{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:42:38Z","timestamp":1789785758300,"version":"4.0.1"},"reference-count":174,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2009,12]]},"abstract":"\n Object<\/jats:title>\n While many studies have been published outlining morbidity following radiosurgical treatment of vestibular schwannomas, significant interpractitioner and institutional variability still exists. For this reason, the authors conducted a systematic review of the literature for non-audiofacial-related morbidity after the treatment of vestibular schwannoma with radiosurgery.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The authors performed a comprehensive search of the English-language literature to identify studies that published outcome data of patients undergoing radiosurgery treatment for vestibular schwannomas. In total, 254 articles were found that described more than 50,000 patients and were analyzed for satisfying the authors' inclusion criteria. Patients from these studies were then separated into 2 cohorts based on the marginal dose of radiation: \u2264 13 Gy and > 13 Gy. All tumors included in this study were < 25 mm in their largest diameter.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 63 articles met the criteria of the established search protocol, which combined for a total of 5631 patients. Patients receiving > 13 Gy were significantly more likely to develop trigeminal nerve neuropathy than those receiving < 13 Gy (p < 0.001). While we found no relationship between radiation dose and the rate of developing hydrocephalus (0.6% for both cohorts), patients with hydrocephalus who received doses > 13 Gy appeared to have a higher rate of symptomatic hydrocephalus requiring shunt treatment (96% [> 13 Gy] vs 56% [\u2264 13 Gy], p < 0.001). The rates of vertigo or balance disturbance (1.1% [> 13 Gy] vs 1.8% [\u2264 13 Gy], p = 0.001) and tinnitus (0.1% [> 13 Gy] vs 0.7% [\u2264 13 Gy], p = 0.001) were significantly higher in the lower dose cohort than those in the higher dose cohort.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The results of our review of the literature provide a systematic summary of the published rates of nonaudiofacial morbidity following radiosurgery for vestibular schwannoma.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2009.9.focus09198","type":"journal-article","created":{"date-parts":[[2009,12,1]],"date-time":"2009-12-01T10:04:21Z","timestamp":1259661861000},"page":"E4","source":"Crossref","is-referenced-by-count":52,"title":["Non-audiofacial morbidity after Gamma Knife surgery for vestibular schwannoma"],"prefix":"10.3171","volume":"27","author":[{"given":"Michael E.","family":"Sughrue","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seunggu J.","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derick","family":"Aranda","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari J.","family":"Kane","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misha","family":"Amoils","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Parsa","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0270004","series-title":"Stereotact Funct Neurosurg","first-page":"165","article-title":"Preservation of cranial nerve function after treatment of acoustic neurinomas with fractionated stereotactic radiotherapy. Preliminary observations in 26 patients","volume":"64","author":"Andrews","year":"1995"},{"key":"b2-0270004","series-title":"Acta Neurochir (Wien)","first-page":"689","article-title":"Gamma knife radiosurgery of acoustic neurinomas","volume":"143","author":"Bertalanffy","year":"2001"},{"key":"b3-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1116","article-title":"Audiologic and treatment outcomes after linear acceleratorbased stereotactic irradiation for acoustic neuroma","volume":"59","author":"Chung","year":"2004"},{"issue":"Suppl","key":"b4-0270004","series-title":"J Neurosurg","first-page":"87","article-title":"Gamma knife surgery for vestibular schwannoma: 10-year experience of 195 cases","volume":"102","author":"Chung","year":"2005"},{"key":"b5-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1341","article-title":"Long-term outcome of stereotactic radiosurgery (SRS) in patients with acoustic neuromas","volume":"64","author":"Combs","year":"2006"},{"key":"b6-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"75","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"},{"key":"b7-0270004","series-title":"Acta Otorhinolaryngol Belg","first-page":"197","article-title":"Preservation of hearing in vestibular schwannomas treated by radiosurgery using Leksell Gamma Knife: preliminary report of a prospective Belgian clinical study","volume":"57","author":"Delbrouck","year":"2003"},{"key":"b8-0270004","series-title":"J Neurosurg","first-page":"1","article-title":"Results of acoustic neuroma radiosurgery: an analysis of 5 years' experience using current methods","volume":"94","author":"Flickinger","year":"2001"},{"key":"b9-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"225","article-title":"Acoustic neuroma radiosurgery with marginal tumor doses of 12 to 13 Gy","volume":"60","author":"Flickinger","year":"2004"},{"key":"b10-0270004","series-title":"J Neurosurg","first-page":"440","article-title":"Analysis of risk factors associated with radiosurgery for vestibular schwannoma","volume":"95","author":"Foote","year":"2001"},{"key":"b11-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1153","article-title":"Stereotactic