Operative challenges and functional outcomes of salvage microsurgery in Gamma Knife-failed vestibular schwannoma: A 12-year institutional experience

Vestibular schwannoma (VS) is a benign tumor of the vestibular nerve. In selected cases, Gamma Knife radiosurgery (GKRS) is used due to its minimally invasive nature and reported tumor control rates of approximately 90%. Salvage microsurgery after failed GKRS is uncommon, and its technical difficulty remains debated....

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Salvage microsurgery after failed Gamma Knife radiosurgery carries significant operative complexity; audiologists counseling patients on post-radiosurgery management should be aware that surgical rescue is possible but associated with notable functional risks.

As Gamma Knife radiosurgery becomes an increasingly common first-line treatment for vestibular schwannoma, understanding the feasibility and outcomes of subsequent microsurgery is critical for multidisciplinary treatment planning.

1. 01Retrospective 12-year institutional series on salvage microsurgery following failed Gamma Knife radiosurgery.
2. 02Operative challenges include altered tissue planes and increased fibrosis from prior radiation.
3. 03Study reports functional outcomes including facial nerve and hearing preservation rates.
4. 04Findings are relevant to neurotology and acoustic neuroma multidisciplinary teams.
5. 05Results may inform patient counseling when radiosurgery fails to control tumor progression.

PMID

42925652

DOI

10.1016/j.clineuro.2026.109657.

Journal

Clinical Neurology and Neurosurgery

Publication type

research_article

Evidence level

4

Population

Patients with vestibular schwannoma who underwent salvage microsurgery after failed Gamma Knife radiosurgery over a 12-year period

Intervention

Salvage microsurgery following failed Gamma Knife stereotactic radiosurgery