{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:09:41Z","timestamp":1791374981236,"version":"4.3.1"},"reference-count":99,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2018,2]]},"abstract":"Abstract<\/jats:title>\n Please see the full-text version of this guideline (https:\/\/www.cns.org\/guidelines\/guidelines-management-patients-vestibular-schwannoma\/chapter_3) for the target population of each recommendation listed below.<\/jats:p>\n \n STEREOTACTIC RADIOSURGERY<\/jats:title>\n <\/jats:sec>\n \n Question 1<\/jats:title>\n What is the overall probability of maintaining serviceable hearing following stereotactic radiosurgery utilizing modern dose planning, at 2, 5, and 10 yr following treatment?<\/jats:p>\n <\/jats:sec>\n \n Recommendation<\/jats:title>\n \n Level 3<\/jats:italic>\n : Individuals who meet these criteria and are considering stereotactic radiosurgery should be counseled that there is moderately high probability (>50%-75%) of hearing preservation at 2 yr, moderately high probability (>50%-75%) of hearing preservation at 5 yr, and moderately low probability (>25%-50%) of hearing preservation at 10 yr.\n <\/jats:p>\n <\/jats:sec>\n \n Question 2<\/jats:title>\n Among patients with AAO-HNS (American Academy of Otolaryngology-Head and Neck Surgery hearing classification) class A or GR (Gardner-Robertson hearing classification) grade I hearing at baseline, what is the overall probability of maintaining serviceable hearing following stereotactic radiosurgery, utilizing modern dose planning, at 2, 5, and 10 yr following treatment?<\/jats:p>\n <\/jats:sec>\n \n Recommendation<\/jats:title>\n \n Level 3<\/jats:italic>\n : Individuals who meet these criteria and are considering stereotactic radiosurgery should be counseled that there is a high probability (>75%-100%) of hearing preservation at 2 yr, moderately high probability (>50%-75%) of hearing preservation at 5 yr, and moderately low probability (>25%-50%) of hearing preservation at 10 yr.\n <\/jats:p>\n <\/jats:sec>\n \n Question 3<\/jats:title>\n What patient- and tumor-related factors influence progression to nonserviceable hearing following stereotactic radiosurgery using\u00a0\u226413 Gy to the tumor margin?<\/jats:p>\n <\/jats:sec>\n \n Recommendation<\/jats:title>\n \n Level 3:<\/jats:italic>\n Individuals who meet these criteria and are considering stereotactic radiosurgery should be counseled regarding the probability of successful hearing preservation based on the following prognostic data: the most consistent prognostic features associated with maintenance of serviceable hearing are good preoperative word recognition and\/or pure tone thresholds with variable cut-points reported, smaller tumor size, marginal tumor dose\u00a0\u226412 Gy, and cochlear dose\u00a0\u22644 Gy. Age and sex are not strong predictors of hearing preservation outcome.\n <\/jats:p>\n <\/jats:sec>\n \n MICROSURGERY<\/jats:title>\n <\/jats:sec>\n \n Question 4<\/jats:title>\n What is the overall probability of maintaining serviceable hearing following microsurgical resection of small to medium-sized sporadic vestibular schwannomas early after surgery, at 2, 5, and 10 yr following treatment?<\/jats:p>\n <\/jats:sec>\n \n Recommendation<\/jats:title>\n \n Level 3<\/jats:italic>\n : Individuals who meet these criteria and are considering microsurgical resection should be counseled that there is a moderately low probability (>25%-50%) of hearing preservation immediately following surgery, moderately low probability (>25%-50%) of hearing preservation at 2 yr, moderately low probability (>25%-50%) of hearing preservation at 5 yr, and moderately low probability (>25%-50%) of hearing preservation at 10 yr.\n <\/jats:p>\n <\/jats:sec>\n \n Question 5<\/jats:title>\n Among patients with AAO-HNS class A or GR grade I hearing at baseline, what is the overall probability of maintaining serviceable hearing following microsurgical resection of small to medium-sized sporadic vestibular schwannomas early after surgery, at 2, 5, and 10 yr following treatment?<\/jats:p>\n <\/jats:sec>\n \n Recommendation<\/jats:title>\n \n Level 3:<\/jats:italic>\n Individuals who meet these criteria and are considering microsurgical resection should be counseled that there is a moderately high probability (>50%-75%) of hearing preservation immediately following surgery, moderately high probability (>50%-75%) of hearing preservation at 2 yr, moderately high probability (>50%-75%) of hearing preservation at 5 yr, and moderately low probability (>25%-50%) of hearing preservation at 10 yr.\n <\/jats:p>\n <\/jats:sec>\n \n Question 6<\/jats:title>\n What patient- and tumor-related factors influence progression to nonserviceable hearing following microsurgical resection of small to medium-sized sporadic vestibular schwannomas?