Vestibular schwannomas are the most common tumors of the cerebellopontine angle (CPA), the junction between the cerebellum and the brainstem. They constitute around 8% of intracranial tumors. They are benign and arise from the vestibular nerve within the internal auditory canal growing from the canal into the CPA eventually causing brainstem compression. Their incidence is around 2.5 per 100,000. Around 70% of tumors do not grow when using linear measurements although more recent studies suggest that a higher proportion demonstrate growth if volumetric measures are used.
Vestibular schwannomas have been extensively investigated over the years with nearly 10,000 peer reviewed papers relating to them on Pubmed. Despite this plethora of data there are very few books that assimilate the literature to provide a comprehensive, readable and contemporary overview of their management. This book aims to meet these requirements covering both sporadic and NF2-related schwannomatosis.
The chapters within the book will cover all aspects of the diagnosis and management of vestibular schwannomas. Opening chapters provide a historical back drop, followed by current state of the art of molecular biology, histopathology and genomics relating to vestibular schwannomas. A comprehensive section related to the assessment of patients with vestibular schwannomas will highlight the multidisciplinary approach to the management of these tumors. This will set out some of the cutting edge research currently being undertaken in prediction of tumor growth using novel biological and radiological markers. The next section focuses on the treatment of vestibular schwannomas. This will make up the largest proportion of the book and will cover all treatment modalities from observation through to stereotactic radiosurgery and microsurgical resection. Lastly will be a section focusing on rehabilitation of neurological deficit arising as a result of the disease or its treatment.
1. History of vestibular schwannoma management
Section I. Basic Science
2. Applied anatomy in vestibular schwannoma
3. Molecular biology and disease models of vestibular schwannomas: State of the art
4. Pathology and tumor microenvironment of vestibular schwannoma
5. Genomics of vestibular schwannoma
6. Vestibular schwannomas: Key research questions and priorities
Section II. Assessment
7. Clinical evaluation and investigation of patients with a sporadic vestibular schwannoma
8. Clinical evaluation and investigation of vestibular schwannoma in NF2-related schwannomatosis
9. Vestibular schwannoma imaging and differential diagnosis
10. Clinical epidemiology of sporadic vestibular schwannomas
11. Clinical epidemiology of NF2-related schwannomatosis
Section III. Treatment
12. Surveillance management of vestibular schwannoma: present and future strategies
13. Medical therapy for vestibular schwannomas
14. Translabyrinthine approach to the cerebellopontine angle
15. Retrosigmoid approach to vestibular schwannoma
16. Middle fossa approach to vestibular schwannomas
17. The retrolabyrinthine approach
18. Endoscopic vestibular schwannoma surgery
19. Vestibular schwannoma microsurgical technique
20. Outcomes following vestibular schwannoma surgery
21. Salvage resection and radiosurgery following failed primary treatment of vestibular schwannomas
22. Hearing preservation surgery for vestibular schwannoma
23. Vestibular schwannoma, postsurgical complications
24. Anesthesia for excision of vestibular schwannoma
Section IV. Stereotactic radiosurgery for vestibular schwannomas
25. Gamma knife radiosurgery for vestibular schwannomas
26. LINAC stereotactic radiosurgery for vestibular schwannomas
27. Fractionated radiotherapy for vestibular schwannoma
28. Proton therapy for vestibular schwannomas
Section V. General Considerations
29. Decision making in sporadic VS
30. Decision making in NF2-related schwannomatosis
31. Management of vestibular schwannoma in the elderly
32. Subtotal versus total excision of vestibular schwannomas
33. Quality of life after treatment of vestibular schwannomas
34. The role of the clinical nurse specialist in managing vestibular schwannoma
35. Vestibular schwannoma: Global perspectives
Section VI. Rehabilitation
36. Secondary trigeminal neuralgia due to vestibular schwannoma
37. Hearing rehabilitation in patients with vestibular schwannomas
38. Prevention and rehabilitation of facial palsy in patients with vestibular schwannomas
39. Dizziness in vestibular schwannomas
40. Tinnitus and its management in patients with vestibular schwannoma
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