{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:19:53Z","timestamp":1762431593769},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"Special_Supplement","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>During the past decades, in small-to-medium size vestibular schwannomas, Gamma Knife surgery (GKS) has become a reliable therapeutic option because of either excellent local tumor control or minimal morbidity, with cranial neuropathy becoming increasingly rare. Although still insufficiently analyzed in larger cohorts of patients with long-term follow-ups, adequate chances of hearing preservation and vestibular sparing seem clinically guaranteed. However, deeper investigations are needed in this regard, expanding the number of cases and the follow-up period.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A small group of patients with vestibular schwannomas (74 patients, including 41 men and 33 women) treated between 2003 and 2009 using GKS at the authors' institution were analyzed\u2014both before and after GKS\u2014with computerized static stabilometry and electronystagmography for balance disorders, vertigo, and ataxia on 1 side and pure tone average, vocal speech discrimination score, auditory brainstem response, and so forth for hearing impairment and tinnitus on the other side. Eligibility criteria for this prospective study included previously untreated unilateral lesions and a Gardner-Robertson hearing class of I\u2013III. Dosimetry plans had been programmed at the lower effective dosages for these tumors (median surface dose 12.4 Gy, range 10\u201313 Gy), carefully avoiding even minimal toxic dosages on the most vulnerable targets: the cochlea (never &gt; 6 Gy) and the vestibular canals (&lt; 7.5 Gy).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>To date, tumor growth control rates remain satisfactory; at a mean follow-up of 50 months, the rate was 96%. The overall level of hearing preservation was 72%, with 81% having Gardner-Robertson Class I hearing. Tinnitus decreased, from 52% to 28% of patients (p &lt; 0.01). Significant improvements were also observed in vestibular symptoms, with computerized static stabilometry abnormalities decreasing from 62% to 32% (p &lt; 0.001) and electronystagmography abnormalities reducing from 48% to 14% (p &lt; 0.001).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Using appropriate radiodosimetry planning, GKS seems to guarantee not only adequate tumor growth control rates, but also better levels of hearing preservation, with a documented, long-lasting improvement in vestibular functions.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.8.gks101089","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T01:09:47Z","timestamp":1542330587000},"page":"128-135","source":"Crossref","is-referenced-by-count":12,"title":["Gamma Knife surgery in vestibular schwannomas: impact on the anterior and posterior labyrinth"],"prefix":"10.3171","volume":"113","author":[{"given":"Massimo","family":"Gerosa","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazarena","family":"Mesiano","sequence":"additional","affiliation":[{"name":"ENT Surgery, \u201cBorgo Trento\u201d University Hospital, Verona; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Longhi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"De Simone","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Foroni","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Verlicchi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Zanotti","sequence":"additional","affiliation":[{"name":"Unit of Neurosurgery, \u201cS. Maria della Misericordia\u201d University Hospital, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Nicolato","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-1130128","series-title":"2007\u20132008 Patient Survey","author":"Acoustic Neuroma Association","year":"2008"},{"key":"b2-1130128","series-title":"Am J Clin Oncol","article-title":"Gamma knife radiosurgery for vestibular schwannomas: tumor control and functional preservation in 70 patients","author":"Arthurs"},{"key":"b3-1130128","series-title":"J Neurosurg","first-page":"913","article-title":"Effect of treatment plan quality on outcomes after radiosurgery for vestibular schwannoma","volume":"107","author":"Beegle","year":"2007"},{"issue":"3 Suppl","key":"b4-1130128","series-title":"Int J Radiat Oncol Biol Phys","first-page":"S50","article-title":"Radiation therapy and hearing loss","volume":"76","author":"Bhandare","year":"2010"},{"key":"b5-1130128","series-title":"Ann Otolaryngol Chir Cervicofac","first-page":"35","article-title":"[Intra-labyrinthine schwannomas: a report of two cases.]","volume":"115","author":"Boutin","year":"1998"},{"key":"b6-1130128","series-title":"J Laryngol Otol","first-page":"1353","article-title":"The distribution of neuroglia and schwann cells in the 8th nerve of man","volume":"94","author":"Bridger","year":"1980"},{"key":"b7-1130128","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":"b8-1130128","series-title":"Ann Otolaryngol Chir Cervicofac","first-page":"11","article-title":"[The origin of acoustic neurionoma. 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