<\/jats:p>\n <\/jats:sec>\n \n Recommendation<\/jats:title>\n \n Level 3:<\/jats:italic>\n Individuals who meet these criteria and are considering microsurgical resection should be counseled regarding the probability of successful hearing preservation based on the following prognostic data: the most consistent prognostic features associated with maintenance of serviceable hearing are good preoperative word recognition and\/or pure tone thresholds with variable cut-points reported, smaller tumor size commonly less than 1 cm, and presence of a distal internal auditory canal cerebrospinal fluid fundal cap. Age and sex are not strong predictors of hearing preservation outcome.\n <\/jats:p>\n <\/jats:sec>\n \n CONSERVATIVE OBSERVATION<\/jats:title>\n <\/jats:sec>\n \n Question 7<\/jats:title>\n What is the overall probability of maintaining serviceable hearing with conservative observation of vestibular schwannomas at 2, 5, and 10 yr following diagnosis?<\/jats:p>\n <\/jats:sec>\n \n Recommendation<\/jats:title>\n \n Level 3:<\/jats:italic>\n Individuals who meet these criteria and are considering observation should be counseled that there is a high probability (>75%-100%) of hearing preservation at 2 yr, moderately high probability (>50%-75%) of hearing preservation at 5 yr, and moderately low probability (>25%-50%) of hearing preservation at 10 yr.\n <\/jats:p>\n <\/jats:sec>\n \n Question 8<\/jats:title>\n Among patients with AAO-HNS class A or GR grade I hearing at baseline, what is the overall probability of maintaining serviceable hearing with conservative observation at 2 and 5 yr following diagnosis?<\/jats:p>\n <\/jats:sec>\n \n Recommendation<\/jats:title>\n \n Level 3:<\/jats:italic>\n Individuals who meet these criteria and are considering stereotactic radiosurgery should be counseled that there is a high probability (>75%-100%) of hearing preservation at 2 yr, and moderately high probability (>50%-75%) of hearing preservation at 5 yr. Insufficient data were available to determine the probability of hearing preservation at 10 yr for this population subset.\n <\/jats:p>\n <\/jats:sec>\n \n Question 9<\/jats:title>\n What patient and tumor-related factors influence progression to nonserviceable hearing during conservative observation?<\/jats:p>\n <\/jats:sec>\n \n Recommendation<\/jats:title>\n \n Level 3:<\/jats:italic>\n Individuals who meet these criteria and are considering observation should be counseled regarding probability of successful hearing preservation based on the following prognostic data: the most consistent prognostic features associated with maintenance of serviceable hearing are good preoperative word recognition and\/or pure tone thresholds with variable cut-points reported, as well as nongrowth of the tumor. Tumor size at the time of diagnosis, age, and sex do not predict future development of nonserviceable hearing during observation.\n <\/jats:p>\n \u2003The full guideline can be found at: https:\/\/www.cns.org\/guidelines\/guidelines-manage-ment-patients-vestibular-schwannoma\/chapter_3.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/neuros\/nyx511","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T15:11:30Z","timestamp":1509117090000},"page":"E35-E39","source":"Crossref","is-referenced-by-count":131,"title":["Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on Hearing Preservation Outcomes in Patients With Sporadic Vestibular Schwannomas"],"prefix":"10.1227","volume":"82","author":[{"given":"Matthew L","family":"Carlson","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Mayo Clinic, School of Medicine, Rochester, Minnesota"},{"name":"Department of Neurologic Surgery, Mayo Clinic, School of Medicine, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther X","family":"Vivas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D Jay","family":"McCracken","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex D","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A","family":"Neff","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Mayo Clinic, School of Medicine, Rochester, Minnesota"},{"name":"Department of Neurologic Surgery, Mayo Clinic, School of Medicine, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil T","family":"Shepard","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Mayo Clinic, School of Medicine, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J","family":"Olson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,2]]},"reference":[{"issue":"8","key":"bib1-20231011","first-page":"464P","article-title":"The bloody angle: 100 years of acoustic neuroma surgery","volume":"88","author":"Ramsden","year":"1995","journal-title":"J R Soc Med"},{"issue":"4","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"642","DOI":"10.3171\/2008.3.17473","article-title":"Evolution of techniques for the resection of vestibular schwannomas: from saving life to saving