감마나이프 시술 이후에 청신경 종양 제거 수술의 임상적 특징

• 영문명: Clinical characteristics of microsurgical removal for vestibular schwannoma after gamma knife radiosurgery
• 발행기관: 대한두개저학회
• 저자명: 고승현(Seung Hyun Koh) 이동원(Dong Won Lee) 정효진(Hyo Jin Chung) 이원상(Won Sang Lee)
• 간행물 정보: 『대한두개저학회지』제5권 제1호, 22~27쪽, 전체 6쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2010.06.30

영문 초록

Background : The aim of the study was to evaluate the clinical characteristics of microsurgery for vestibular schwannoma (VS) after failed gamma knife radiosurgery (GKS) Methods : The retrospective analysis included tumor control rate, pre- and post-operative facial function, postoperative complications, operative findings and difficulties during microsurgery. Results : Between 1991 and 2010, 203cases of VS were surgically treated at the Severance hospital, Seoul, Korea. We had to manage surgically 5 patients that previously underwent gamma knife surgery (GKS) and 3 patients that have previously underwent microsurgery. In patients who underwent GSK, microsurgery was performed via translabyrinthine/ transcochlear approach in all patients. Severe adhesion to the brain stem was identified in 3 patients and the tumor was subtotally removed in 3 patients. Anantomical presevation of the facial nerve was in 5 operations. Dissection of the tumor from the facial nerve was difficult in most interventions because of severe adhesions or color change. The facial nerve function deteriorated in 3 patients, while 2 patients showed no change. Conclusions : Microsurgery for VS after failed GKS is usually considerably more difficult than primary surgery. When making their initial choice of treatment, patients should be counseled that surgery might be more difficult after failed GKS.

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키워드

Vestibular schwannoma Microsurgery Gamma knife radiosurgery