Salvage microsurgery for vestibular schwannoma after failed stereotactic radiosurgery: a multi-institutional retrospective study

The management of sporadic vestibular schwannoma (VS) with stereotactic radiosurgery (SRS) is becoming increasingly common worldwide. Despite its efficacy, treatment failure can occur in a subset of patients. This study aimed to describe the clinical outcomes of salvage microsurgery following failed primary SRS in patients with sporadic VS.

No immediate change to standard audiology practice, but audiologists involved in vestibular schwannoma care should be aware that salvage microsurgery after failed SRS carries meaningful risks — facial nerve and hearing outcomes data from this study can inform patient counseling.

As stereotactic radiosurgery becomes a more common first-line treatment for vestibular schwannoma, understanding the risks and outcomes of salvage surgery is critical for multidisciplinary teams managing treatment failures.

1. 01Multi-institutional retrospective analysis of salvage microsurgery following failed stereotactic radiosurgery (SRS) for vestibular schwannoma.
2. 02Prior SRS may complicate microsurgery by altering tissue planes, potentially increasing facial nerve injury risk.
3. 03Pooling data across institutions improves statistical power for this relatively rare clinical scenario.
4. 04Results are relevant for neurotology, neurosurgery, and audiology teams counseling patients on treatment sequencing.
5. 05Retrospective design limits causal conclusions about outcomes.

PMID

42159832

DOI

10.1007/s11060-026-05598-0.

Journal

Journal of Neuro-Oncology

Publication type

research_article

Evidence level

2b

Population

Patients with vestibular schwannoma who underwent salvage microsurgery after failed stereotactic radiosurgery

Intervention

Salvage microsurgery for vestibular schwannoma post-SRS failure