| Clinical and Radiologic Outcomes of Gamma Knife Radiosurgery for Jugular Foramen Schwannoma |
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Myeongjong Kim, Young Hyun Cho, Sung Woo Roh, Do Hoon Kwon |
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Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea |
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| Abstract |
Objective
Resection, the current first-line treatment for jugular foramen schwannomas (JFSs), can result in postoperative neurological deterioration caused by damage to adjacent cranial nerves, highlighting the need for less invasive treatment options. The objective of this study was to evaluate the tumor control rate and functional outcomes in patients who underwent gamma knife radiosurgery (GKRS) for JFS.
Methods
We analyzed the 12 patients with JFS who underwent GKRS at our center since 2000. The patients comprised of four men and eight women (mean age 55.3 years, range 37-78 years). At the time of GKRS, the patients were experiencing the following symptoms: swallowing disturbance (5 patients), tongue deviation (2 patients), tinnitus (2 patients), facial pain (2 patients), dizziness (1 patient), headache (1 patient), hoarseness (1 patient), and gait disturbance (1 patient). 3 patients had two symptoms each. GKRS was used as an initial treatment without conventional surgery in 11 patients, and after initial subtotal resection in 1 patient. The mean tumor volume was 4,018mm3 (range 540-11,245mm3). The average maximum and marginal tumor doses were 25Gy (range 24-27Gy), and 12.5Gy (range 11.5-14Gy), respectively.
Results
The mean radiological and clinical follow-up time was 41.5 months (range 6-170 months). Tumor growth control was achieved in 11 patients (91.7%). Six patients showed improvement of neurological symptoms after GKRS. In 2 of these 6 patients, two symptoms each were resolved after GKRS. In the other 6 patients, the symptoms remained unchanged after GKRS. Conclusions: Our findings indicate that GKRS is an effective alternative to surgical resection for patients with JFSs. Given the excellent long-term tumor control and clinical outcomes, GKRS might represent first–line treatment for JFS patients with neurologic deficits. |
| Key Words:
Gamma knife, Radiosurgery, Jugular foramen, Schwannoma, Stereotactic. |
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