function","volume":"110","author":"Akard","year":"2009","journal-title":"J Neurosurg"},{"issue":"3","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.otc.2015.02.003","article-title":"Management of sporadic vestibular schwannoma","volume":"48","author":"Carlson","year":"2015","journal-title":"Otolaryngol Clin North Am"},{"issue":"8","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.jocn.2012.01.019","article-title":"The effect of the 2003 Consensus Reporting Standards on publications describing patients with vestibular schwannoma treated with stereotactic radiosurgery","volume":"19","author":"Han","year":"2012","journal-title":"J Clin Neurosci"},{"issue":"4","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1097\/MAO.0b013e31824f998b","article-title":"Reporting standard compliance in publications of vestibular schwannoma patients treated with microsurgery","volume":"33","author":"Han","year":"2012","journal-title":"Otol Neurotol"},{"issue":"4","key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/MAO.0b013e3181d8d3ad","article-title":"Radiation therapy for the treatment of vestibular schwannoma: a critical evaluation of the state of the literature","volume":"31","author":"Bassim","year":"2010","journal-title":"Otol Neurotol"},{"issue":"2","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1093\/jrr\/rrt121","article-title":"Linac-based stereotactic radiosurgery and fractionated stereotactic radiotherapy for vestibular schwannomas: comparative observations of 139 patients treated at a single institution","volume":"55","author":"Puataweepong","year":"2014","journal-title":"J Radiat Res"},{"issue":"9","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1007\/s00066-014-0630-4","article-title":"Hypofractionated stereotactic radiotherapy of acoustic neuroma","volume":"190","author":"Kranzinger","year":"2014","journal-title":"Strahlenther Onkol"},{"issue":"5","key":"bib9-20231011","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1227\/NEU.0000000000000299","article-title":"Significance of cochlear dose in the radiosurgical treatment of vestibular schwannoma","volume":"74","author":"Jacob","year":"2014","journal-title":"Neurosurgery"},{"issue":"1","key":"bib10-20231011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2013\/297093","article-title":"Clinical evaluation of CyberKnife in the treatment of vestibular schwannomas","volume":"2013","author":"Tsai","year":"2013","journal-title":"BioMed Res Int"},{"issue":"1","key":"bib11-20231011","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1097\/MAO.0b013e3182a435f5","article-title":"Treatment outcomes in patients treated with CyberKnife radiosurgery for vestibular schwannoma","volume":"35","author":"Vivas","year":"2014","journal-title":"Otol Neurotol"},{"issue":"Suppl","key":"bib12-20231011","first-page":"733","article-title":"Irradiation of cochlear structures during vestibular schwannoma radiosurgery and associated hearing outcome","volume":"119","author":"Massager","year":"2013","journal-title":"J Neurosurg"},{"issue":"Suppl","key":"bib13-20231011","first-page":"195","article-title":"Radiosurgery of vestibular schwannomas: summary of experience in 829 cases","volume":"119","author":"Lunsford","year":"2013","journal-title":"J Neurosurg"},{"issue":"2","key":"bib14-20231011","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.radonc.2012.10.013","article-title":"Fractionated stereotactic radiotherapy for acoustic neuromas: A prospective monocenter study of about 158 cases","volume":"106","author":"Litre","year":"2013","journal-title":"Radiother Oncol"},{"issue":"1","key":"bib15-20231011","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.ijrobp.2012.03.036","article-title":"Hearing outcomes after stereotactic radiosurgery for unilateral intracanalicular vestibular schwannomas: implication of transient volume expansion","volume":"85","author":"Kim","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3-4","key":"bib16-20231011","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.wneu.2012.04.001","article-title":"Cochlea radiation dose correlates with hearing loss after stereotactic radiosurgery of vestibular schwannoma","volume":"80","author":"Hayden Gephart","year":"2013","journal-title":"World Neurosurg"},{"issue":"2","key":"bib17-20231011","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.radonc.2012.12.004","article-title":"Hearing preservation after radiotherapy for vestibular schwannomas is comparable to hearing deterioration in healthy adults and is accompanied by local tumor control and a highly preserved quality of life (QOL) as patients\u2019 self-reported outcome","volume":"106","author":"Combs","year":"2013","journal-title":"Radiother Oncol"},{"issue":"3","key":"bib18-20231011","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1227\/NEU.0000000000000019","article-title":"Reduced-dose fractionated stereotactic radiotherapy for acoustic neuromas","volume":"73","author":"Champ","year":"2013","journal-title":"Neurosurgery"},{"key":"bib19-20231011","first-page":"A253","article-title":"Long-term hearing outcomes following stereotactic radiosurgery for vestibular schwannoma","volume":"73","author":"Carlson","year":"2012","journal-title":"J Neurol Surg, Part B: Skull Base"},{"issue":"3","key":"bib20-20231011","doi-asserted-by":"crossref","first-page":"571","DOI":"10.3171\/2012.10.JNS12880","article-title":"Hearing preservation in patients with vestibular schwannoma treated with Gamma Knife surgery","volume":"118","author":"Baschnagel","year":"2013","journal-title":"J Neurosurg."