radiosurgery using the gamma knife for acoustic neuromas","volume":"32","author":"Foote","year":"1995"},{"key":"b12-0270004","series-title":"Otol Neurotol","first-page":"240","article-title":"Intracochlear hemorrhage after gamma knife radiosurgery","volume":"28","author":"Franco-Vidal","year":"2007"},{"key":"b13-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1381","article-title":"Conventionally fractionated stereotactic radiotherapy (FSRT) for acoustic neuromas","volume":"48","author":"Fuss","year":"2000"},{"key":"b14-0270004","series-title":"Med Dosim","first-page":"147","article-title":"Fractionated stereotactic intensity-modulated radiotherapy (FS-IMRT) for small acoustic neuromas","volume":"27","author":"Fuss","year":"2002"},{"key":"b15-0270004","series-title":"Neurosurgery","first-page":"257","article-title":"Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years","volume":"57","author":"Hasegawa","year":"2005"},{"key":"b16-0270004","series-title":"J Neurosurg","first-page":"10","article-title":"Long-term outcomes in patients with vestibular schwannomas treated using gamma knife surgery: 10-year follow up","volume":"102","author":"Hasegawa","year":"2005"},{"key":"b17-0270004","series-title":"Br J Neurosurg","first-page":"178","article-title":"Stereotactic radiosurgery and vestibular schwannoma: hydrocephalus associated with the development of a secondary arachnoid cyst: a report of two cases and review of the literature","volume":"19","author":"Hayhurst","year":"2005"},{"key":"b18-0270004","series-title":"Eur Arch Otorhinolaryngol","first-page":"714","article-title":"Functional outcome after gamma knife treatment in vestibular schwannoma","volume":"263","author":"Hempel","year":"2006"},{"key":"b19-0270004","series-title":"Neurol Med Chir (Tokyo)","first-page":"737","article-title":"Gamma knife radiosurgery for acoustic schwannoma: early effects and preservation of hearing","volume":"35","author":"Hirato","year":"1995"},{"key":"b20-0270004","series-title":"Acta Otolaryngol","first-page":"244","article-title":"Audiological findings after stereotactic radiosurgery in acoustic neurinomas","volume":"106","author":"Hirsch","year":"1988"},{"key":"b21-0270004","series-title":"Acta Otolaryngol","first-page":"155","article-title":"Audiologic findings after stereotactic radiosurgery in nine cases of acoustic neurinomas","volume":"88","author":"Hirsch","year":"1979"},{"key":"b22-0270004","series-title":"J Chin Med Assoc","first-page":"315","article-title":"Radiosurgery for vestibular schwannomas","volume":"68","author":"Huang","year":"2005"},{"issue":"Suppl","key":"b23-0270004","series-title":"J Neurosurg","first-page":"111","article-title":"Low-dose radiosurgery for large vestibular schwannomas: long-term results of functional preservation","volume":"102","author":"Inoue","year":"2005"},{"key":"b24-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"75","article-title":"Risk factors for neurological complications after acoustic neurinoma radiosurgery: refinement from further experiences","volume":"48","author":"Ito","year":"2000"},{"key":"b25-0270004","series-title":"Neurosurgery","first-page":"282","article-title":"Radiosurgery for acoustic neuromas: results of low-dose treatment","volume":"53","author":"Iwai","year":"2003"},{"key":"b26-0270004","series-title":"Br J Radiol","first-page":"1202","article-title":"Improved trigeminal and facial nerve tolerance following fractionated stereotactic radiotherapy for large acoustic neuromas","volume":"72","author":"Kalapurakal","year":"1999"},{"key":"b27-0270004","series-title":"Ann Otol Rhinol Laryngol","first-page":"631","article-title":"Gamma knife: an alternative treatment for acoustic neurinomas","volume":"97","author":"Kamerer","year":"1988"},{"key":"b28-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1410","article-title":"Treatment of acoustic neuroma: stereotactic radiosurgery vs. microsurgery","volume":"54","author":"Karpinos","year":"2002"},{"key":"b29-0270004","series-title":"Arch Otolaryngol Head Neck Surg","first-page":"903","article-title":"Microsurgery vs gamma knife radiosurgery for the treatment of vestibular schwannomas","volume":"129","author":"Kaylie","year":"2003"},{"key":"b30-0270004","series-title":"Surg Neurol","first-page":"383","article-title":"Radiosurgery for bilateral neurinomas associated with neurofibromatosis type 2","volume":"53","author":"Kida","year":"2000"},{"key":"b31-0270004","series-title":"Cancer","first-page":"1203","article-title":"Fractionated stereotactic radiotherapy for acoustic neuroma: single-institution experience at The Princess Margaret Hospital","volume":"109","author":"Koh","year":"2007"},{"key":"b32-0270004","series-title":"N Engl J Med","first-page":"1426","article-title":"Long-term outcomes after radiosurgery for acoustic neuromas","volume":"339","author":"Kondziolka","year":"1998"},{"issue":"3","key":"b33-0270004","series-title":"Neurosurg Focus","first-page":"e2","article-title":"Outcomes after gamma knife radiosurgery in solitary acoustic tumors and neurofibromatosis Type 2","volume":"5","author":"Kondziolka","year":"1998"},{"key":"b34-0270004","series-title":"Acta Chir Scand","first-page":"763","article-title":"A note on the treatment of acoustic tumours","volume":"137","author":"Leksell","year":"1971"},{"key":"b35-0270004","series-title":"J Neurosurg","first-page":"800","article-title":"Radiation exposure of normal temporal bone structures during stereotactically guided gamma knife surgery for vestibular