stereotactic Neurosurgery , Marseille , France"},{"name":"Aix-Marseille Universit\u00e9, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Institut de Neurosciences des Syst\u00e8mes (INS) UMR1106 , Marseille , France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"issue":"5","key":"2024030503145753600_CIT0001","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1227\/NEU.0b013e3181f22660","article-title":"True incidence of vestibular schwannoma","volume":"67","author":"Stangerup","year":"2010","journal-title":"Neurosurgery."},{"issue":"1","key":"2024030503145753600_CIT0002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1215\/S1522851704001097","article-title":"Descriptive epidemiology of vestibular schwannomas","volume":"8","author":"Propp","year":"2006","journal-title":"Neuro-Oncol"},{"issue":"5","key":"2024030503145753600_CIT0003","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/ane.13220","article-title":"Gamma knife surgery in the treatment of intracanalicular vestibular schwannomas","volume":"141","author":"Dzierz\u0119cki","year":"2020","journal-title":"Acta Neurol Scand."},{"issue":"2","key":"2024030503145753600_CIT0004","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s11060-016-2170-5","article-title":"Does where you live influence how your vestibular schwannoma is managed? 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