},{"issue":"5","key":"bib21-20231011","doi-asserted-by":"crossref","first-page":"877","DOI":"10.3171\/2012.7.JNS10672","article-title":"Longitudinal analysis of hearing before and after radiosurgery for vestibular schwannoma","volume":"117","author":"Yomo","year":"2012","journal-title":"J Neurosurg."},{"issue":"Suppl","key":"bib22-20231011","doi-asserted-by":"crossref","first-page":"57","DOI":"10.3171\/2012.7.GKS12783","article-title":"Long-term follow-up studies of Gamma Knife surgery with a low margin dose for vestibular schwannoma","volume":"117","author":"Sun","year":"2012","journal-title":"J Neurosurg"},{"issue":"5","key":"bib23-20231011","doi-asserted-by":"crossref","first-page":"e607","DOI":"10.1016\/j.ijrobp.2012.01.078","article-title":"Fractionated stereotactic radiotherapy of vestibular schwannomas accelerates hearing loss","volume":"83","author":"Rasmussen","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"21","key":"bib24-20231011","doi-asserted-by":"crossref","first-page":"5441","DOI":"10.1002\/cncr.27501","article-title":"Hearing preservation in patients with unilateral vestibular schwannoma who undergo stereotactic radiosurgery","volume":"118","author":"Han","year":"2012","journal-title":"Cancer"},{"issue":"5","key":"bib25-20231011","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/j.ijrobp.2010.04.057","article-title":"Stereotactic fractionated radiotherapy and LINAC radiosurgery in the treatment of vestibular schwannoma\u2014report about both stereotactic methods from a single institution","volume":"80","author":"Kopp","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"bib26-20231011","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1159\/000321913","article-title":"Efficacy of corticosteroids in hearing preservation after radiosurgery for vestibular schwannoma: A prospective study","volume":"89","author":"Kim","year":"2011","journal-title":"Stereotact Funct Neurosurg"},{"issue":"6","key":"bib27-20231011","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.3171\/2011.7.JNS11749","article-title":"Factors associated with hearing preservation after Gamma Knife surgery for vestibular schwannomas in patients who retain serviceable hearing","volume":"115","author":"Hasegawa","year":"2011","journal-title":"J Neurosurg"},{"issue":"6","key":"bib28-20231011","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1227\/NEU.0b013e318222e451","article-title":"Multisession stereotactic radiosurgery for vestibular schwannomas","volume":"69","author":"Hansasuta","year":"2011","journal-title":"Neurosurgery"},{"issue":"4","key":"bib29-20231011","doi-asserted-by":"crossref","first-page":"e503","DOI":"10.1016\/j.ijrobp.2011.04.066","article-title":"Single fraction versus fractionated Linac-based stereotactic radiotherapy for vestibular schwannoma: a single-institution experience","volume":"81","author":"Collen","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"Suppl","key":"bib30-20231011","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3171\/2010.8.GKS101058","article-title":"Wait-and-see strategy compared with proactive Gamma Knife surgery in patients with intracanalicular vestibular schwannomas","volume":"113","author":"Regis","year":"2010","journal-title":"J Neurosurg"},{"issue":"2","key":"bib31-20231011","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1227\/01.NEU.0000338256.87936.7C","article-title":"Hearing preservation after gamma knife radiosurgery for vestibular schwannomas presenting with high-level hearing","volume":"64","author":"Tamura","year":"2009","journal-title":"Neurosurgery"},{"issue":"4","key":"bib32-20231011","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1227\/01.NEU.0000340684.60443.55","article-title":"Vestibular schwannoma: surgery or gamma knife radiosurgery? A prospective, nonrandomized study","volume":"64","author":"Myrseth","year":"2009","journal-title":"Neurosurgery"},{"issue":"8","key":"bib33-20231011","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1097\/MAO.0b013e31818b6639","article-title":"Gamma knife radiosurgery for vestibular schwannoma","volume":"29","author":"Lasak","year":"2008","journal-title":"Otol