schwannomas","volume":"98","author":"Linskey","year":"2003"},{"key":"b36-0270004","series-title":"Neurosurgery","first-page":"736","article-title":"Radiosurgery for acoustic neurinomas: early experience","volume":"26","author":"Linskey","year":"1990"},{"key":"b37-0270004","series-title":"Neurosurgery","first-page":"829","article-title":"Tumor control after stereotactic radiosurgery in neurofibromatosis patients with bilateral acoustic tumors","volume":"31","author":"Linskey","year":"1992"},{"issue":"Suppl","key":"b38-0270004","series-title":"J Neurosurg","first-page":"195","article-title":"Radiosurgery of vestibular schwannomas: summary of experience in 829 cases","volume":"102","author":"Lunsford","year":"2005"},{"key":"b39-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1331","article-title":"Role of intracanalicular volumetric and dosimetric parameters on hearing preservation after vestibular schwannoma radiosurgery","volume":"64","author":"Massager","year":"2006"},{"key":"b40-0270004","series-title":"Neurosurgery","first-page":"460","article-title":"Stereotactic radiosurgery for vestibular schwannomas in patients with neurofibromatosis type 2: an analysis of tumor control, complications, and hearing preservation rates","volume":"60","author":"Mathieu","year":"2007"},{"key":"b41-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"45","article-title":"Fractionated stereotactic radiation therapy and single high-dose radiosurgery for acoustic neuroma: early results of a prospective clinical study","volume":"46","author":"Meijer","year":"2000"},{"key":"b42-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"305","article-title":"Decrease in cranial nerve complications after radiosurgery for acoustic neuromas: a prospective study of dose and volume","volume":"43","author":"Miller","year":"1999"},{"key":"b43-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1400","article-title":"Patterns of patient movement during frameless image-guided radiosurgery","volume":"55","author":"Murphy","year":"2003"},{"key":"b44-0270004","series-title":"Neurosurgery","first-page":"927","article-title":"Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery","volume":"56","author":"Myrseth","year":"2005"},{"key":"b45-0270004","series-title":"Neurology","first-page":"590","article-title":"Cerebellar infarction after gamma knife radiosurgery of a vestibular schwannoma","volume":"68","author":"Neuhaus","year":"2007"},{"key":"b46-0270004","series-title":"Neurosurgery","first-page":"753","article-title":"Dose reduction improves hearing preservation rates after intracanalicular acoustic tumor radiosurgery","volume":"45","author":"Niranjan","year":"1999"},{"issue":"1 Suppl","key":"b47-0270004","series-title":"Stereotact Funct Neurosurg","first-page":"65","article-title":"Long-term complications following gamma knife radiosurgery of vestibular schwannomas","volume":"70","author":"Nor\u00e9n","year":"1998"},{"key":"b48-0270004","series-title":"Arch Neurol","first-page":"73","article-title":"Cranial nerve preservation after stereotactic radiosurgery for small acoustic tumors","volume":"52","author":"Ogunrinde","year":"1995"},{"key":"b49-0270004","series-title":"J Neurosurg","first-page":"53","article-title":"Linear accelerator radiosurgery for vestibular schwannoma: measuring tumor volume changes on serial three-dimensional spoiled gradient-echo magnetic resonance images","volume":"103","author":"Okunaga","year":"2005"},{"key":"b50-0270004","series-title":"Neurol Med Chir (Tokyo)","first-page":"607","article-title":"Early changes in volume and non-enhanced volume of acoustic neurinoma after stereotactic gamma-radiosurgery","volume":"34","author":"Oyama","year":"1994"},{"key":"b51-0270004","series-title":"Cancer","first-page":"580","article-title":"Hearing preservation after gamma knife stereotactic radiosurgery of vestibular schwannoma","volume":"104","author":"Paek","year":"2005"},{"key":"b52-0270004","series-title":"J Neurooncol","first-page":"167","article-title":"Therapeutic strategy for large vestibular schwannomas","volume":"77","author":"Park","year":"2006"},{"key":"b53-0270004","series-title":"Adv Tech Stand Neurosurg","first-page":"227","article-title":"Relative indications for radiosurgery and microsurgery for acoustic schwannoma","volume":"28","author":"Pellet","year":"2003"},{"key":"b54-0270004","series-title":"Neurosurgery","first-page":"1299","article-title":"Reduced-dose radiosurgery for vestibular schwannomas","volume":"49","author":"Petit","year":"2001"},{"key":"b55-0270004","series-title":"Neurosurgery","first-page":"1299","article-title":"Fractionated stereotactic radiosurgery and preservation of hearing in patients with vestibular schwannoma: a preliminary report","volume":"45","author":"Poen","year":"1999"},{"key":"b56-0270004","series-title":"Otol Neurotol","first-page":"1220","article-title":"Distortion of magnetic resonance images used in gamma knife radiosurgery treatment planning: implications for acoustic neuroma outcomes","volume":"26","author":"Poetker","year":"2005"},{"key":"b57-0270004","series-title":"Otolaryngol Head Neck Surg","first-page":"611","article-title":"Patient choice in treatment of vestibular schwannoma","volume":"130","author":"Pogodzinski","year":"2004"},{"key":"b58-0270004","series-title":"Neurosurgery","first-page":"241","article-title":"Management of vestibular schwannomas that enlarge after stereotactic radiosurgery: treatment recommendations based on a 15 year