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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Long-term follow-up after stereotactic radiosurgery of intracanalicular acoustic neurinoma

Meeting Abstract

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  • Daniel Rueß - Klinik für Stereotaxie und funktionelle Neurochirurgie, Universitätsklinikum Köln, Germany
  • Lea Pöhlmann - Klinik für Stereotaxie und funktionelle Neurochirurgie, Universitätsklinikum Köln, Germany
  • Christina Hamisch - Klinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Universitätsklinikum Köln, Germany
  • Harald Treuer - Klinik für Stereotaxie und funktionelle Neurochirurgie, Universitätsklinikum Köln, Germany
  • Martin Kocher - Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Köln, Germany
  • Maximilian I. Ruge - Klinik für Stereotaxie und funktionelle Neurochirurgie, Universitätsklinikum Köln, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.13.03

doi: 10.3205/16dgnc307, urn:nbn:de:0183-16dgnc3076

Published: June 8, 2016

© 2016 Rueß et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Microsurgical resection of solely intracanalicular acoustic neurinoma (iAN) is challenging. The risk of hearing loss is described with up to 40% and N. VII disturbance ranging from 4 -16%. Stereotactic Radiosurgery (SRS) has evolved as alternative first-line treatment for small AN. Here we report about the long-term follow-up of an unique cohort of patients with iAN after LINAC or Cyberknife® based radiosurgery.

Method: In this single center retrospective analysis we included all patients with iAN who underwent single session LINAC or Cyberknife® based radiosurgery between 1993 and 2015 and had a minimum follow-up of 5 months. Patient data were analyzed in terms of radiological tumor- and clinical symptom control, preservation of hearing and incidence of complications or unexpected side effects.

Results: 51 patients (f/m =22/29, median age 54 ± 12, range 20-77 years) were identified. Mean tumor volume was 0.24 ± 0.12 cm3 (range, 0.1-0.68 cm3), the mean marginal dose was 12.6 ± 0.6 Gy (range, 11.0-14.0 Gy) and the prescription isodose was 75 ± 7.5% (range, 47-86%). Mean follow-up was 38 months (range, 5-142 months). Radiological tumor control was observed at 6 and 12 months follow-up with 100% and at 24 months with 96%. Functional hearing prior to SRS remained stable in 75% (n=18/24) at last follow-up. No radiation induced adverse effects were observed; one case developed transient facial palsy (House and Brackmann II) after 12 months and another case sustained hemifacial spasm after three months resolving six months after SRS.

Conclusions: SRS for iAN shows long-term a reliable tumor control with a high rate of hearing preservation without considerable permanent side effects and can be proposed as save and effective treatment alternative to microsurgical resection.