Neurotol"},{"issue":"5","key":"bib34-20231011","doi-asserted-by":"crossref","first-page":"917","DOI":"10.3171\/JNS-07\/11\/0917","article-title":"Hearing preservation following fractionated stereotactic radiotherapy for vestibular schwannomas: prognostic implications of cochlear dose","volume":"107","author":"Thomas","year":"2007","journal-title":"J Neurosurg"},{"issue":"3","key":"bib35-20231011","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.ijrobp.2007.01.001","article-title":"Long-term follow-up of acoustic schwannoma radiosurgery with marginal tumor doses of 12 to 13 Gy","volume":"68","author":"Chopra","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"bib36-20231011","first-page":"77","article-title":"Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery","volume":"59","author":"Pollock","year":"2006","journal-title":"Neurosurgery"},{"issue":"5","key":"bib37-20231011","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/j.ijrobp.2005.10.030","article-title":"Role of intracanalicular volumetric and dosimetric parameters on hearing preservation after vestibular schwannoma radiosurgery","volume":"64","author":"Massager","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"bib38-20231011","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1002\/cncr.21190","article-title":"Hearing preservation after gamma knife stereotactic radiosurgery of vestibular schwannoma","volume":"104","author":"Paek","year":"2005","journal-title":"Cancer"},{"issue":"2","key":"bib39-20231011","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1227\/01.NEU.0000166542.00512.84","article-title":"Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years","volume":"57","author":"Hasegawa","year":"2005","journal-title":"Neurosurgery"},{"issue":"5","key":"bib40-20231011","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/j.ijrobp.2005.10.024","article-title":"Long-term outcome of stereotactic radiosurgery (SRS) in patients with acoustic neuromas","volume":"64","author":"Combs","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"bib41-20231011","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ijrobp.2005.01.055","article-title":"Management of acoustic neuromas with fractionated stereotactic radiotherapy (FSRT): Long-term results in 106 patients treated in a single institution","volume":"63","author":"Combs","year":"2005","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"bib42-20231011","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.ijrobp.2004.02.019","article-title":"Acoustic neuroma radiosurgery with marginal tumor doses of 12 to 13 Gy","volume":"60","author":"Flickinger","year":"2004","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"bib43-20231011","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/j.ijrobp.2003.12.032","article-title":"Audiologic and treatment outcomes after linear accelerator\u2013based stereotactic irradiation for acoustic neuroma","volume":"59","author":"Chung","year":"2004","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"bib44-20231011","doi-asserted-by":"crossref","first-page":"685","DOI":"10.3171\/jns.2003.99.4.0685","article-title":"Management of vestibular schwannoma by fractionated stereotactic radiotherapy and associated cerebrospinal fluid malabsorption","volume":"99","author":"Sawamura","year":"2003","journal-title":"J Neurosurg"},{"issue":"5","key":"bib45-20231011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/foc.2003.14.5.4","article-title":"Preservation of functional hearing after gamma knife surgery for vestibular schwannoma","volume":"14","author":"Litvack","year":"2003","journal-title":"Neurosurg Focus"},{"issue":"2","key":"bib46-20231011","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1227\/01.NEU.0000073416.22608.B3","article-title":"Radiosurgery for acoustic neuromas: results of low-dose treatment","volume":"53","author":"Iwai","year":"2003","journal-title":"Neurosurgery"},{"issue":"5","key":"bib47-20231011","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.3171\/jns.2002.97.5.1091","article-title":"Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas","volume":"97","author":"Regis","year":"2002","journal-title":"J Neurosurg"},{"issue":"6","key":"bib48-20231011","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1097\/00006123-200112000-00003","article-title":"Reduced-dose radiosurgery for vestibular schwannomas","volume":"49","author":"Petit","year":"2001","journal-title":"Neurosurgery"},{"issue":"1","key":"bib49-20231011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/jns.2001.94.1.0001","article-title":"Results of acoustic neuroma radiosurgery: an analysis of 5 years' experience using current methods","volume":"94","author":"Flickinger","year":"2001","journal-title":"J Neurosurg"},{"issue":"5","key":"bib50-20231011","doi-asserted-by":"crossref","first-page":"745","DOI":"10.3171\/jns.2000.92.5.0745","article-title":"Gamma