experience","volume":"58","author":"Pollock","year":"2006"},{"key":"b59-0270004","series-title":"Neurosurgery","first-page":"215","article-title":"Outcome analysis of acoustic neuroma management: a comparison of microsurgery and stereotactic radiosurgery","volume":"36","author":"Pollock","year":"1995"},{"key":"b60-0270004","series-title":"J Neurosurg","first-page":"745","article-title":"Gamma surgery for vestibular schwannoma","volume":"92","author":"Prasad","year":"2000"},{"key":"b61-0270004","series-title":"J Neurosurg","first-page":"1091","article-title":"Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas","volume":"97","author":"R\u00e9gis","year":"2002"},{"key":"b62-0270004","series-title":"Australas Radiol","first-page":"185","article-title":"Radiosurgery at the Royal Adelaide Hospital: the first 4 1\/2 years' clinical experience","volume":"44","author":"Roos","year":"2000"},{"key":"b63-0270004","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1536","article-title":"Gamma knife stereotactic radiosurgery for unilateral acoustic neuromas","volume":"74","author":"Rowe","year":"2003"},{"key":"b64-0270004","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1288","article-title":"Clinical experience with gamma knife stereotactic radiosurgery in the management of vestibular schwannomas secondary to type 2 neurofibromatosis","volume":"74","author":"Rowe","year":"2003"},{"key":"b65-0270004","series-title":"Radiother Oncol","first-page":"83","article-title":"Long-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma","volume":"82","author":"Rutten","year":"2007"},{"key":"b66-0270004","series-title":"Am J Otol","first-page":"364","article-title":"Microsurgical removal of a vestibular schwannoma after stereotactic radiosurgery: surgical and pathologic findings","volume":"20","author":"Schulder","year":"1999"},{"key":"b67-0270004","series-title":"J Neurosurg","first-page":"816","article-title":"Glioblastoma multiforme occurring in a patient treated with gamma knife surgery. Case report and review of the literature","volume":"94","author":"Shamisa","year":"2001"},{"key":"b68-0270004","series-title":"Rev Endocr Metab Disord","first-page":"59","article-title":"Radiation therapy in acromegaly","volume":"9","author":"Shih","year":"2008"},{"key":"b69-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1395","article-title":"Fractionated stereotactic radiotherapy for vestibular schwannoma (VS): comparison between cystic-type and solid-type VS","volume":"48","author":"Shirato","year":"2000"},{"issue":"1 Suppl","key":"b70-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"S131","article-title":"Quality assurance of immobilization and target localization systems for frameless stereotactic cranial and extracranial hypofractionated radiotherapy","volume":"71","author":"Solberg","year":"2008"},{"key":"b71-0270004","series-title":"Stereotact Funct Neurosurg","first-page":"45","article-title":"Fractionated stereotactic radiosurgery for treatment of acoustic neuromas","volume":"73","author":"Song","year":"1999"},{"key":"b72-0270004","series-title":"Isr Med Assoc J","first-page":"8","article-title":"Radiosurgery for acoustic neurinomas (vestibular schwannomas)","volume":"1","author":"Spiegelmann","year":"1999"},{"key":"b73-0270004","series-title":"J Neurosurg","first-page":"815","article-title":"Stereotactic radiosurgery in the management of acoustic neuromas associated with neurofibromatosis Type 2","volume":"90","author":"Subach","year":"1999"},{"issue":"3 Suppl","key":"b74-0270004","series-title":"J Neurosurg","first-page":"78","article-title":"Immediate neurological deterioration after gamma knife radiosurgery for acoustic neuroma. Case report","volume":"93","author":"Tago","year":"2000"},{"key":"b75-0270004","series-title":"Am J Otol","first-page":"330","article-title":"Gamma knife: hydrocephalus as a complication of stereotactic radiosurgical treatment of an acoustic neuroma","volume":"11","author":"Thomsen","year":"1990"},{"key":"b76-0270004","series-title":"Acta Neurochir (Wien)","first-page":"1281","article-title":"Radiosurgery of vestibular schwannomas: a minimally invasive alternative to microsurgery","volume":"141","author":"Unger","year":"1999"},{"key":"b77-0270004","series-title":"Acta Neurochir Suppl","first-page":"77","article-title":"Cranial nerve preservation after radiosurgery of vestibular schwannomas","volume":"84","author":"Unger","year":"2002"},{"issue":"Suppl","key":"b78-0270004","series-title":"J Neurosurg","first-page":"204","article-title":"Increased preservation of functional hearing after gamma knife surgery for vestibular schwannoma","volume":"102","author":"van Eck","year":"2005"},{"key":"b79-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"141","article-title":"Fractionated stereotactic radiotherapy for the treatment of acoustic neuromas: preliminary results","volume":"36","author":"Varlotto","year":"1996"},{"key":"b80-0270004","series-title":"Otol Neurotol","first-page":"752","article-title":"Gamma knife radiosurgery for acoustic neuromas performed by a neurotologist: early experiences and outcomes","volume":"25","author":"Wackym","year":"2004"},{"key":"b81-0270004","series-title":"Ann Otol Rhinol Laryngol","first-page":"69","article-title":"Vestibular evoked myogenic potentials in neurofibromatosis 2","volume":"114","author":"Wang","year":"2005"},{"key":"b82-0270004","series-title":"J Neurosurg","first-page":"916","article-title":"Facial neuropathy due to axonal degeneration and microvasculitis following gamma knife