Author details

rate of 98.7% and the overall hearing preservation outcome of 50.3%, while facial neuropathy

Ahsan et al. performed a systematic review and meta-analysis on long-term hearing preservation after resection of VS, and they reported immediate postoperative hearing preservation

Possible complications of surgery include CSF leakage in 3–13% [72, 83], postoperative hemorrhage in 2.2% [84], meningitis in 0.8–2.5% [85, 86], lower cranial nerve deficit in 0.5–5.5%, and hydrocephalus in 1–3% [84]. The possible complications associated with microsurgery may result in death; however, mortality rates are very low; a 3-month mortality rate of 0.5% was recently reported in a hospital-based study that included 2643 VS surgeries in 265 US

To the best of our knowledge, currently, there is no class 1 evidence to support one treatment modality for vestibular schwannoma (VS). There are six studies that compared microsurgery (MS) and radiosurgery (RS) for treatment of VS, two of which are prospective controlled studies with predefined inclusion criteria [88, 89]. The other four studies are retrospective cohort studies with a matched control group, all comparing microsurgery with radiosurgery [90–93]. The results of these studies are summarized in Table 3. The relatively small patient groups, short follow-up periods, and heterogeneity in the comparison groups are potential

Until additional prospective comparisons or randomized trials can be accomplished, systematic meta-analysis of the available literature offers the most powerful guidance for clinical

Follow-up (mean in months) 42 24 36 69 36 MS 24

Not included Not

MS 5 0 14 5 36 40 RS 63 68 75 32 50 44

MS 83 82 78 80 67 64.7 RS 98 100 91 95 100 93.9

Table 3. Cohort studies comparing microsurgery (MS) and radiosurgery (RS) for solitary VS.

included

Pollock 1995 Myrseth 2005

> 94.2% (MS) 89.2% (RS)

Regis 2002 Kaprinos 2000

Retreatment MS (9%) RS (3%)

RS 48

100% (MS) 91%(RS)

rate of 50–70%; in addition, the hearing durability at 5 years was found to be 70% [82].

rate was ranged from 0 to 5.3% per study and trigeminal neuropathy in 0% [39].

3.4. Studies comparing microsurgery and radiosurgery

weaknesses of some of these comparison studies [94].

included

Pollock 2006 Myrseth 2009

3.5. Summary of the literature review

Authors and publication

Hearing preservation (%)

Facial preservation (%)

Tumor control Not

year

Hospitals [87].

96 Brain Tumors - An Update

Ahmed Rizk1,2\*

\*Address all correspondence to: arizkrizk@gmail.com