surgery for vestibular schwannoma","volume":"92","author":"Prasad","year":"2000","journal-title":"J Neurosurg"},{"issue":"12","key":"bib51-20231011","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1007\/s007010050431","article-title":"Radiosurgery of vestibular schwannomas: A minimally invasive alternative to microsurgery","volume":"141","author":"Unger","year":"1999","journal-title":"Acta Neurochir"},{"issue":"3","key":"bib52-20231011","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S0167-8140(99)00031-6","article-title":"Small-field fractionated radiotherapy with or without stereotactic boost for vestibular schwannoma","volume":"50","author":"Kagei","year":"1999","journal-title":"Radiother Oncol"},{"issue":"1","key":"bib53-20231011","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1227\/01.neu.0000429862.50018.b9","article-title":"Conservative management or Gamma knife radiosurgery for vestibular schwannoma","volume":"73","author":"Breivik","year":"2013","journal-title":"Neurosurgery"},{"issue":"3","key":"bib54-20231011","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":"Yamakami","year":"2014","journal-title":"J Neurosurg"},{"issue":"4","key":"bib55-20231011","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1177\/0194599814567874","article-title":"Hearing preservation after middle fossa vestibular schwannoma removal","volume":"152","author":"Quist","year":"2015","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"1","key":"bib56-20231011","doi-asserted-by":"crossref","first-page":"131","DOI":"10.3171\/2013.1.JNS1297","article-title":"Durability of hearing preservation after microsurgical treatment of vestibular schwannoma using the middle cranial fossa approach","volume":"119","author":"Wang","year":"2013","journal-title":"J Neurosurg."},{"issue":"5","key":"bib57-20231011","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1097\/MAO.0b013e318254ede3","article-title":"Middle fossa approach for resection of vestibular schwannoma","volume":"33","author":"Vincent","year":"2012","journal-title":"Otol Neurotol"},{"issue":"2","key":"bib58-20231011","first-page":"98","article-title":"Hearing preservation surgery in acoustic neuroma: long-term results","volume":"32","author":"Mazzoni","year":"2012","journal-title":"Acta Otorhinolaryngol Ital"},{"issue":"1","key":"bib59-20231011","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/MAO.0b013e3182001c7d","article-title":"Late failure rate of hearing preservation after middle fossa approach for resection of vestibular schwannoma","volume":"32","author":"Hilton","year":"2011","journal-title":"Otol Neurotol"},{"issue":"3","key":"bib60-20231011","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":"Di Maio","year":"2011","journal-title":"Neurosurgery"},{"issue":"7","key":"bib61-20231011","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1097\/MAO.0b013e3181edb8b2","article-title":"Long-term hearing preservation after microsurgical excision of vestibular schwannoma","volume":"31","author":"Woodson","year":"2010","journal-title":"Otol Neurotol"},{"issue":"6","key":"bib62-20231011","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1227\/NEU.0b013e3181f8d3d3","article-title":"A critical evaluation of vestibular schwannoma surgery for patients younger than 40 years of age","volume":"67","author":"Sughrue","year":"2010","journal-title":"Neurosurgery"},{"issue":"5","key":"bib63-20231011","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1055\/s-0028-1086056","article-title":"What is the best tumor size to achieve optimal functional results in vestibular schwannoma surgery?","volume":"18","author":"Gjuric","year":"2008","journal-title":"Skull Base"},{"issue":"1","key":"bib64-20231011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/jns.2005.102.1.0001","article-title":"Preservation of hearing in patients undergoing microsurgery for vestibular schwannoma: degree of meatal filling","volume":"102","author":"Mohr","year":"2005","journal-title":"J Neurosurg"},{"issue":"2","key":"bib65-20231011","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1097\/01.mlg.0000154736.38904.c3","article-title":"Unilateral acoustic neuromas: long-term hearing results in patients managed with fractionated stereotactic radiotherapy, hearing preservation surgery, and expectantly","volume":"115","author":"Lin","year":"2005","journal-title":"Laryngoscope"},{"issue":"10","key":"bib66-20231011","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1080\/00016480510038013","article-title":"Conservative management versus surgery for small vestibular schwannomas","volume":"125","author":"Bozorg Grayeli","year":"2005","journal-title":"Acta Oto-Laryngol"},{"issue":"1","key":"bib67-20231011","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3171\/jns.2005.102.1.0006","article-title":"Long-term hearing