surgery for vestibular schwannoma: a histological analysis. Case report","volume":"99","author":"Watanabe","year":"2003"},{"key":"b83-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"500","article-title":"Fractionated stereotactic radiotherapy for acoustic neuromas","volume":"54","author":"Williams","year":"2002"},{"key":"b84-0270004","series-title":"J Clin Neurosci","first-page":"48","article-title":"Fractionated stereotactic radiotherapy for acoustic neuromas: preservation of function versus size","volume":"10","author":"Williams","year":"2003"},{"issue":"Suppl","key":"b85-0270004","series-title":"J Neurosurg","first-page":"114","article-title":"Outpatient gamma knife surgery for vestibular schwannoma: definition of the therapeutic profile based on a 10-year experience","volume":"102","author":"Wowra","year":"2005"},{"key":"b86-0270004","series-title":"Acta Neurochir Suppl (Wien)","first-page":"89","article-title":"Special indications in gamma knife surgery","volume":"91","author":"Wowra","year":"2004"},{"key":"b87-0270004","series-title":"J Clin Neurosci","first-page":"742","article-title":"Hearing preservation after stereotactic radiosurgery for vestibular schwannoma: a systematic review","volume":"16","author":"Yang","year":"2009"},{"key":"b1-0270004","series-title":"Stereotact Funct Neurosurg","first-page":"165","article-title":"Preservation of cranial nerve function after treatment of acoustic neurinomas with fractionated stereotactic radiotherapy. Preliminary observations in 26 patients","volume":"64","author":"Andrews","year":"1995"},{"key":"b2-0270004","series-title":"Acta Neurochir (Wien)","first-page":"689","article-title":"Gamma knife radiosurgery of acoustic neurinomas","volume":"143","author":"Bertalanffy","year":"2001"},{"key":"b3-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1116","article-title":"Audiologic and treatment outcomes after linear acceleratorbased stereotactic irradiation for acoustic neuroma","volume":"59","author":"Chung","year":"2004"},{"issue":"Suppl","key":"b4-0270004","series-title":"J Neurosurg","first-page":"87","article-title":"Gamma knife surgery for vestibular schwannoma: 10-year experience of 195 cases","volume":"102","author":"Chung","year":"2005"},{"key":"b5-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1341","article-title":"Long-term outcome of stereotactic radiosurgery (SRS) in patients with acoustic neuromas","volume":"64","author":"Combs","year":"2006"},{"key":"b6-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"75","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"},{"key":"b7-0270004","series-title":"Acta Otorhinolaryngol Belg","first-page":"197","article-title":"Preservation of hearing in vestibular schwannomas treated by radiosurgery using Leksell Gamma Knife: preliminary report of a prospective Belgian clinical study","volume":"57","author":"Delbrouck","year":"2003"},{"key":"b8-0270004","series-title":"J Neurosurg","first-page":"1","article-title":"Results of acoustic neuroma radiosurgery: an analysis of 5 years' experience using current methods","volume":"94","author":"Flickinger","year":"2001"},{"key":"b9-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"225","article-title":"Acoustic neuroma radiosurgery with marginal tumor doses of 12 to 13 Gy","volume":"60","author":"Flickinger","year":"2004"},{"key":"b10-0270004","series-title":"J Neurosurg","first-page":"440","article-title":"Analysis of risk factors associated with radiosurgery for vestibular schwannoma","volume":"95","author":"Foote","year":"2001"},{"key":"b11-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1153","article-title":"Stereotactic radiosurgery using the gamma knife for acoustic neuromas","volume":"32","author":"Foote","year":"1995"},{"key":"b12-0270004","series-title":"Otol Neurotol","first-page":"240","article-title":"Intracochlear hemorrhage after gamma knife radiosurgery","volume":"28","author":"Franco-Vidal","year":"2007"},{"key":"b13-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1381","article-title":"Conventionally fractionated stereotactic radiotherapy (FSRT) for acoustic neuromas","volume":"48","author":"Fuss","year":"2000"},{"key":"b14-0270004","series-title":"Med Dosim","first-page":"147","article-title":"Fractionated stereotactic intensity-modulated radiotherapy (FS-IMRT) for small acoustic neuromas","volume":"27","author":"Fuss","year":"2002"},{"key":"b15-0270004","series-title":"Neurosurgery","first-page":"257","article-title":"Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years","volume":"57","author":"Hasegawa","year":"2005"},{"key":"b16-0270004","series-title":"J Neurosurg","first-page":"10","article-title":"Long-term outcomes in patients with vestibular schwannomas treated using gamma knife surgery: 10-year follow up","volume":"102","author":"Hasegawa","year":"2005"},{"key":"b17-0270004","series-title":"Br J Neurosurg","first-page":"178","article-title":"Stereotactic radiosurgery and vestibular schwannoma: hydrocephalus associated with the development of a secondary arachnoid cyst: a report of two cases and review of the literature","volume":"19","author":"Hayhurst","year":"2005"},{"key":"b18-0270004","series-title":"Eur Arch Otorhinolaryngol","first-page":"714","article-title":"Functional outcome after gamma knife treatment in vestibular schwannoma","volume":"263","author":"Hempel","year":"2006"},{"key":"b19-0270004","series-title":"Neurol Med Chir (Tokyo)","first-page":"737","article-title":"Gamma knife radiosurgery for acoustic