preservation after surgery for vestibular schwannoma","volume":"102","author":"Betchen","year":"2005","journal-title":"J Neurosurg"},{"issue":"3","key":"bib68-20231011","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1046\/j.1365-2273.2003.00702.x","article-title":"Hearing preservation and facial nerve function in vestibular schwannoma surgery","volume":"28","author":"Maw","year":"2003","journal-title":"Clin Otolaryngol"},{"issue":"6","key":"bib69-20231011","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/j.otohns.2003.08.002","article-title":"Long-term hearing preservation after middle fossa removal of vestibular schwannoma","volume":"129","author":"Friedman","year":"2003","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"4","key":"bib70-20231011","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1097\/00129492-200307000-00023","article-title":"Acoustic neuroma surgery: the results of long-term hearing preservation","volume":"24","author":"Chee","year":"2003","journal-title":"Otol Neurotol"},{"key":"bib71-20231011","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1080\/000164800453865","article-title":"Is hearing preservation worthwhile in vestibular schwannoma surgery?","volume":"543","author":"Levo","year":"2000","journal-title":"Acta Otolaryngol Suppl"},{"issue":"4","key":"bib72-20231011","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1055\/s-2002-35750-1","article-title":"Current results of the surgical management of acoustic neuroma","volume":"12","author":"Lee","year":"2002","journal-title":"Skull Base"},{"issue":"5","key":"bib73-20231011","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1097\/00129492-200109000-00022","article-title":"Acoustic neuroma surgery outcomes","volume":"22","author":"Kaylie","year":"2001","journal-title":"Otol Neurotol."},{"issue":"2","key":"bib74-20231011","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/00129492-200103000-00019","article-title":"Enlarged middle fossa vestibular schwannoma surgery: experience with 735 cases","volume":"22","author":"Gjuri\u0107","year":"2001","journal-title":"Otol Neurotol"},{"issue":"1","key":"bib75-20231011","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/S0090-3019(99)00199-8","article-title":"Selection of surgical approaches for small acoustic neurinomas","volume":"53","author":"Kumon","year":"2000","journal-title":"Surg Neurol"},{"issue":"2","key":"bib76-20231011","first-page":"212","article-title":"Acoustic neuromas presenting with normal or symmetrical hearing: factors associated with diagnosis and outcome","volume":"19","author":"Lustig","year":"1998","journal-title":"Am J Otol"},{"issue":"3","key":"bib77-20231011","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1055\/s-2008-1058601","article-title":"Hearing preservation surgery in acoustic neuroma patients with normal hearing","volume":"7","author":"Kanzaki","year":"1997","journal-title":"Skull Base"},{"issue":"1","key":"bib78-20231011","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/00006123-199707000-00012","article-title":"Acoustic neuromas: results of current surgical management","volume":"41","author":"Gormley","year":"1997","journal-title":"Neurosurgery"},{"issue":"4","key":"bib79-20231011","first-page":"669","article-title":"Results and complications from acoustic neuroma excision via middle cranial fossa approach","volume":"17","author":"Weber","year":"1996","journal-title":"Am J Otol"},{"issue":"2","key":"bib80-20231011","doi-asserted-by":"crossref","first-page":"191","DOI":"10.3171\/jns.1995.83.2.0191","article-title":"Hearing preservation in vestibular schwannoma surgery: what factors influence outcome?","volume":"83","author":"Post","year":"1995","journal-title":"J Neurosurg"},{"issue":"1","key":"bib81-20231011","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1227\/00006123-199501000-00036","article-title":"Outcome analysis of acoustic neuroma management: a comparison of microsurgery and stereotactic radiosurgery","volume":"36","author":"Pollock","year":"1995","journal-title":"Neurosurgery"},{"issue":"2","key":"bib82-20231011","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1288\/00005537-199502000-00014","article-title":"Hearing preservation in acoustic tumor surgery: results and prognostic factors","volume":"105","author":"Dornhoffer","year":"1995","journal-title":"Laryngoscope"},{"issue":"2","key":"bib83-20231011","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1055\/s-2008-1058974","article-title":"Hearing preservation by the extended and nonextended middle cranial fossa approach for acoustic neuroma","volume":"4","author":"Kanzaki","year":"1994","journal-title":"Skull Base"},{"issue":"3","key":"bib84-20231011","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/j.1365-2273.1994.tb01216.x","article-title":"Hearing preservation in acoustic neuroma surgery","volume":"19","author":"Brookes","year":"1994","journal-title":"Clin Otolaryngol"},{"issue":"6","key":"bib85-20231011","doi-asserted-by":"crossref","first-page":"864","DOI":"10.3171\/jns.1993.78.6.0864","article-title":"Preservation of hearing in surgery for acoustic neuromas","volume":"78","author":"Glasscock","year":"1993","journal-title":"J Neurosurg"},{"issue":"5","key":"bib86-20231011","doi-asserted-by":"crossref","first-page":"685","DOI":"10.3171\/jns.1992.77.5.0685","article-title":"Late course of preserved hearing and tinnitus after acoustic neurilemoma surgery","volume":"77","author":"Goel","year":"1992","journal-title":"J Neurosurg"},{"issue":"6","key":"bib87-20231011","doi-asserted-by":"crossref","first-page":"910","DOI":"10.3171\/jns.1992.76.6.0910","article-title":"Hearing preservation in acoustic neurinoma surgery","volume":"76","author":"Fischer","year":"1992","journal-title":"J Neurosurg"},{"issue":"1","key":"bib88-20231011","first-page":"5","article-title":"Acoustic neuroma (vestibular schwannoma): growth and surgical and nonsurgical consequences of the wait-and-see policy","volume":"113","author":"Charabi","year":"1995","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"11","key":"bib89-20231011","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1097\/00005537-200011000-00015","article-title":"Tumor growth and audiometric change in vestibular schwannomas managed conservatively","volume":"110","author":"Massick","year":"2000","journal-title":"Laryngoscope"},{"issue":"2","key":"bib90-20231011","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/00005537-200002010-00012","article-title":"Consequences to hearing during the conservative management of vestibular schwannomas","volume":"110","author":"Walsh","year":"2000","journal-title":"Laryngoscope"},{"issue":"10","key":"bib91-20231011","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1080\/00016480510038013","article-title":"Conservative management versus surgery for small vestibular schwannomas","volume":"125","author":"Bozorg Grayeli","year":"2005","journal-title":"Acta Otolaryngol"},{"issue":"1","key":"bib92-20231011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000096152","article-title":"Hearing in patients with intracanalicular vestibular schwannomas","volume":"12","author":"Caye-Thomasen","year":"2007","journal-title":"Audiol Neurotol"},{"issue":"4","key":"bib93-20231011","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1055\/s-2007-984491","article-title":"Change in hearing and tinnitus in conservatively managed vestibular schwannomas","volume":"17","author":"Quaranta","year":"2007","journal-title":"Skull Base"},{"issue":"6","key":"bib94-20231011","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1097\/MLG.0b013e31816a8955","article-title":"Conservative management of vestibular schwannomas: an effective strategy","volume":"118","author":"Ferri","year":"2008","journal-title":"Laryngoscope"},{"issue":"7","key":"bib95-20231011","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1017\/S0022215107001077","article-title":"Change in hearing during 'wait and scan' management of patients with vestibular schwannoma","volume":"122","author":"Stangerup","year":"2008","journal-title":"J Laryngol Otol"},{"issue":"2","key":"bib96-20231011","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/MAO.0b013e3181c34bda","article-title":"Long-term hearing preservation in vestibular schwannoma","volume":"31","author":"Stangerup","year":"2010","journal-title":"Otol Neurotol"},{"issue":"1","key":"bib97-20231011","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1227\/NEU.0b013e3181fc60cb","article-title":"Natural history of hearing deterioration in intracanalicular vestibular schwannoma","volume":"68","author":"Pennings","year":"2011","journal-title":"Neurosurgery"},{"issue":"7","key":"bib98-20231011","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1097\/MAO.0000000000000285","article-title":"Conservative management of vestibular schwannoma: expectations based on the length of the observation period","volume":"35","author":"Fayad","year":"2014","journal-title":"Otol Neurotol"},{"issue":"2","key":"bib99-20231011","doi-asserted-by":"crossref","first-page":"381","DOI":"10.3171\/2010.4.JNS091962","article-title":"A prospective study of hearing preservation in untreated vestibular schwannomas","volume":"114","author":"Sughrue","year":"2011","journal-title":"J Neurosurg"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00006123-201802000-00024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:49:46Z","timestamp":1786121386000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006123-201802000-00024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,20]]},"references-count":99,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyx511","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,20]]}}}