schwannoma: early effects and preservation of hearing","volume":"35","author":"Hirato","year":"1995"},{"key":"b20-0270004","series-title":"Acta Otolaryngol","first-page":"244","article-title":"Audiological findings after stereotactic radiosurgery in acoustic neurinomas","volume":"106","author":"Hirsch","year":"1988"},{"key":"b21-0270004","series-title":"Acta Otolaryngol","first-page":"155","article-title":"Audiologic findings after stereotactic radiosurgery in nine cases of acoustic neurinomas","volume":"88","author":"Hirsch","year":"1979"},{"key":"b22-0270004","series-title":"J Chin Med Assoc","first-page":"315","article-title":"Radiosurgery for vestibular schwannomas","volume":"68","author":"Huang","year":"2005"},{"issue":"Suppl","key":"b23-0270004","series-title":"J Neurosurg","first-page":"111","article-title":"Low-dose radiosurgery for large vestibular schwannomas: long-term results of functional preservation","volume":"102","author":"Inoue","year":"2005"},{"key":"b24-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"75","article-title":"Risk factors for neurological complications after acoustic neurinoma radiosurgery: refinement from further experiences","volume":"48","author":"Ito","year":"2000"},{"key":"b25-0270004","series-title":"Neurosurgery","first-page":"282","article-title":"Radiosurgery for acoustic neuromas: results of low-dose treatment","volume":"53","author":"Iwai","year":"2003"},{"key":"b26-0270004","series-title":"Br J Radiol","first-page":"1202","article-title":"Improved trigeminal and facial nerve tolerance following fractionated stereotactic radiotherapy for large acoustic neuromas","volume":"72","author":"Kalapurakal","year":"1999"},{"key":"b27-0270004","series-title":"Ann Otol Rhinol Laryngol","first-page":"631","article-title":"Gamma knife: an alternative treatment for acoustic neurinomas","volume":"97","author":"Kamerer","year":"1988"},{"key":"b28-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1410","article-title":"Treatment of acoustic neuroma: stereotactic radiosurgery vs. microsurgery","volume":"54","author":"Karpinos","year":"2002"},{"key":"b29-0270004","series-title":"Arch Otolaryngol Head Neck Surg","first-page":"903","article-title":"Microsurgery vs gamma knife radiosurgery for the treatment of vestibular schwannomas","volume":"129","author":"Kaylie","year":"2003"},{"key":"b30-0270004","series-title":"Surg Neurol","first-page":"383","article-title":"Radiosurgery for bilateral neurinomas associated with neurofibromatosis type 2","volume":"53","author":"Kida","year":"2000"},{"key":"b31-0270004","series-title":"Cancer","first-page":"1203","article-title":"Fractionated stereotactic radiotherapy for acoustic neuroma: single-institution experience at The Princess Margaret Hospital","volume":"109","author":"Koh","year":"2007"},{"key":"b32-0270004","series-title":"N Engl J Med","first-page":"1426","article-title":"Long-term outcomes after radiosurgery for acoustic neuromas","volume":"339","author":"Kondziolka","year":"1998"},{"issue":"3","key":"b33-0270004","series-title":"Neurosurg Focus","first-page":"e2","article-title":"Outcomes after gamma knife radiosurgery in solitary acoustic tumors and neurofibromatosis Type 2","volume":"5","author":"Kondziolka","year":"1998"},{"key":"b34-0270004","series-title":"Acta Chir Scand","first-page":"763","article-title":"A note on the treatment of acoustic tumours","volume":"137","author":"Leksell","year":"1971"},{"key":"b35-0270004","series-title":"J Neurosurg","first-page":"800","article-title":"Radiation exposure of normal temporal bone structures during stereotactically guided gamma knife surgery for vestibular schwannomas","volume":"98","author":"Linskey","year":"2003"},{"key":"b36-0270004","series-title":"Neurosurgery","first-page":"736","article-title":"Radiosurgery for acoustic neurinomas: early experience","volume":"26","author":"Linskey","year":"1990"},{"key":"b37-0270004","series-title":"Neurosurgery","first-page":"829","article-title":"Tumor control after stereotactic radiosurgery in neurofibromatosis patients with bilateral acoustic tumors","volume":"31","author":"Linskey","year":"1992"},{"issue":"Suppl","key":"b38-0270004","series-title":"J Neurosurg","first-page":"195","article-title":"Radiosurgery of vestibular schwannomas: summary of experience in 829 cases","volume":"102","author":"Lunsford","year":"2005"},{"key":"b39-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1331","article-title":"Role of intracanalicular volumetric and dosimetric parameters on hearing preservation after vestibular schwannoma radiosurgery","volume":"64","author":"Massager","year":"2006"},{"key":"b40-0270004","series-title":"Neurosurgery","first-page":"460","article-title":"Stereotactic radiosurgery for vestibular schwannomas in patients with neurofibromatosis type 2: an analysis of tumor control, complications, and hearing preservation rates","volume":"60","author":"Mathieu","year":"2007"},{"key":"b41-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"45","article-title":"Fractionated stereotactic radiation therapy and single high-dose radiosurgery for acoustic neuroma: early results of a prospective clinical study","volume":"46","author":"Meijer","year":"2000"},{"key":"b42-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"305","article-title":"Decrease in cranial nerve complications after radiosurgery for acoustic neuromas: a prospective study of dose and volume","volume":"43","author":"Miller","year":"1999"},{"key":"b43-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1400","article-title":"Patterns of patient movement during frameless image-guided radiosurgery","volume":"55","author":"Murphy","year":"2003"},{"key":"b44-0270004","series-title":"Neurosurgery","first-page":"927","article-title":"Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery","volume":"56","author":"Myrseth","year":"2005"},{"key":"b45-0270004","series-title":"Neurology","first-page":"590","article-title":"Cerebellar infarction after gamma knife radiosurgery of a vestibular schwannoma","volume":"68","author":"Neuhaus","year":"2007"},{"key":"b46-0270004","series-title":"Neurosurgery","first-page":"753","article-title":"Dose reduction improves hearing preservation rates after intracanalicular acoustic tumor radiosurgery","volume":"45","author":"Niranjan","year":"1999"},{"issue":"1 Suppl","key":"b47-0270004","series-title":"Stereotact Funct Neurosurg","first-page":"65","article-title":"Long-term complications following gamma knife radiosurgery of vestibular schwannomas","volume":"70","author":"Nor\u00e9n","year":"1998"},{"key":"b48-0270004","series-title":"Arch Neurol","first-page":"73","article-title":"Cranial nerve preservation after stereotactic radiosurgery for small acoustic tumors","volume":"52","author":"Ogunrinde","year":"1995"},{"key":"b49-0270004","series-title":"J Neurosurg","first-page":"53","article-title":"Linear accelerator radiosurgery for vestibular schwannoma: measuring tumor volume changes on serial three-dimensional spoiled gradient-echo magnetic resonance images","volume":"103","author":"Okunaga","year":"2005"},{"key":"b50-0270004","series-title":"Neurol Med Chir (Tokyo)","first-page":"607","article-title":"Early changes in volume and non-enhanced volume of acoustic neurinoma after stereotactic gamma-radiosurgery","volume":"34","author":"Oyama","year":"1994"},{"key":"b51-0270004","series-title":"Cancer","first-page":"580","article-title":"Hearing preservation after gamma knife stereotactic radiosurgery of vestibular schwannoma","volume":"104","author":"Paek","year":"2005"},{"key":"b52-0270004","series-title":"J Neurooncol","first-page":"167","article-title":"Therapeutic strategy for large vestibular schwannomas","volume":"77","author":"Park","year":"2006"},{"key":"b53-0270004","series-title":"Adv Tech Stand Neurosurg","first-page":"227","article-title":"Relative indications for radiosurgery and microsurgery for acoustic schwannoma","volume":"28","author":"Pellet","year":"2003"},{"key":"b54-0270004","series-title":"Neurosurgery","first-page":"1299","article-title":"Reduced-dose radiosurgery for vestibular schwannomas","volume":"49","author":"Petit","year":"2001"},{"key":"b55-0270004","series-title":"Neurosurgery","first-page":"1299","article-title":"Fractionated stereotactic radiosurgery and preservation of hearing in patients with vestibular schwannoma: a preliminary report","volume":"45","author":"Poen","year":"1999"},{"key":"b56-0270004","series-title":"Otol Neurotol","first-page":"1220","article-title":"Distortion of magnetic resonance images used in gamma knife radiosurgery treatment planning: implications for acoustic neuroma outcomes","volume":"26","author":"Poetker","year":"2005"},{"key":"b57-0270004","series-title":"Otolaryngol Head Neck Surg","first-page":"611","article-title":"Patient choice in treatment of vestibular schwannoma","volume":"130","author":"Pogodzinski","year":"2004"},{"key":"b58-0270004","series-title":"Neurosurgery","first-page":"241","article-title":"Management of vestibular schwannomas that enlarge after stereotactic radiosurgery: treatment recommendations based on a 15 year experience","volume":"58","author":"Pollock","year":"2006"},{"key":"b59-0270004","series-title":"Neurosurgery","first-page":"215","article-title":"Outcome analysis of acoustic neuroma management: a comparison of microsurgery and stereotactic radiosurgery","volume":"36","author":"Pollock","year":"1995"},{"key":"b60-0270004","series-title":"J Neurosurg","first-page":"745","article-title":"Gamma surgery for vestibular schwannoma","volume":"92","author":"Prasad","year":"2000"},{"key":"b61-0270004","series-title":"J Neurosurg","first-page":"1091","article-title":"Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas","volume":"97","author":"R\u00e9gis","year":"2002"},{"key":"b62-0270004","series-title":"Australas Radiol","first-page":"185","article-title":"Radiosurgery at the Royal Adelaide Hospital: the first 4 1\/2 years' clinical experience","volume":"44","author":"Roos","year":"2000"},{"key":"b63-0270004","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1536","article-title":"Gamma knife stereotactic radiosurgery for unilateral acoustic neuromas","volume":"74","author":"Rowe","year":"2003"},{"key":"b64-0270004","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1288","article-title":"Clinical experience with gamma knife stereotactic radiosurgery in the management of vestibular schwannomas secondary to type 2 neurofibromatosis","volume":"74","author":"Rowe","year":"2003"},{"key":"b65-0270004","series-title":"Radiother Oncol","first-page":"83","article-title":"Long-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma","volume":"82","author":"Rutten","year":"2007"},{"key":"b66-0270004","series-title":"Am J Otol","first-page":"364","article-title":"Microsurgical removal of a vestibular schwannoma after stereotactic radiosurgery: surgical and pathologic findings","volume":"20","author":"Schulder","year":"1999"},{"key":"b67-0270004","series-title":"J Neurosurg","first-page":"816","article-title":"Glioblastoma multiforme occurring in a patient treated with gamma knife surgery. Case report and review of the literature","volume":"94","author":"Shamisa","year":"2001"},{"key":"b68-0270004","series-title":"Rev Endocr Metab Disord","first-page":"59","article-title":"Radiation therapy in acromegaly","volume":"9","author":"Shih","year":"2008"},{"key":"b69-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1395","article-title":"Fractionated stereotactic radiotherapy for vestibular schwannoma (VS): comparison between cystic-type and solid-type VS","volume":"48","author":"Shirato","year":"2000"},{"issue":"1 Suppl","key":"b70-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"S131","article-title":"Quality assurance of immobilization and target localization systems for frameless stereotactic cranial and extracranial hypofractionated radiotherapy","volume":"71","author":"Solberg","year":"2008"},{"key":"b71-0270004","series-title":"Stereotact Funct Neurosurg","first-page":"45","article-title":"Fractionated stereotactic radiosurgery for treatment of acoustic neuromas","volume":"73","author":"Song","year":"1999"},{"key":"b72-0270004","series-title":"Isr Med Assoc J","first-page":"8","article-title":"Radiosurgery for acoustic neurinomas (vestibular schwannomas)","volume":"1","author":"Spiegelmann","year":"1999"},{"key":"b73-0270004","series-title":"J Neurosurg","first-page":"815","article-title":"Stereotactic radiosurgery in the management of acoustic neuromas associated with neurofibromatosis Type 2","volume":"90","author":"Subach","year":"1999"},{"issue":"3 Suppl","key":"b74-0270004","series-title":"J Neurosurg","first-page":"78","article-title":"Immediate neurological deterioration after gamma knife radiosurgery for acoustic neuroma. Case report","volume":"93","author":"Tago","year":"2000"},{"key":"b75-0270004","series-title":"Am J Otol","first-page":"330","article-title":"Gamma knife: hydrocephalus as a complication of stereotactic radiosurgical treatment of an acoustic neuroma","volume":"11","author":"Thomsen","year":"1990"},{"key":"b76-0270004","series-title":"Acta Neurochir (Wien)","first-page":"1281","article-title":"Radiosurgery of vestibular schwannomas: a minimally invasive alternative to microsurgery","volume":"141","author":"Unger","year":"1999"},{"key":"b77-0270004","series-title":"Acta Neurochir Suppl","first-page":"77","article-title":"Cranial nerve preservation after radiosurgery of vestibular schwannomas","volume":"84","author":"Unger","year":"2002"},{"issue":"Suppl","key":"b78-0270004","series-title":"J Neurosurg","first-page":"204","article-title":"Increased preservation of functional hearing after gamma knife surgery for vestibular schwannoma","volume":"102","author":"van Eck","year":"2005"},{"key":"b79-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"141","article-title":"Fractionated stereotactic radiotherapy for the treatment of acoustic neuromas: preliminary results","volume":"36","author":"Varlotto","year":"1996"},{"key":"b80-0270004","series-title":"Otol Neurotol","first-page":"752","article-title":"Gamma knife radiosurgery for acoustic neuromas performed by a neurotologist: early experiences and outcomes","volume":"25","author":"Wackym","year":"2004"},{"key":"b81-0270004","series-title":"Ann Otol Rhinol Laryngol","first-page":"69","article-title":"Vestibular evoked myogenic potentials in neurofibromatosis 2","volume":"114","author":"Wang","year":"2005"},{"key":"b82-0270004","series-title":"J Neurosurg","first-page":"916","article-title":"Facial neuropathy due to axonal degeneration and microvasculitis following gamma knife surgery for vestibular schwannoma: a histological analysis. Case report","volume":"99","author":"Watanabe","year":"2003"},{"key":"b83-0270004","series-title":"Int J Radiat Oncol Biol Phys","first-page":"500","article-title":"Fractionated stereotactic radiotherapy for acoustic neuromas","volume":"54","author":"Williams","year":"2002"},{"key":"b84-0270004","series-title":"J Clin Neurosci","first-page":"48","article-title":"Fractionated stereotactic radiotherapy for acoustic neuromas: preservation of function versus size","volume":"10","author":"Williams","year":"2003"},{"issue":"Suppl","key":"b85-0270004","series-title":"J Neurosurg","first-page":"114","article-title":"Outpatient gamma knife surgery for vestibular schwannoma: definition of the therapeutic profile based on a 10-year experience","volume":"102","author":"Wowra","year":"2005"},{"key":"b86-0270004","series-title":"Acta Neurochir Suppl (Wien)","first-page":"89","article-title":"Special indications in gamma knife surgery","volume":"91","author":"Wowra","year":"2004"},{"key":"b87-0270004","series-title":"J Clin Neurosci","first-page":"742","article-title":"Hearing preservation after stereotactic radiosurgery for vestibular schwannoma: a systematic review","volume":"16","author":"Yang","year":"2009"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/27\/6\/article-pE4.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/27\/6\/article-pE4.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/27\/6\/article-pE4.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:24:50Z","timestamp":1780129490000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/27\/6\/article-pE4.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,12]]},"references-count":174,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2009.9.focus09198","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,12]]}}}